Hi there... again... You can usually tell just by the treatment plan and sometimes the outcome if you are at a CCC - strange as it sounds. That's why I mentioned it. Clear margins are hard to get. The one difference between a local hospital and a CCC is not only the drs. (though if it's a well recognized CCC it tends to attract the best of the best) but also technology and trials - for example - here in Toronto one of the top CCCs in the world is PMH it's in the top 5 and in Canada it's number 1. So the surgeon who did my surgery pioneered a technology that is now widely used even outside of PMH. This technology can locate cancer insitu and allows him to follow it in the body - this is different from normal surgery where the surgeon cuts based on a CT. So basically he is seeing it in real time while he's working. As far as I recall it lowers the recurrence rate by 15 -20% which is no small matter. As I said I know it's being used in other CCCs in Canada at this point - however - budgets and knowledge etc... being a factor with local hospitals - I am pretty certain it isn't being used at that level yet. This isn't aimed specifically at you - just general knowledge for someone reading. And then there are the trial drugs - which are also not available at local hospitals - though I am sure there may be channels to go through where people get in to the program from outside the offering hospital - I imagine it takes a lot to get in and would be faster if actually at the hospital from the outset.

Hopefully that is knowledge you will no longer be in need of, because the rads and chemo will do what it has to to kill the cancer.

All of that said - the real reason I am replying is to say. Implementation is hard particularly if it is not what you are used to. As you move further into treatment you will lose all taste, and your mouth will be sore. Get into the habit of adding one or two high powered protein smoothies daily. They can be bland, and creamy is a better texture, add fresh fruit if you want but at some point the acidity may bother you.

Protein boosts healing and creamy will make it easier to swallow and swallowing is important even if it's just sips of water - radiation burns and damages muscles as well as the mucosa - that muscle damage can be permanent so stretching them and maintaining your swallowing reflex is imperative throughout treatment despite the pain - you need to do it - for now things shouldn't be too bad. Also no matter how crappy you feel if you have a dog or a friend/companion go for a short walk daily - the increased O2 helps fight the cancer. Hugs and best of luck.