Several things push docs towards one treatment idea or another. One of these is cancer etiology. What risk factors did he have for the disease? If tobacco is out of the picture, I would want them to take the tonsils at the same time and do pathology on them. A patient that is intraorally occult, with positive cervical unilateral nodes, (based on clinical experience at Johns Hopkins) has a high probability of having the tonsil contain the unknown primary. While tonsillectomies for kids are no big deal, for adults it is a bit more involved.

The JH experience found patients that presented like this, when bilateral tonsillectomies were performed prophylactically, they found SCC in one of the tonsils in about 70% of the patients that were visually occult. This could change treatment protocols, and that tissue excised at surgery (tonsil or cervical) should be typed for HPV by PCR testing.

Some institutions are doing chemo /rad and that can be simultaneous or neo adjunctive. It would be helpful to know more about what you have been told at this point, staging etc, and where you are being treated to help in giving you useful information. We all wish you the fastest and most successful path through this treatment process.