Amy, I read what you posted in the Introduction section and I think you shouold probably be more concerned about getting a second opinion at a CCC right now and not be worrying too much over the details of radiation, since it's possible they will agree you don't need it.
I'll try to answer some of your questions (since I'm up at 3 am with a bad cold might as well do someone some good!)
1. If I were you, I would go to the nearest comprehensive cancer center. The National Cancer Institute web site has a list of these. If there's a choice of two equally near, there are some rankings of them that you can refer to. These are on the web too but off the top of my head I can't recall where and don't have it bookmarked. Maybe someone else can help you there (it's quite possible there's a link from some page on this site if you look around).
2. When you decide which to go to, almost all of them have a patient phone number on their wesbite that you can call to set up an appointment. You don't need a referral from your doctor, although maybe for the purposes of your insurance covering it you will (you should call your insurance provider to find out). Some CCCs even have a web form you can fill out requesting an appointment and then they call you. It's really very easy.
3. When they speak to you, they'll tell you the records and other stuff (probably pathology slides)they need, whether you can bring them with you or if they need them ahead of time, and how to send them. You then need to go to the hospital and doctor's offices and request that those records/slides be sent. You need to sign forms for this, releasing the information. This happens all the time. There's no cost to you except the cost of some legwork. Allow a couple of days for them to do the sending, though sometimes if it's a matter of faxing something it can happen right away.
4. If the advice you're getting is from a CCC you can be confident it's good advice. My impression is there are some gray areas even so in terms of how aggressive you want to be with radiation in early sytage cancers(this is from my experience and the experience of others I've seen posting here in the year I've been here). In that case, it may be a tougher decision and I think it's important to ask yourself how you would feel if the worst-case consequence happens and you made the decision to radiate versus if you did not. But you may not have to make that kind of hard decision, the decision is likely to seem much clearer after you go to the CCC and get their advice.
6. There are people here who have had radiation and reported little to no severe drymouth only a short while after. I had IMRT radiation and I take salagen every day and, 8 months out, I actually don't get severe drymouth all that often except at night when I sleep (my mouth is always a little dry but I've gotten used to it). There are also sprays and other stuff you can use in your mouth that might not qualify as food or drink by OSHA standards. But everyone responds to radiation differently and it is possible you'll have some serious drymouth issues, at least at first,I don't want to sugar coat it.
I was concerned about doing my job too when I was first told I might need radiation (I'm a college teacher at a place with a fairly heavy teaching load and I LOVE the classroom). Fortunately, my workplace has been fantastic about giving me leave (and the union has banked sick days that they gave me after my nown ran out) and, now, allowing me to teach online and do some other stuff in lieu of classroom teaching. I still don't know if I'll ever be able to be in the classroom regularly several times a day again(I get hoarse when I talk for a length of time now) and if I can't it will be a great loss to me.
But it's way better than having recurrent cancer. Life is still sweet overall. Way too sweet to not have fought hard to get to keep it for a while. This is my thinking about these things anyway. Your job is important but it needs to be kept in perspective when you're talking about cancer.
6. Insurance questions I really can't answer except to say you should call them and ask them. If they give you a hard time about soemthing and you're at a large workplace where they're all buying into that plan, you may want to see if someone in your human resources department can call and argue with them for you. They might ahve more clout.
7. Another few weeks to start raidation would not be too late, although you don't want to delay more than absolutely necessary, and if you really need the treatment even late is better than never.
I know how scary and confusing this all can be, Amy. Keep asking questions here if you need to and, if you haven't already, look around the OCF site at all the other info. they have about second opinions, radiation,etc.
Nelie
