Hi Brian:

As usual, your reply is real, informative, and so helpful. I have shared all of the information with Dace. He is on the surgical schedule at Mass Eye & Ear for 9/16 which was the soonest date we could get. We have held to spot during the research/second opinion process to make sure we had one for exactly the reasons you outline-we need to lead the waltz, not our cancerous friend.

One curious thing-in speaking with the radiation oncologist this week, I inquired about radiation to the nodes on the affected side BEFORE surgery which they said probably was necessary if the nodes were going to come out during surgery anyway. I just relaized from your post above that you progressed to surgery and had not initially had it to remove the primary. I assume then that you did not go through the flap & graft procedures.

So, I still have thsi overriding question about how we know that the radiation/chemo route will actually shrink the primary? Are most squamous cell lesions sensitive? It still feels safer in some respects to remove the lesion and nodes and do the blast of radiation to follow. Noone has mentioned the option of a course of chemo too if we go the surgical route but I will inquire.

Dave did have a chect film the other day and we did get the green light to ask for a spiral chest CT although the guys the other day at his stage the risk was low but never say never and if we want it they'll order it. So, I am pleased to report that the MGH/ Mass Eye & Ear Team and seems very human with the exception of the one surgeon who is a little shy on the bedside manner but by all accounts a superior technician which is okay as long as he isn't the point pain running our team.

How long was your actual course of radiation prior to the neck dissection? I am very concerned (and have seen way too many bad reactions) to think that Dave will actually be able to resume work in January if we choose the the chemo radiation option. If he then needed to progress to a subsequent surgery that would take an enourmous financial toll on us since we depend on two paychecks.

Dave is a big Harley fan too so maybe you have a lot more in common than you know.

Think you are right-make a decision and make peace with having made it...

Will keep you posted,

Kim