Gail, I'm curious, is it *all* tongue surgery Johns Hopkins avoids or just base of tongue or cases where some sort of flap reconstruction is needed? Is it related at all to stage? I can see not doing surgery when its already a pregiven conclusion that the person will need rad., but this isn't true for Stage IIs.

My understanding from my ENT, and the first rad oncologist I saw, is that if my cancer had been base of tongue, I might have had rad recommended to me as an alternative choice because of the risks associated with the surgery, but since it was on the upper tongue, fully visible, and not anything that would most likely require a graft, even though it involved removing about 1/3 of my upper tongue, that surgery was considered relatively low risk for lasting problems with speaking or eating and much less likely to produce lasting effects than rad, so it become the first choice. This makes sense to me. I mean, it's hard to imagine advocating the radiation, even tomo., would have less longlasting effects than the effects I had from the surgery which were almost totally nonexistent two months after surgery.

Nelie