Tim,

I just had to make this same decisision. Surgery or radiation. I had a 4cm. tumor on the base of my tongue and up the jawline. The surgeon, oncologist, and radiation therapist sat down with my husband and me and proposed a path of surgery first. They had several reasons for this proposal:
1. I was young and healthy enough to tolerate the surgery well.
2. They thought they could get good margins and indications were good there was no lymph node involvement.
3. Since I am relatively young (42), if I did have a recurrence, radiation would be a weapon to keep in my "arsenal", and I wouldn't have "burned that card", so to speak. (I have had previous leukoplastic patches removed from the same side of my tongue in the past...all benign.)

The surgery involved a jaw-split, partial glossectomy, neck dissection, tracheostomy, etc... so I really discussed radiation. Avoiding this surgery was very appealing. The radiation therapist told me he would recommend surgery in my case since they thought they could get it all without any follow up radiation. He said it can be possible to irradiate an area a second time, but it is much more difficult. He also said it is much more difficult for surgeons to operate on irradiated tissues.

Anyway, after much discussion, I opted for the surgery and am currently home recovering. It definitely wasn't fun, but I believe it was the best choice for my situation.

Good luck and I hope this helps!

Jennifer