Jessica,
I had an unknown primary & mets to one lymph node back in 1997. I had right modified neck disection followed by 36 XRT treatments, no chemo. Back then they didn't feel chemo increased my chances by more than 5% and didn't think making me that sick was worth it. He definitely needs to quit smoking. Even one a day is too many, as I discovered 4 years later. The radiation will be rough but he can do it. See that he gets something to preserve the saliva function even if it is only Salagen. Also make certain he drinks as much water as possible. It helps drain the bad stuff from radiation from the body.

Take care,
Eileen


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Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I