The issue is that surgeons like to do surgery and radiation oncologists like to use radiation, and (sometimes) the twain doesn't meet ---

Perhaps ask both ENT and RO (at MDA) about why they theink their approach would provide a better prognosis for you. Try to get some feeling about success with previous cases similar to yours. Our MO says that ND is falling out of favor as it is not showing consistent long-term benefits (this a quote) -- apparently a lot of discussion of this at last ASCO meetings. But radiation is a very rough road and most folks say that comparatively, the ND was easy to handle.

I do know one person who had a similar situation to you, had oral tongue surgery and brachytherapy in NYC, this failed after two years and she came to Hopkins, where she had more surgery (on tongue). She told us the Hopkins ENT was very conservative to spare tongue tissue and had to leave fairly narrow margins so they then followed up with tomoTherapy IMRT. This very precise radiation delivery system allowed them to specifically target the surgical margins. I saw her last summer and she was doing well, never had a ND as the ENT did not feel it would improve her prognosis. But each doctor has his or her own set of experiences and past cases, which is why there is so much variation in details of treatment.

Gail