Being a tonsil cancer survivor myself this is one of my key concerns - that not enough screening is being done for distant mets. I get an annual MRI (and they begrudgingly give me this) and a chest x-ray. I would like to get an annual PET/CT. The best scan, in terms of image quality, for the lungs is the spiral CT.

My theory is that the head & neck guys & oncologists, for that matter, are in denial that distant mestastesis is a very real possibility for H&N patients. I go round and round with my MO over this issue. It's like they put their blinders on and say "hey we only look for local recurrence". Maybe after they've sued a few times then they'll get the message, unforunately that seems to be what it takes in "bottom line" oriented America. I think in the future I will force them to document the requests in my medical record so that if my estate has to sue them there is a paper trail at least.