Many thanks, guys. The ENT is shaking her head, and has given him her personal mobile number to give to the avmed doctors. A big problem is they have never accepted the ENT as being competent to judge his risk of metastasis, and continue to insist on medical oncology reports. The medical and radio onologists were co-ordinated by the ENT, who does all my brother's checks. The AVmed people are GPs who think cancer = oncology. They have scans on disc, written 3 monthly scope reports etc etc etc, but I also think they want to be told that the risk of a recurrance is 0%!! Dealing with his work medical department has been hugely stressful. If someone can post the link to the treatment guidelines that would be great.