Lee, Welcome. Sorry to have you among us. If your insurance won't help you at MDAnderson, check on the University of Chicago Medical Center. Both centers are top notch and will give you good counsel. And, there are other centers too.

Different treatment centers have differing philosophies (approaches) about head/neck cancer. No one has proved one approach superior to another - except that the drugs are getting better, the radiation more specific and the surgeries more effective. It truly pays big dividends to be among medicos who are up to speed. No matter where you go, ask lots of questions, take notes (I carried a tape recorder to every visit) and be really invoved. You'll get better care no matter where you are treated.

And, you do not always have to travel to get the best care. Your treatment plan can be prepared in one place and delivered in another. The cancer center near you may be able to provide for all your needs. My tx plan was written in Chicago and I got treated in northern Colorado. A couple of plane rides was all it took. Distant treatment isn't necessarily better treatment.

Make your docs tell you about all the other treatment options - no matter where you wind up. Be convinced that your docs have both experience with and good reasons for their choices of care. Remember that cancer treatment is a business - and you are the customer. Don't buy the first thing they 'show' you. Be hard to please. Make them 'prove it' to you on every detail. You'll feel better and they won't mind.

Questions to ask: Who else in the country treats this type of cancer? How do they treat it and why? Do I really need the surgery? (I chose not to have it) Which chemo drugs are you recommending and why? What are the negative effects of each drug? Are there alternative drugs if I can't tolerate this one or that one? I want to get the cancer on the first try here. How does your treatment plan assure me that its enough? Do I need a peg tube? Can I keep my teeth? Do I need a port or a pic line for chemo? Why not the other? I want blood work done every day that I have chemo. I want extra hydration with every treatment. I want drugs to support my white cell count. I want drugs for nausea, pain, constipation, vommiting, sleep and mood. I want a variety of pain meds at my house: minor, medium and 'oh my god'. I'll choose the one I need. I want rinses for my mouth and throat. I want HBO in the chemo room!

We are with you. Be strong. Tom