I'm sorry you feel the web site is hard to navigate. In the year that it has been up, it has gotten rave reviews, and been nominated for several awards. You are actually the first person to make the comment that the site is difficult to navigate. If you have suggestions for its improvement send them to me by email. We are always interested in improving things. Anyway, there is no rule for what treatment comes first. It has to do with the size and location of the lesion(s), degree of metastasis, and the personal and institutional philosophy of the doctor and the institution treating. The treatments are as individual as each of us and each disease.