The chances are pretty high that it is just inflammation or infection -- aspiration of food post-treatment (including "silent aspiration" when you don't know you're doing it) is not uncommon. That sent my husband Barry into the hospital for 3 days a week after his treatment ended, with an aspiration pneumonia.

When he had his first PET/CT scan two months later, the radiologist saw uptake in the right lung (where he had the pneumonia) and rightly ID'd it as residual infection, although Barry had pretty heavy-duty IV antibiotics while in hospital. The doctors said it can take 3-4 months for this to resolve. They gave him a chest Xray after the PET/CT as a baseline and then a course of another (oral) antibiotic, then a month later another chest Xray. No sign of anything on that. The second PET/CT (3 months after teh first) was also clear.

It is actually rather rare (per our MO and ENT) for chest mets to show up so soon after treatment -- far more likely to be infection.

An experienced radiologist who sees and reads lots and lots of head/neck cancer scans is going to be more certain about what is infection, inflammation or healing (all of which will show up as a "hot spot" ) and what is cancer -- one reason for trying to get to a center that treats a lot of oral cancer, when at all possible. An inexperienced radiologist is going to be super-conservative and thus there is an increased risk of "false positive" diagnoses.

Gail