Jeff and Charm have really hit the nail on the head. My ENT surgeon didn't hesitate once the biopsy came back "suspious" of SCC. Once you're opened up, they can immediately run tests on the lymph nodes to see if cancer is present and go from there. In my case it was so they took them, got a more complete report a week or so thereafter, then set up the program with my RO. As Charm, notes there are lingering ramifications of surgery but I think this path was the right one for me. One thing's for sure for all of us . . . you'd better feel real good about the hands you're putting yourself in.