Bonnie,
in regards to your questions, first off about radiation. If they are indicating standard XRT then the salivary glands will probably not recover. Many here have that problem and they work around it. If she can get IMRT or PBT they may very well spare a lot of healthy tissue.

Secondly about the risk for metastesis - the playing field is pretty even here. We are all at risk for that. A bigger concern would be locoregional recurrence at the original tumor site.

Age issues: The latest research would indicate that a poorly functioning immune system may play a role with younger patients.

Causitive issues: 20- 25% of H&N patients neither drank or smoked. New evidence has surfaced that some viruses may be causitive factors such as EBV or HPV.

The bigger issue here is the "poorly differentiated" business. In balance, they caught it early so that gives her many advantages. This is certainly not a death sentence but she must be very aggressive and use all of the state of the art treatment options available to her.

This is a classic case that screams out to be done at a comprehensive cancer center, and most definitely a second opinion BEFORE any treatment or surgery happens. We have several CCC's here in California and PBT is available at Loma Linda in So. Cal.