Hello Shawna, (from Minnesota also) I would not stage him a 4. With only one node and a small tumor size he would probably be three or less (I am not a medical professional.) Staging is somewhat art as well as numbers and at this point there is no way to determine if he has microscopic cancer cells in more nodes. Leave staging up to his doctors or ignore the stage altogether.

I had a radical neck dissection and tonsillectomy. No trach was needed nor did I have a feeding tube (G tube or PEG tube).

Before he has surgery, make sure he talks to someone about radiation and chemo as an alternative (no surgery) If his present doctors don't seem keen on the idea seek a second opinion. The radiation chemo combination has less side effects and may be as good or better than surgery. Mayo in Rochester is highly rated (number 5 nation wide) if he can get there. The best results are from the best cancer centers

http://www.usnews.com/usnews/health/hosptl/rankings/specihqcanc.htm

Mark, 21 Year survivor, SCC right tonsil, 3 nodes positive, one with extra-capsular spread. I never asked what stage (would have scared me anyway) Right side tonsillectomy, radical neck dissection right side, maximum radiation to both sides, no chemo, no PEG, age 40 when diagnosed.