Sorry to hear.

As mentioned, the usual HPV postive treatment is with Chemoradiation, maybe induction chemo prior, which preserves the structures, and swallowing, and HPV is more responsive, has better outcome, but sometimes not. This was my recommended treated with surgery as a last resort. Surgery was not recommended by my ENT who said it would be too debilitative, and would not know the extent of the tumor until he did surgery, and may be more extensive,

Surgery followed by radiation, is an option for early stage T1,T2, according to NCCN guidelines for oropharyngeal cancer, and is just that, a guideline not set in stone. Each doctor, hospital, and patient is different. In the same NCCN chart, Chemoradiation is recommended for T2N1 tumors, which can be close to a T1 in size. I had 70Gy IMRT Radiation Alone, and that did not work, and cancer came back 6 months later. In order to kill SCCOPC it has to be over 5OGy, with more like 70-74Gy to the primary, especially BOT. I had two more surgeries alone, at different intervals, and that did not work either, and had two more recurrences following the, and I'm mostly likly HPV associated, although never tested.

Adding chemo to radiation improves radiation up to 20 or 30 present, based on type of chemo or targeted therapy used, and has better outcome than radiation alone. BOT is more difficult to treat, due to the deep musculature, lymphatics to the area, and has a higher rate of recurrences. You do not want a recurrence, which is more difficult to treat, possibly with different outcome or may not be treatable later on.

As far as leaving in a cancerous lymph node to monitor a primary, I wouldn't. It needs to be taken out or treated like the primary, before it spreads, ECE, metastasizes further, attaches to structures or carotid artery.

There are other treatment options, possibly used in conjunction with radiation, chemo, like Brachytherapy as a boost, followed by Chrmoradiation, is very good for BOT, and seen a recent positive article, Intraoral microscopic laser surgery, which doesn't effect future surgery or radiation, TORS, transorl robotic surgery, instead of the split lip method.

I would see about a 2nd opinion also. You may even stick with the first proposal, but if you don't get a different opinion, some wish they did later on. Good luck with everything.