Hi Becky,

Ok,lets take a long cleansing deep breath here.(inhale...exhale) Now that some of that pent up anxiety has been exhaled (if not take another) lets talk.
After reading all the previous posts I find myself feeling all wound up inside and bombarded with information. My thraot tightened up and I got this feeling of extreme urgency. So I can only imagine how you feel after reading all these posts. I know none of us want to add to your anxiety over this. So lets take a step back, take another long relaxing breath and approach this in a more methodical manner.
First let me say everyone is right. You need to have all your options layed out to you and you should always consult with more then one physcian who specialies in oral & facial cancer. Preferably ENT oncologists associated with a cancer center. You have begun that.
You need to have a through pre-treatment evaluation which may include but is not limited to, biopsies, MRI's CT scans and most importantly a PET scan. this also you have begun.
I know from "our" recent experience it is also important to see a dentist and/or oral surgeon before tx to evaluate the health of your teeth and gums. This dosen't mean you will need to have any extractions but from our experience and how it was explained to us. It's importatant to have your teeth cleaned. any minor cavities filled and if there are any teeth that may need more major dental work ie...root canal, that they maybe should be removed to prevent any nessecity of major dental work after tx. The reasoning behind this is, that after tx the jaw bone and facial bones are weakened and are much more brittle after tx and if by chance a tooth needs to be extracted later after tx it could compromise these bones. This does not mean that if your oral surgeon recommends any extractions that you have to do it. It's only a preventive option that only you with information in hand will decide on when/if this is recommended.
Before tx our oncologist sent us to the dentist and I'm glad for it! The dentist recommended 3 molars removed. Two were crowns and one had a large cavity. We went ahead and opted to go ahead with all 3 extractions. We didn't have to. The oral surgeon made it quite clear it was our decision. We could have gone with just the one and left the crowns. Or none at all. Anyway we decided. The best part of visiting the dentist before tx was she gave us all sorts of good products for my husband to use duing treatment to help promote good health in his mouth during tx. Fluoride, special tooth paste, an extra soft tooth brush and special mouth wash to name a few. She also gave him a detailed outline of when and how often to use them. She cleaned his teeth and made an appt to see him again after tx for a follow-up. All I can say is, it was a good experience and we went into tx feeling his mouth was in the best health possible for the days to come.
I believe ( my opinoin only I am not a Dr.) your new RO is making a good recommendation about the chemo IV patch and most importantly the PEG. Since you are already having trouble eating and good nutrition is so important thru all this I would seroiusly consider taking her adivice on the PEG.
I understand your concern about all the time it takes getting all this done before deciding on a tx plan and getting started. From the time my Husband had his 3rd surgery and the start of tx it was exactly 2 months. We fretted every minute that the cancer was coming back and spreading every minute we waited. But I really do feel it was good we did all the right steps first so that now he is getting the best poss. tx so he can have the best recovery and be cancer free once and for all.
One question, may I suggest after all the tests have been done may be...
Will I need surgery? before? after? treatment.
( my husbands surgery came first and his tx is hopefully a preventive to keep it away once and for all and hopefully should not need anymore surgery)(Some folks have surgery after. The tx is used to keep it from spreading and to shrink the area before surgery is done)Both ways work. I can't say one is better then the other Just depends on the individuals circumstances. And many folks have no surgery at all.
May I also suggest you not get too obsessed over percentages and odds vs recurrance and the like. I can honestly say they will just drive you crazy with worry. Every individual case is unique and altho they give you an idea on how a certain course of treatment may have worked in the past (on average) for a certain test group. It does not dictate or predict what your outcome and possibilty of recurrance will be.
I firmly believe with all my heart that your ability to face this with determination and grit is the most important factor. Keeping a stiff upper lip and keeping your outlook in the most positive manner you can muster from day to day is the key. We are all here to help you do that. Please don't hesitate to lean on the folks here. They are an amazing group of people and I feel so fortunate to have found them. As for me? I'm here for you if you need anything. Even if it's just to vent. whine, grumble or rant uncontrolably. It has only been a few month's since we stood were you stand and I understand the frustartinon and fear that you have at this moment.
Now let me tell ya something good personally after being where you are and now standing where we are. Life is good! WoooHooo...Today is my Husbands 22nd radiation treatment and time has flown by so much faster then we thought it would. We have had good days and bad days but it has not been near as scarey as we imagined. After today we will have only 15 radiation treatments to go!!! ~happy, happy dance~. And it's a beautiful fall day outside, the sun is shining and I'm so happy he is sitting here beside me drinking his power shake and watching CSI repeats. ~big grin~ We still have a difficult road ahead.(most likely the most difficult) but we're prepared to face it one day at a time. And we will get thru it. Just as you will too!

Please let me know how your appt goes on Thursday. Hang in there. Sincerly, ~Ija~