My advice - I would do the surgery (neck dissection...) 3-4 weeks to heal then radiation and chemo. I did a bit of reading and they say adeno squamous carcinoma should be treated as a high grade scc - my reasoning for suggesting the surgery is two fold... First off its hard to operate on radiated skin (in case the node doesn't die off) -. Secondly HPV related cancers respond well to rads and chemo - therefore may not require surgery depending on size, location etc..., however this is non HPV related and thus usually the treatment for standard scc is surgery (often including a neck dissection ) then radiation/chemo for any possible clean up. Plus if they remove what the "know to be cancer" then rads is just sweeping up the remnants. Definitely get a solid second opinion. The mayo clinic sounds good, but have they met your husband examined him, his films and read his file? Regardless good luck with everything.