Larynx cancer - what would you do?

Hi all,

a 58-year-old friend was diagnosed with iwth Larynx Cancer. He is living in Afghanistan and hence has limited access to healthcare. So he went to India. There the hospitals are known to "overtreat" and put financial before the patient.  So the family is confused what to do. 

The question what do you all, who had to suffer this cancer or who are family members of people who went through this suggest? We know that Chemo helps, but not all the time and we don't want to put him through an aggressive treatment which later turns out to be palliative. 

Kindly read the diagnosis and please feel free openly to say what you think. Thanks a lot!

The study reveals a large irregularly lobulated altered signal intensity mass lesion involving the right supraglottic & glottic region of larynx involving the right true and false vocal cords as well as posterior and anterior commissures, right aryepiglottic fold, pyriform sinus, laryngeal ventricle and encroaching into the adjacent paraglottic space. The left aryepiglottic fold also appears thickened with effacement of the pyriform sinus. The mass is seen to cause severe narrowing of the laryngeal air column with deviation toward left side in the glottic region. 

Superiorly it is seen to abut the epiglottis on the right side. Inferiorly it is seen to extend up to the subglottic region. The mass is seen encase and involve the right cricoarytenoid joint which could be separately visualized. Posteriorly, the mass is seen to cross the midline and extend towards the left side. 

It shows an acut restriction on DWI and ADC mapping. It measures 3.2 (AP) x 3.4 (TR) x 4.8 (CC) cm in size. 

Multiple enlarged bilateral submandibular, right upper & mid jugular cervical lymphnodes are seen., the largest is seen in the right submandibular location measuring approx. 3.2 x 1.9 cm in size. On injection of contract, these nodes show nonenhancing necrotic areas within. 

The epiglottis, glossoepiglottic fold, and bilateral vallecula are largely unremarkable in MR morphology. The muscles of the tongue as well as the soft tissue planes are normal. Both the internal and external carotid arteries on both sides are normal in course and caliber. 

Salivary glands are normal. Thyroid lobes are normal

Spondylotic changes are seen in the cervical spine in the form of osteophytes and disc desiccation.

Underlying muscles are normal.

Impression:

Large irregularly lobulated homogeneously enhancing mass lesion involving the right supraglottic & glottic region of larynx involving the right true and false vocal cords as well as posterior and anterior commissure, right aryepiglottic fold, pyriform sinus, laryngeal ventricle, adjacent paraglottic space, right cricoarytenoid joint & also causing severe narrowing of the laryngeal air column - probably suggestive of malignant mass - Carcinoma larynx. Multiple enlarged necrotic bilateral submandibular, right upper & mid jugular cervical lymphnodes - likely metastatic.  

Thanks a lot for your opinion and help! We are grateful!