Michael,

In answer to your question about my staging, the perineural involvemnt and lymphatic invasion referred to features of my primary tumor on my tongue, not anything in my lymph nodes (there are small lymph pathways all through your body so the angiolymphatic injvasion just menas that there were blood vessels or lyumph pathways that had become a part of the promary tumor). So I am a stage 2 because I have a tumor the right size for a T2 and no nodal involvement (as far as we knew--I only had a neck dissection on the tumor side and there is a small chance that there was lymph node involvement on the other side that wouldn't have shown up on the CT scans. It's a pretty small chance but large enough that I needed both sides of my neck, esp. the nodes, radiated.

Like you, I am into learning as much as I can about staging, risk factors, prognosis, and the science behind this. I firmly believe that for some of us, that is how we cope the best, while for others it's distracting and dismaying and they don't need that stuff to cope. Go with the styke that feels most comfortable to you.

But I will say that the more I learn, the more it's clear there's all sorts of grey areas. You don't have much time to make a treatment decision and it's true you will never learn as much as the experts, which is why it's also important to get expert opinions. Ask them for research to read that would justify their recommendations. The docs I ended up trusting were the ones who could produce that and who didn't treat me like an idiot in terms of my abiulity to underetand the research (I also have a lot of grad training in stats adn experimental design and I was very grateful for that in sorting the wheat from the chaff in terms of the research I found).

Let me know if I can answer any other questions you have. I saw you are going for second opinions next week which I think is great. be aware (you probably already are) that they will want path slides, most likely, from your surgery as well as the path reports so there may be some running around you need to do before then to get things sent.

Nelie
Nelie