Tounge squamous cell carcinoma - expert opinion needed!?

Bgrd: Female, 51yo, Chinese ancestry, married wth 2 children, not smoking/drinking.No history of betel nut intake.PS=0
History: tounge ulcer for~1 mth, went to see H&N surgeon in late Mar06
Diagnosis & treatment:H&N surgeon resected her ulcer & during surgery did excisional biopsy.Pathology returned with well-differentiated SCC.H&N surgeon performed more surgery to create clear margin.Pathology reported clear margins.Post-op MRI (3 d post) of H&N indicated no regional metastasis.No further treatment.
Mid Jun06 patient returned to surgeon with enlarged sub-mental LN. Surgeon performed FNAC.Pathology reported metastatic SCC. Surgeon ordered full-body PET Scan which revealed metabolic activities on her sub-mental LN, R lev 2 cervical LN & ambiguous activity on her L lev 2 LN.Patient seeks medical oncologist opinion & started 2 cycles of taxol/cisplatin/FU.Tumor responds within 1st cycle.No serious side-effects.
Q:should she undergo surgery again?Is her metastasis of iatrogenic origin?

I mean surgery to remove the remaining cervical LN's. The oncologist suggests that she should undergo surgery (radical or modified neck dissection) to remove the LN's as the most definitive way to control the disease. Chemo-radiotherapy will then commence 4-6 weeks after surgery. Any comments?

this is a very aggressive cancer. my boyfriend was diagnosed with this in nov. 05 went thur chemo and radiation.last treatment was may 06. it helped slow the growth. but the tumor is still there and growing fast.he is now headed for surgery that will take at least 10 hrs will llose most of his tongue and jaw bone. reconstruction has to be done.will have trache,feeding tube for rest of life. don't know if this answered your questions but i hope it helped some way. god bless

Surgery of what? If SCC is had already metastasize, chances tongue SCC is just the secondary site. Surgery is not advisable for this kind of cancer that is why the patient was advised to undergo the Chemotherapy. We can not claim it is iatrogenic (on what grounds) since Cancer is idiopathic (there are no proofs of where it really came from of what is the root cause).Hope this helps. God bless!

Metastasis not iatrogenic.Surgery is not to be performed.5yr survival possible with chemotherapy under expert care.

Try glyconutrients.

Info on my page.