Ray

[quote]we all tread lightly when we hear something we don't agree with[/quote] makes me feel left out

No, getting surgery right off the bat for base of tongue cancer with lymph node involvement does not sound "right". The base of the tongue actually develops from different embryonic tissue than the oral tongue so their treatment is usually different . The majority of oncologists acknowledge that while it may technically feasible to surgically remove some base of tongue cancers, most can and should be treated by radiation and chemotherapy. Surgery, even robotic, is a last resort for BOT because of all the negative consequences on speech and swallowing. Most BOTs are discovered at a later stage than oral tongue tumors so that is a factor
Whatever problems your brother in law's friend fears from chemo & radiation are not half as bad as what he's going to get with BOT surgery. Maybe if he only is Stage I it might not be so bad.
Of course, the tumor could be on the oral part of the tongue
(The tongue has 2 separate anatomical areas, the oral tongue is the part you can "stick out" at somebody and extends backward to the back of the tongue) The treatment for the oral part is exactly the reverse of BOT. Surgery is the first option for those tumors.
The "exception" to surgery for BOT is that often a neck dissection is done after radiation and chemo although with PETscans actually accurate for lymph nodes, they are no longer as commonplace.
It can't hurt to suggest that he get a second opinion or a full briefing on the downsides of BOT surgery or share what is the majority opinion on BOT treatment
Charm.