Gwen --

You may wish t seriously consider having your brother go to one of the top CCCs for head and neck cancer -- for him teh closest would be MD Anderson in Houston -- and get a consult with their experts as to whether he would benefit from a clinical trial or perhaps, a different approach than is available to him in NM. If he feels up to it, that is.

Most of the large centers have special hotel rates, will arrange accommodation and help with transport (as will the ACS) for folks like your brother. I know at Hopkins there were several advanced, recurrent patients from quite a distance coming in for treatment.

At the very least this will give your family the feeling that they have done as much as possible to help.

What chemo treatment did they give your brother? There are a variety of agents available, some can cause severe reactions in certain people (esp. Taxol and cisplatin) while others are much easier to handle (e.g. carboplatin). There are also two EGFr drugs, one available clinically (Erbitux) and another in widespread clinical trails (Tarceva). These have proved helpful in *some* cases of advanced, recurrent disease.

Best of luck,
Gail