After the radiation and chemo, the neck dissection is a cake walk. It is no big deal. For sure the neck will no longer be completely symmetrical, but in my own case while I definitely notice it, most new people I meet do not. You can look at a picture of my final results in the flash movie that plays on this page - http://www.oralcancerfoundation.org/about/brianhill.htm For sure I'm no Brad Pitt, but no one stares at me either....

Choosing not to do this would be a HUGE mistake if there are active cells still there. The lymph system is a highway to the vital organs far away from the oral cancer. Remember that oral cancer doesn't kill you in your mouth, it kills by metastasizing to vital organs via the circulatory system or lymph system. It would only be a matter of time before this happens. They are not going to go away on their own. There really is not choice in this matter. And she's right - this is no time for vanity.

Remember that PET scans are NOT specific for cancer. Lots of things will elevate SUV's. (serum uptake values) Healing, infection, chronic irritation, and more will all light it up. Of places that a head and neck cancer would metastasize to, the colon seems an unlikely location.