Hello @usnavysailor8404. So sorry to hear that you are going through this. My son in law, age 44, has just completed radiation and chemo for SCC of tonsil with local metastasis to lymph node near vocal fold. His is HPV associated. He was given a 95% cure rate with this treatment. Have you been tested for that? The HPV tumors are more responsive to radiation/chemo than non-hpv. That knowledge might help you make a decision. A second opinion, at a large referral center or cancer center, would be helpful to you. Might be non-VA but you would benefit from another viewpoint. You are your own best advocate for your health care so pursue answers until you are satisfied. I would ask if laryngectomy is still an option if radiation/chemo fails. Also know that rad/chemo is a tough treatment, with swallowing issues and long term effects that can keep arising years later. Radiation is the gift that keeps on giving. Ask if Proton beam radiation is available nearby instead of Photon the traditional radiation. There can be better results with proton. I have metastatic SCC which began in my ear, not HPV associated. Mayo Clinic has handled my care for the last 14 years with multiple surgeries and radiation, chemo therapies. You must have trust in your medical team to do the best for you as an individual. It helps to know that you have done your best to find the right team. Would you consider a second opinion?