Usually the primary for this cancer is your surgeon. But if the MO is telling you he thinks you will get a response or hoping for one that is good - I suppose. I would however ask him what the next steps are. I'm saying this because I'm wondering what they are hoping for and what the expectation is based on. It's all about the questions you ask.

SO... I'm going to throw a few out there for you.

How often has this treatment worked against NON-HPV related oral tongue cancer?

How often do you use this form of treatment for this particular cancer? (I'm saying this because it's usually used for HPV+ cancers as it's virus related and responds very well to chemo and rads - But rarely for oral tongue NON HPV cancer - because it has a different cause/etiology)

So if I do this treatment and say we get a shrinkage of 20% say... then what is the next step?
(I'm assuming the response would be rads and chemo combo)

If this is his response, ask him how many patients with oral tongue cancer are cured by rads and chemo alone. and how many he has treated with this form of treatment only?

There is a distinction between non HPV related and HPV related cancers and their responses to certain treatments.

I know you're trying to avoid surgery - but most CCCs have a cancer board. ALL three work together to create a treatment plan that best serves the patient. They do this based on years of experience. Ask a surgeon... usually he'll want to cut... an MO they will want to give you chemo, and a rads guy he'll want to fry you. They need to work together to offer you the best possible outcome. That's a balanced option.

So after all of that ask them based on the stats for your type of cancer and size / stage of your tumor what is the realistic expectation that you will get to avoid surgery.

Also with at tumor that size it's very likely in your nodes - if not visible on a scan - then microscopically.

Based on what you've said on the forum. Stage 4a - (read up on it and educate yourself thoroughly on what it actually means if you haven't already.) this is not a tumor to be messed with. I had stage 2 and was terrified based on what I had read.

I wish you all the luck.

hugs.