I don't know how helpful this response will be for you, but I offer it in the chance that it might be (helpful.) BTW, I turned 74 on the 10 of this month.

I started out as Stage IV, got one tumor removed surgically (actually, that led to the initial diagnosis,) followed by 6 weeks of trying to find the primary (in the base of my tongue.) Found that and three other Metastatic tumors in lymph nodes in the throat.) 8 weeks radiation with Cisplatin at 3 week intervals (3 dosages in all) and was clean. For 17 months.

Recurrence in the liver (distant metastasis, now Stage IVc) treated with Taxol/taxetere and Carboplatin for 7 cycles and clean again.

HOWEVER, the time from detection to beginning the treatment was lenghy, 4+ months. This included two liver biopsies and installation of gold markers as targets to burn the new tumor(s) out with radiation.

After all that, it was decided to treat with chemo as described above. I suppose that's because I'm considered incurable. In any event, it eliminated the tumors.

Next (and most recent) recurrence was again in the liver, only this time in multiple locations. This, 90 days after my clean report. This time we treated it with Xeloda, a pill form of FU5. I completed those treatments with a clean bill of health mid-April, and won't have another PET scan until late Sept.

I believe that you are getting good advice about waiting as for those with HPV association, the disease seems to be very slow growing, and even for those of us in Stage IVc, seems to be quite manageable. I know that in my case, it will eventually cease to be so amenable, but single, localized tumors do seem to present no immediate or emergency demands. In other words, I'd go with my MO's suggestion and not worry too much about it.