Welcome Mrgodguy,

I have no medical background, and just offer my insite and experience as a cancer patient, although my cancer was the tonsil in the oropharynx and lymph nodes, it's clear now.

Your surgeons are most likely following the flow chart from the NCCN Guidelines, from their experience, by the tumor board meeting, and your request and health. For your type cancer, oral cavity, basically NCCN Guidelines go by the TNM grading, meaning Tumor size (T), size and numbet of Lymph Nodes (L) and Distant Metastases (M), and others, which treatment you had was surgery route. From there it can go in several directions, depending on pathology for one positive node with no adverse features to "consider RT" and adverse features, which can involve radiation, chemo, resection or combination thereof.

I'm not sure when you mention it began to infect the lymph tube if it would be lymphovascular invasion, LVI, or Extrascasular spread, which are adverse features, and may influence the treatment, and suggestion for Chemoradiation by your doctors. This would be on the surgical pathology if you have it or can ask your doctor.

The only treatment for SCC in the head and neck is Surgery or Radiation with or without chemo, targeted therapy or combination there of. Being a 7x cancer fighter, I go for treating this cancer as hard as possible, safely, with mininimal side effects, for cure at the first try. If cancer comes back it can be more difficult to treat or maybe not even possible. Through all my treatments I never considered what may or may not occur in the future, but did consider the best treatment and how to get though it. All I knew is I just wanted the cancer gone, although age and minimal side effects do come into play it was more on the doctors advise, and usually followed their advise, although it came to a point none was offered after another recurrence, with adverse features, which is most likely to recur, and knew that, so I changed my medical teams for the better, which really saved my life.

There are a variety of caused for SCCHN. I have heard about injury where the cells go to repair it they don't stop in the right environment to go on to cause cancer. I'm not sure we're at a point to say what the direct causes are from, environmental, genetic, smoking/alcohol related, immune response, but their working on it, and have a number of findings and ideas like from HPV in the oropharynx, and Epstein Barr in the Nasopharynx, and others.

Good luck with everything!