In my cancer diagnosis I have been receiving radiation only, ie no chemo. Several on this forum have mentioned they thought rads with chemo is the way to go. As you can imagine it has caused me to question my treatment protocol and ultimately to ask my doctor point blank did he think I needed to be getting chemo also. He shook his head NO. I asked could he explain further.

He goes and gets a copy of the NCCN (National Comprehensive Cancer Network) Guidelines for my diagnosis (tonsilar cancer for T2N0 staging). And there it is in plain english, for this diagnosis radiation only is the recommended treatment plan.

He then offers on his own that the downside risks of chemo for your diagnosis are riskier than the benefits you will receive. So, for your diagnosis it's radiation only.

If your diagnosis changes then we will consider chemo. I asked how much change for that. He says lymph node would have to grow to larger than 1cm size and give doctor reason to think it was involved in the cancer. I expect I would then receive a fine needle aspiration biopsy to confirm cancer and surgical removal prior to chemo.

For those of you not familiar with my case, my first CT showed one lymph node same side of neck as tumor swollen to about 1cm size. As part of my treatment simulation they run a second CT. On this CT lymph node swelling had gone down back to normal size.

I hope this helps future patients.