My diagnosis is stage 4A invasive squamous cell carcinoma, intermediate differentiation. I've had two partial glossectomies and 10 lymph nodes removed and examined. Three of the latter showed some cancer, the largest example was less 2mm. The treatment recommended by the Tumor Board is six weeks of radiation with three 4-6 hour IV cisplatin sessions. This will begin on 3/29. I had a clean CT scan in between glossectomies, and a clean PET scan after the second one. My team's original plan was radiation alone, but the board discussion them pushed them into favoring chemo as well.

I hope you will permit me this indulgence: Let's say you believe there is a good chance that there is a serial murderer in Paris. You're not absolutely sure that he's there and you're not sure that you can hit him. Still, your first tactic is to carpet bomb the city and trust that the French people are resilient enough to survive and rebuild the city. This is a parallel scenario to my team's cancer strategy.

Most of my working life has involved me being required to make quick decisions based upon limited information. There's a pretty straightforward strategy in these cases. You determine an approach which seems likely to succeed which offers limited ancillary consequences. If that doesn't solve it, you move to something which might have more potential for collateral damage. And so on. What you never do is to opt for the most extreme of options immediately. That would be considered a panic response. I think this points out how limited our understanding is of this disease.

With that out of the way, I have read with appreciation ChristineB's observations regarding the importance of hydration and caloric intake and am developing strategies around that. I'm interested in other observations and experience you folks might think useful as well.

Thanks in advance.