One problem with scans in general, including PET/CT, is that they cannot detect tumors smaller than 2mm (i.e. 1/8"). Although prone to some false positives in the immediate post Tx (due to scar and such), it is relatively accurate in pre Tx. PET/CT even more so.

In my case a PET was required as part of the pre Tx workup by the comprehensive cancer center. It verified the location of the cancer and no other "hot spots" which was a relief.

Based on the very agressive nature of SCC (especially in the case of the tongue), most physicians recommend a very agressive approach (and I believe most people will on this site as well). Ultimately you will have to choose which tools in the arsenal to use against your cancer. One of the tough decisions to make in treatment (especially for stage I tumors) is whether to radiate or not. Radiation is no picnic and I sure that if you have read the threads here about the side effects they have scared you pretty good. Bear in mind that many do NOT have severe side effects.

I "only" had radiation and chemo (no surgery) and it was rough for a long time. I am well now, enjoying life again and cancer free (today). Recent studies have shown that radiation significantly improves the odds of survival (at least in the case of breast cancer patients).