@yolande73, this sounds like a very difficult situation. I have had SCC treated with radiation with a targeted IV treatment, multiple surgeries including select neck dissection, and finally 2 years on an Immunotherapy Libtayo. At the moment cancer free after 11 years of treatment. All but the radiation and Immunotherapy infusions have been at Mayo Rochester. It sounds like your options are quite limited where you are located. I don't understand why Immunotherapy is not being offered to him. The Mayo head and neck oncologist Dr. Katharine Price is fantastic. She has prolonged my life and is my hero. Perhaps, since your husband is in such a weak state, you can pursue a second opinion via video visit with Mayo. Or you could have all records sent and have your oncologist do a consult with her. Then if other options are recommended, you can decide about travel for treatment. We drive 600 miles to Minnesota from Ohio because the medical care has been so great. It's not easy, but has been worth it. Good luck to you both.