R,
my very Dx was a 1-2 punch. The first ENT I saw scolded me for "waiting so (too) long to come in -that I had a very advanced SCC and to get my affairs in order). I am happy to tell you that I am a 4 year survivor now and doing quite well. I had chemoradiation only as my cancer was deemed "inoperable". The doctors always have to give you the worst case scenario.

The "burst lymph nodes" are a new one for me but consider this. Tumors release thousands of cancer cells into the blood everyday anyway and the immune system does a pretty good job of taking them out. the chemoradiation should take care of the rest. You should ask the doctors about that.

Nelie & Tim give excellent advice. You are at the best facility in the world. They have to prepare you for the battle ahead and make you aware that many of the nasty side effects are normal and not a sign of "impending death".

Also many of the people here are caregivers because many patients can't deal with "too much" knowledge. Many patients here have "worst case" scenario issues and it can be very scary to patients responding well to treatment.

Have him ask about meds for anxiety if he needs them.

All of us fear recurrence - it's part of the cancer adventure. It can be overwhelming very quicklly. There has been many success stories here with advanced stage patients - don't give up hope. Concentrate on getting through treatment each day and not what may or may not happen.