Hello,
I had HPV SCC in my tongue and one lymph node. I’m in remission now since my treatment ended in September, 2022. To answer your question, to my knowledge, a biopsy is the only sure way to determine if the lymph node is cancerous. My biopsy showed it was positive for cancer. The treatment for my cancer was radiation, both the tongue and the lymph node, not removal by surgery. I hope this helps. I pray you have complete recovery at the end of your treatment journey. God bless.