The problem with BOT is that the lesion can go deeper into the structure than other areas that are more contained like tonsil, and not be visible at the surface. BOT has propensity for nodal metastases also due to the high lymphatics. They really don't know the extent sometimes until surgery. I had T1, same thing, not visible, and only found after finding an enlarged lymph node, further scan, biopsy. Surgery was not recommended, chemoradiation was, with induction chemo to be done in 3 cycles before that, which many do, but I would not again.

Have they considered minimally invasive transoral laser surgery being it's small T1. This does not effect future treatment options, such as surgery or radiation, and highly effective, to my understanding.