God bless you Shawna for taking such a proactive roll in your Father's health.

I am sorry that this has touched both of your lives, but the good news is, you can get beyond the negatives.

1st of all, I am not a Dr, so you can't take what I say too seriously...Always confirm what you hear from others and read on the internet with a licensed professional.

It sounds to me that 1 involved node, and less than 3 cm would put your Dad around Stage III/IV, but there are several others on this site that know the math much better than I do.

I have three nodes positive, and up to 4cm on the tonsil (also presented, coincidentally, as a lump on my neck in early May).

My Stage is IV, and that may be because there isn't a Stage five :-0 Who knows..?

But, what's more important than Staging is that you have started treatment with a good prognosis.

It's good news that no other metastisis is showing on the scans and that he is already on chemo and radiation.

At this point, I would concentrate on managing and limiting the side effects from the 2 treatment arms. There is a WEALTH of information on this site, and you can spend hours and hours gathering it here.

Also, don't put much weight in the Fine Needle biopsy (FNA), they are notoriously inconclusive, and it doesn't really mean anything one way or the other.

As far as the surgery question, that is a hot topic and there is no easy answer. The only advice I can give you is the following:

1) If done well, by a very competent surgeon, the MRND is NOT as big a deal as it seems; I just had mine 3 weeks ago and am dealing w/minor side effects, and cosmetic changes that are well worth the potential life saving benefit.

2) Consider a 2nd, or 3rd opinion, possibly at a major CCC (comprehensive cancer center) (which Univ of Minn might be, but I don't recall seeing it on the list). These additional opinions won't solve your challenge of making the MRND decision, but they will help you balance all the information, and make an informed choice.

Your father is very lucky to have you as an advocate by his side, and again I'm sorry this has entered your life...Remember to be strong and brave, but don't hesisitate to ask for help. You are going to be challenged beyond your wildest dreams by the demands of his treatment. There will be good days, and bad days. We are here for you while you have each one.

This website and forum board is a miracle and use it as much as you can.

- Michael