Dave, I think I would first ask if the goal of the radiation is curative than I would say yes to get it. I would be afraid that by waiting for later would be strictly palliative.I wish the awnser was more simple for you Dave but my thoughts are with you and wishing you strength, and sanity in what is a very difficult time.
Mark D.

You have heard here from people who have been on this board for some time. They have either experienced personally the difficulty of recurrence, or watched as others have fought and had poor outcomes from those battles. The clinical outcomes from people that hit this with the biggest hammer the first go around, that do not hold things in reserve, are clearly better. Is the additional treatment difficult? You bet. But recurrences are very hard to beat with radiation or anything else. They occur in areas that give the disease pathways and free access to the rest of your body, and when you begin to fight non-regional, distant mets, it is very difficult to win. In my personal opinion holding things in reserve has not served many people well. It is a bitch when it comes back. There have been many posts here about whether or not these are even recurrences when they come back in 18-30 months, or they are the result of incomplete original treatment. Micro mets too small to be seen on scans that take that long to prosper into something big enough to image and be discovered. Too many of them had surgical only solutions to their primary for us to discount the impact of that kind of decision. Again only in my own opinion, you get one chance to make an informed decision..... rads plus concurrent chemo plus targeted therapy such as Erbitux if you can get it. I am a go for broke kind of person, and we may not be alike in many ways. I never want to say I wish I had. If I'm up to my ass in QOL issues and still alive as a reulst of my choices... so be it.

Well said Brian. In my opinion this is a beast and as such you should throw the kitchen sink at it, if you can, and hold nothing back.

Dave,

My head and neck cancer team was emphatically against the notion of "holding something in reserve", for the reasons Brian stated so eloquently above. While I wasn't happy to hear their advice at the time (when I thought my surgery should be enough), I followed their recommendations for radiation as soon as possible after the surgery and have never had reason to regret it. (That was more than 17 years ago.)

I was a 39 year old non-smoker when I was diagnosed, so I know it can be pretty daunting to hear, at a fairly young age, that you have only one shot at radiation. While I had some of the typical side effects for quite awhile after, I'm thankful that I was able to heal to the point where my quality of life issues became minimal. If you have experienced head and neck cancer professionals recommending that you have radiation sooner rather than later, please pay attention to them.

Cathy

thanks for all your varied point of views, it is quite helpful. As Brian pointed out, individuals have different thresholds of risk with which they feel comfortable. I guess that I am one of those who likes to always have some kind of option left in my back pocket.

But I realise that this may not be possible now that I have reached what could be labelled as a critical junction. The evidence does suggest that the RT is the logical thing to do...and that will likely be what I decide to go for.
Watch this space
dave

dave, in this fight, we'd all like to have some kind of option left in our back pocket and, even after using radiation to fight this thing full force, we may. Because there are new clinical trials of new methods of treating this cancer going on all the time--recently someone here posted about being in a trial where chemo alone is being used to try to kill the cancer.

I think in general radiation should not be the back-pocket option, though. For all the reasons Brian gave above. Good luck with the decision--it can't be easy facing a second round of RT on the other side of your neck!

Nelie