Hi Paul --

Just back from a trip -- I think you are correct to go with chemoradiotherapy, rough as it may be, as the long-term side effects of base-of-tongue surgery can be significant (permanent speech and swallowing difficulties). So much so that at Hopkins and at Sloan-Kettering, two of the top 3 CCCs in USA, they do not do it. Note, this is base of tongue (BOT) cancer, not oral (mobile, outer) tongue cancer, in which case prior surgery is usually done, at least at Hopkins.

My husband had a tonsillar, base of tongue and two nodes SCC d'xd in June 2005, got the tumor board recommendions from Hopkins for chemoradiation and ditto from Sloan as a 2nd opinion, he went with Hopkins and is now over 1 year out and doing very well, no swallowing problems now (they have you go to a therapist pre and post-treatment) and never had any speec issues. His medical onc says they get excellent results with chemoradiation only for BOT, "no need for the surgery".

By the way, my husband's cancer was human papilloma virus positive (many BOT cancers are) so you may wish to ask about this. These seem to be more sensitive to radiation and also, less apt to recur. He was a never-smoker.

Gail