Ak123, I left you private a message. This was pretty much my scenario also. The cancer was out of the lymph nodes, basically free roaming, after several treatments, and surgeries. I mentioned the last curative treatment I had was in 2013/14, a neck dissection to remove the cancer along with resecting a section of the common, internal and external carotid artery, and IORT during surgery. Then I had 5 weeks of Proton Therapy with Carboplatin. I pretty much had this same treatment a year earlier, besides the prior radiation, surgeries, and chemo before that, Not all doctors can or will do this, and have bern turned down for certain treatments along my travels the past 5 years. You have to find that experienced doctor to see if it's possible to do curative treatment, maybe it's not, if your brother wants, otherwise all others are going to say the same thing, which is doing palliative treatment with chemo/immune therapy, which is an option also. Some use it to shrink the tumors to see if further surgery, radiation can be done in the future.

There are risks. To have the carotid artery removed they do a Temporary Balloon Occlusion, TBO, and a Cervical Angiography, which have risks too, to see if you're a candidate, and can function with one carotid artery. I did not have a vein graft as cancer was on the artery, and needed more radiation. Even with the resection, there was still risk of carotid blow out at the stubs, 17%, from further radiation, but as discussed with my doctor, it was worth the risk since cancer had a 70% chance of coming back, and with my prior 7 (see Mets), it was most likely. If needed, I can give you the names of some doctors.

I just had my 3rd follow-up scan last week, and again showed no sign of cancer, which is the longest time span, 13 months, I had without a recurrence,

Good luck, and best wishes.