Hi there I'm going to agree if this is his first recurrence, I would be seeking a second opinion on the lack of a second choice -

It's been almost 8 years since a previous cancer... Aside from medicine changing yearly - (monthly) I would thing that at this point he is good candidate for more radiation (which this type of cancer responds well to) as opposed to a life letting surgery -

I can't say for certain - because I don't know his details - but there are a few here who've had more than two rounds of radiation - it does have long term effects but I imagine it will be less traumatic than the surgery.

I really would search out a second opinion. Hugs and welcome