Another view of the same subject: In the case of head and neck cancers (SCC), often the first indication or symptom of the disease is a lump in the neck. This lump is not usually the cancer primary site (it is not the tumor) Instead it is a lymph node that is attempting to trap and contain the already spreading cancer cells. I suppose there is a risk of releasing the cancer by puncturing the node, but it is far less risky than general surgery to accomplish the biopsy. Not every lump is cancer.

The issue is really fairly easy and logical. If you do biopsy and it is not cancer then no harm done. If it is cancer then you know and are able to proceed immediately with treatments which in my opinion will give you the best chance of winning.

Better results long term are with early diagnosis and treatment. Watch and wait are not words to use when dealing with oral cancers. (probably any cancers)

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.