Hello Donna. I just saw your e-mail, so this may be too late to assist you in making your decisions. My husband (57)was diagnosed 2 years ago with scc at base of tongue,stage 2/3 HPV 16+. He was treated in Ottawa, but prior to treatment we went to Johns Hopkins in Baltimore for a 2nd opinion (cost $600)& they agreed with treatment plan that ottawa docs had planned & said he couldn't have surgery, which at that time I recall was the most standard approach in the US.Our chemo oncologist here said if we wanted to see the best docs for head & neck cancers, go to MD Anderson in Houston. So we do that every 6 months but there is no comparison between the check-ups in the 2 countries: in Houston we see the surgeon, the oncologist, & most importantly he has an ultrasound of his lymph nodes but yet another separate oncologist who does only that all day long. He also has a ct scan, blood work each visit. Pathology results take 1.5 hours to come back. It costs us about $5-6,000 each trip. He also still sees his docs here every 3 months, altho we only saw the oncologist 1 or 2 & now only see the surgeon.You can't put a price on your health & your life. If he were ever to need surgery, there is a good surgeon in TO who the oncologist @ MD Anderson knows as well. We could not likely afford the surgey in the US. Hope this information helps.