Everybody is different. I had base of tongue cancer (very small sandpaper like could barely be felt during biopsy). But, it had spread to the lymph nodes in both right and left neck. So, I was sent to radiation first with a "chemo wash".

There was a lot of discussion and controversy among the Docs about what to do next. A city wide tumor review booard found that at least modified neck dissection was indicated for the right side due to the lymph node size. But a PET/CT scan found that the radiation had eradicated all cancer in the tongue, body, lymph nodes. Due to persistence of re occurance in Head/neck cancer the board still receommended a dissection and the Docs and I decided to do it bilaterally. When they biopsed the lymph nodes, no cancer was found.

The point of all this is that radiation using a linear accelator (Notre Dame-St. Joe) and a good Doctor can destroy certain cancers without surgery being required. The cutting edge now according to my four Docs is that radiation with PET/CT scan afterwards can determine if cancer is erradicated. When the industry gets more confidence in this, radiation only will be performed and surgery will not be required.

Sorry for this long post but thought that people should be aware of this developement. In summary, looks like radiation should be completed first and then use surgery (keeping in the "Golden operating window" of about 3-4 weeks after radiation completion) if the PET/CT scan still shows cancer.