hello Tim,
I am sorry to say that this is probably never going to be crystal clear decision. Post treatment results weighed against post treatment quality of life.

I think if you asked all of these same doctors what the statistics say if the cancer returns or is unsuccesfully treated in the first go around and I think they will all be in agreement. If it doesn't work the first time, it becomes very serious.

I would ask the doctor proposing surgery how extensive the surgery will be. If it results in a smaller loss of the tongue and resultant side effects are minimal, that is one thing. If he/she is proposing significant loss of tongue then the resulting permanant side effects are substantially worse.

The best suggestion I have is to go with what ever offers the best statistics. If you talk to a surgeon you will almost always hear "knife" if you talk to a rad-onc you will hear radiation.

Frankly these stage two and three cases are very difficult because you have more options. Of course with more options comes more opportunity to look back and say to yourself "if I had only......"

In my case I was told that the surgery alone was a potential cure 50% of the time. I truely wish I could have known which side of the coin was mine before I went through radiation.

What ever you choose I wish you well.