Pilot Study of Metformin in HNSCC to Investigate the Effects of MF, Tumor Genotype and MF-genotype Interactions, on Tumor Metabolism and Anoikis

Inclusion Criteria:

* Newly diagnosed HNSCC Stage II-IVB (T1N1-3, T2-3, N0-3, M0) OR Patients with suspected Stage II-IVB tumor as determined by clinical examination or noted via imaging.
* Planned complete resection of the primary tumor.
* Age \>= 18 years.
* ECOG performance status of 0 or 1
* Adequate hepatic, renal, and bone marrow function

Exclusion Criteria:

* Prior therapy for head and neck cancer
* Candidates for neo-adjuvant chemotherapy or chemo-radiation therapy for curative intent.
* Co-existing malignancy or malignancies diagnosed within the last 3 years with the exception of basal cell carcinoma or in situ cervical cancer.
* History of diabetes mellitus or taking any medications indicated for diabetes mellitus treatment
* Contraindication to metformin including hypersensitivity or allergic reaction
* Active diagnosis of Alcoholism
* Congestive heart failure requiring pharmacologic treatment.
* BMI \< 25
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
* Pregnant or breastfeeding women are excluded from this study