Paul, does it sound like a sensible strategy to first have robotic surgery on the primary BOT and forego a neck dissection at that time but instead have IMRT? Then, if the neck tumor is not shrunk and killed by the radiation to then have a neck dissection?

DX in 12/2010. Stage 4 SCC HPV+ BOT swollen lymph. I've spent the past 3 years away from medical treatments. Instead I've focused on good nutrition, active exercise, singing, laughing, oral exercises and such. I've had neither pain nor discomfort. But I haven't been able to kill the cancer. So, I'm now considering robotic surgery and/or radiation.