Actually neck dissection IS getting a bit controversial and by no means do most oncologists recommend them. They are not done at Sloan-Kettering (considered #1 CCC in USA) and also, are increasingly not done at Hopkins. When we went to Sloan for 2nd opinion, (we agree with Warren, these are important!) top MO there told us MD Anderson also doesn't do ND routinely either, but I have no direct knowledge on this.

Reason is probably because some recent studies have shown that although ND improves local control by about 5-10%, there is less evidence for a long-term survival benefit. (Our RO said "no evidence" but some studies have shown a benefit albeit a modest one).

Getting a clear answer on benefits of post-treatment surgery may be complicated by the fact that such studies probably include patients who have smoking-related disease with others who have HPV-induced disease (an increasing proportion of the oral cancer population). These cancers seem to respond differently to treatment and also, differ in their tendency to recur. This would really muddy the data...

My husband declined further surgery (he had had a pre-chemoradiation tonsillectomy which was his primary. ENT would not touch the base of tongue and said chemoradiation should take care of it.) Obviously if the post-treatment scans had shown a problem there would have been a different decision, although not BOT surgery. For this area they said they might consider brachytherapy -- interesting...

Treatment recommendations reflect the training, experience and professional outlook of the doctor (or team) and, as we see repeatedly on this forum, they do not all agree!

In any case, you are near the end, Gary -- good luck and hang in there! It WILL get better!!

Gail