She needs to have this discussion with her doctors so that they can prescribe the appropriate, and increasingly stronger, pain meds that she will need as the disease progresses. There is little other than the regime of treatments that have been mentioned that will slow the progression of the disease. Major tumor masses could be excised or destroyed by RFA, but that will not have a major time factor influence. Please remember that no doctor can tell her with certainty if the treatments will buy her 6 months, a year or longer even. The lack of any treatment can be more accurately be predicted in the rate at which things will deteriorate.

If this is the plan that she is comfortable with, please be sure that you have appropriate hospice people ready as things begin to wind down. They will make the process much more comfortable for both the family and for her. Obviously oral cancer does not kill us in our mouths, but through mets to a vital organ. If this happens slowly in her case, it is not a visually or physically pleasant means of death for the patient or the family. Some can linger on for protracted periods of time and develop serious complications in the head and neck region, such as open draining fistulas and more as things progress that require constant attention.

Her decision is being based on her current lack of discomfort. Untreated, that situation will not last for long. Please be sure that she has carefully considered all the possibilities, and is without any doubt, and has given this careful consideration since there will be no turning back. A frank discussion with the doctors in which they describe the likely sequence of events and outward manifestations of the disease process is in order. I would do this early, so that if their comments and prognosis sway her choice, it happens early enough to be able to allow positive effects should she choose some treatments.