Sherry-
I certainly am not a doctor, but I have worked a lot with cancer patients, as well as my family members who have been diagnosed in the past, I recently lost my 35 year old brother to this evil disease, and being a Medical Social Worker, unfortunately, I see a lot of different types of cancer.
I think prompt treatment is EXTREMELY important in this case. Once cancer is in the lymphatic system, it can spread so quickly. In most cases, radiation is given first in an attempt to shrink the cancer cells,especially if large tumors are pushing or are extremely close to vital organs. After a course of radiation, then chemo will follow. However, when dealing with the Intrahilar lymphnodes, my feelings are that the physican would commence chemo right away due to the rapid spreading nature of the cells in the lymphatic system. I sure hope this is helpful, and please communicate openly with the patient's physician. Good Luck!