I should clarify that chemo is indeed not very effective in head and neck cancer but Cisplatin is an aylkylating agent that enhances oxygenation of the tissues, thereby rendering the radiation more effective. So there is a seed of truth that chemo us not very effective, just the type of chemo designed to attack the cancer cells themselves (this, of course, subject to change). When I was told of the choice for chemo or not, the data at the time only suggested a small percentage of benefit, contrasted with the risks. I went with it because, at the time, a 6% increase in the survival rate seemed logical to me. If I had the surgery, I might have opted out the chemo as well. If I had other health issues I may have made different choices. Lot's of "what if's"... Chemo was no walk in the park.

In regards to radiation treatment choices, I have found that if a particular treatment modality is not offered within the practice, most doctors won't recommend it for one reason for another. Either lack of experience or knowledge, such as PBT or even IMRT in some cases (although that is changing rapidly). It might even be that the radiologist has an financial interest in the equipment and wants to maintain a high patient throughput. The medical profession is a profit making business after all.

Linear accelerators typically pay for themselves in 3 years and have about a 5 year lifespan -you do the math. My IMRT treatments cost over 5K for every 45 minute session (with about 15 minutes prep time, etc. -it was another $20,000 for the programming)

For this reason I consistently plead with people to find their way to a comprehensive cancer center where they can offer all possible treatment options.

I also personally feel that second opinions should be done outside of the original practice.

There are some whose lives were saved by second opinions and there were some who did everything right, had the most aggressive treatment at the best treatment centers and still died.

Ultimately it's up to God when we are called home. Stay in the "now", love one another, serve one another, treat each other with kindness, forget about the numbers. Each of us only has this moment.

PS In spite of Dan said, even though I didn't surgery and am eating quite a lot of different things now, I still have some swallowing issues and certain foods I have to be very careful with. I too am the last one to finish eating and frequently leave food behind because people get impatient with me (but not my wife fortunately). I still occasionally choke on things. At 14 months post Tx I am little surprised that some things have just not improved appreciably. If I had it to do over again I wouldn't change anything.

In balance I am grateful to be alive because without treatment I would died a long time ago. I am grateful for every day.