I am an MDACC "Graduate" with node involvement bilaterally when diagnosed. That means a poorer prognosis as you have found out, but that was almost 6 years ago for me. It is consistently rated as the number one cancer facility in the WORLD, occasionally swapping that distinction with Memorial Sloan Kettering in NY. They see over 250,000 cancer patient visits a year, have a staff of over 40,000 people, and it covers acres of land. It is like going to NASA. When you walk down the hallways, there are people speaking every language you can image, from Farsi and Chinese, to the gamut of European languages...people arrive there each day from all over the world to be treated for good reason. They have the statistical sucess rates that merit their number one spot, they have access to the majority of clinical trial drugs that you wouldn't find at a smaller institution if thigs are not looking good, and as cancer patients always have some sort of complications in treatment, they have seen it all before..thousands of times. When something dosen't go according to plan, they have people there that have seen that complication a hundred times if not a thousand times before. This is important, as a change in plans, treatment etc. dictated by a complication is handled right then and there, not reffered out for consultation to another facility or doctor, wasting valuable time. They have the latest equipment, the finest doctors, and if you go there it will be like nothing you have ever experienced in AZ. My tumor board had over 30 doctors of different disciplines in it, all involved in my treatment plan. When my local docs said I was a late stage cancer patient with poor prognosis, I wanted to be where the best in the world were, not where it was the most geographically convenient to be. I honestly believe that if had not been treated at MDACC I would not be here today. You have one shot at things to make the best choices possible, as cancer can be very unforgiving of half measures, or incomplete treatment plans. The only choice you really get to make in it all when the dust settles on things is choosing the doctors that you believe have the right stuff to save your life. After that