Hi there... Hopefully surgery will be a quick recovery. I know some people are against doing a radical surgery and want to do the minimum. The concern with this is that a dr. will then be hesitant to do what he - in his educated opinion - knows he should. If your dr. is good and well versed in head and neck cancer, and hopefully is part of a CCC - I would take his advice. Chances are if he does what he is supposed to do and gets clear margins that will be the end of it. SCC is sneaky it can hide in the nodes and on a cellular level it is not detectable on a ct, or pet scan. Only when it becomes a certain size does a scan pick it up, or the node swell to a noticeable size. So your dr. is actually being proactive. The alternative is that you have the gland removed, and then often what happens is a few months later you note a swollen node and have to have a second surgery regardless.

With an HPV positive cancer it's different because HPV cancers (base of tongue and tonsil cancer - primarily) respond well to radiation and chemotherapy (which is the main treatment for this kind of cancer) so surgery is often not performed - though they do seem to take out tonsils.

With regular SCC - which is likely what you have -they tend to remove nodes as a precaution, knowing that the cancer cells can hide in the nodes.

It is entirely your choice - of course, and I know the surgery seems daunting but it's relatively painless (as they cut the nerves in the neck - and you are numb!) The only difficulty will be with your arm and shoulder post op - you will likely have to have physio to regain function. and massage to clear the build up of fluid.

I would do what I could to try to avoid having radiation and chemo - which may be a possibility if you do go ahead with the neck dissection. best of luck.