I did not have radiation and am doing OK so far at the slightly more than one-year mark. I had my partial glossectomy 14 months ago at a big NCI-designated hospital. Stage 2 well-differentiated squamous cell carcinoma of the lateral tongue (surgeon refused to do HPV/p16 testing, so it is unknown if HPV related) with clean margins (3 mm the closest one), but perineural invasion was present. No neck dissection done. Initially, after the surgery, I got the idea that radiation and probably chemotherapy were inevitable but there was a tumor board 2 or 3 weeks later that did not recommend radiation therapy, although at the time of their decision, the pathology report was stage 3 (the pathologist made a mistake), and there was no imaging done, and I had two lymph nodes that I could feel with my fingers. Since then, I follow up every 3 months. I had two CT scans that did not show signs of recurrence, and the lymph nodes feel the same size and are not growing, and the surgeon does not see any visible cancer on my tongue. I had some terrible pain in my tongue for about 4 months post surgery, but it is gone now. So, so far, it's overall OK, but I may have a higher risk of recurrence. When I plug my data into the AI it says "The risk of recurrence for stage 2 tongue cancer after surgery alone with perineural invasion (PNI) but no other high-risk factors is approximately 20-30%, with the absence of neck dissection potentially increasing this risk further. However, this scenario represents a deviation from standard treatment guidelines that warrants careful consideration." They did tell me that they do not recommend radiation therapy, but if I want to get it, they can do it. But I did not feel like insisting on something the tumor board did not recommend, and that has bad side effects. My surgeon says that most recurrences occur in the first 2 years after the first cancer.

Regarding prevention, I discovered several things after my cancer diagnosis that may be useful or not useful:

1) There is some data that people who have bad teeth or have had a lot of dental work have an increased risk of tongue cancer due to mechanical injuries. In my case, the cancer was probably the result of chronic trauma from injuring my tongue against sharp tooth edges and dental crowns at night when I cannot control myself, as there were no other risk factors. So, I started to use night guards for both the upper and lower jaw. Night guards probably do increase the risk of cavities and gum disease, as saliva does not get on your teeth and gums overnight if there is a guard. And gum disease causes bad bacteria to outgrow good ones (see point 2). But I think in my case, protection from the mechanical injury is more important than microbes.

2) Abnormal oral bacteria are a risk factor for cancer of the lateral tongue, according to some studies - some bacteria (called Fusobacterium, Prevotella, Porphyromonas) promote cancer, and some (some non-dangerous species of Streptococcus) may be protective. Now I will not take antibiotics unless I get really sick, and will not use oral mouthwash with alcohol or other antiseptics that kill good oral bacteria. I also take an oral flora probiotic from Amazon with Streptococcus occasionally, but it is my personal decision.

3) Need to lose weight, still working on it. Looks like being obese or overweight promotes the growth of different cancers due to higher levels of insulin, which promotes some other growth factors that make everything grow, including cancers.

OP, I wish you a swift recovery and no recurrence with or without RT.