I agree... the gold standard - is a standard... because it works.. (most of the time) as for the robotics. I had surgery followed by rads and chemo. Overkill? maybe... but I've seen the outcome turn bad when people second guess their drs, or go for a lesser treatment.

We are all individuals. We all respond differently. Some people have a cancer that no matter what they do will kill them. But for the most part, the best results I've seen have come from hitting it between the eyes with everything they offer.

hugs.

Cheryl, did you say that you first had robotics surgery and then radiation and chemo?

Don, you say that one "must trust the doctors" But my problem is that the last two docs have advised different treatments. So, I have now a consultation with a third doc at a third institution. I'm just trying to "zero in" on the best path for me. Thanks for your input.

As mentioned, if you go to a CCC or several, the tumor board will come up with the best plan of action, maybe not all agreeing, but majority will. There are as many doctor opinions out there as there are laymens opinions on here, so they will be different to some extent with surgery, radiation, chemo, induction chemo, Chemoradiation, etc. due to their education, training, technology, experience, clininical trials, professional guidlines. Good luck.

Like Paul, trust and their opinions are different traits. Cancer is not cookie cutter. Give 3 qualified doctors the same fact sheet and they can easily have 3 different rationales and recommendations.

Generally, they follow the standard of care as defined by NCCI guidelines. But these therapies fall pretty broad umbrellas. Each patient has unique characteristics that once factored in produce the variability so often found in the recommendations.

Tumor board and second opinions validate your case. Even though they may have different finding, it is reasonable you trust all the providers, individual and facilities.

Bill. I had regular surgery (by the top guy in Toronto - who is also the head of the head and neck oncology departmant - at the TOP cancer center in Canada. However. I would NOT have had surgery if it had been HPV related cancer - which is what yours is. The first line of defense for your type of cancer (because it responds really well to chemo and rads) is actually chemo radiation.

I had a follow up of chemo and rads as a secondary treatment because my cancer wasn't HPV related. And despite my surgeon's certainty he got it all - he wanted to play it safe and throw the works at me (because I am not a smoker/or drinker and was fairly young) I trusted his expertise in the matter as this is ALL HE DOES for a living. (amazingly complicated head and neck cancers) He consulted with the rads and chemo team and told me his recommendation, and the radiation dr. said the same - so I when for it.

and so far so good.

hugs.

Cheryl, that's interesting about the not having surgery part of your hypothetical. I've read many instances here on the forum of people being treated only with chemo and rads for essentially the same kind of cancer as mine. But at the time of my diagnosis - exactly 5 years ago, maybe even this week (!) - there was never a question of them not operating.

Now of course I didn't know anything about OCF at the time and was as we all are more or less numbed by the news. Also didn't have anyone else to help me out, i.e. partner or knowledgeable friend. So I went with the docs' recommendations (RO, MO and ENT) and have always trusted them and have never second guessed them. At the time, and today, I consider myself fortunate to have been able to avoid chemo.

But I wonder if had I been better educated I might have tried to push for avoiding surgery. Or is it just that in the last 5 years the trend for HPV+ SCC has been moving away from the neck dissection. Interesting points, and of course for me now moot.

Bill,

I had TORS followed by 6 weeks chemo/radiation. I was treated at Johns Hopkins, the #1 for H&N cancer. That being said, I too had a different recommendation prior. I'm here and thus far cancer free so that's testament to the docs at JH.

Positive thoughts and prayers

"T"