Ronnie --

The standard approach for base of tongue tumors at the three top CCCs (Sloan-Kettering, MD Anderson and Johns Hopkins) are chemoradiation first, possibly followed by selective surgery if indicated -- such as cancer remianing in nodes for more advanced stages.

You need to ask hard questions as to *exactly* what would be involved if the surgery were done first -- our ENT surgeon at Hopkins said that b.o.t. surgery would involve a tracheostomy and also, the high probabity of significant impairment of swallowing and speech (needing quite a bit of recovery time and therapy). Thus he very strongly recommended chemoradiation as the treatment for my husband who has Stage IV bot and tonsil (plus two nodes) -- the Hopkins tumor board concurred on this. We went to Sloan-Kettering for a second opinion and the recommendation was exactly the same.

Having said that, chemoradiation is no walk in the park either -- Barry is just at the end and is doing well but it has been a marathon, not a sprint.

Gail