I was diagnosed on 2/22/08 with metastatic SCC after resection of a 4 cm cancerous lymph node in my right neck. My local surgeon thought it was a lymph node "gone bad" after my tonsils were removed in 11/07. I first noticed a lump in neck just prior to the holidays. The primary tumor was in my right tonsil and was 8mm and was completely removed on 3/5/08. It tested positive on the p16 stain. There are also two additional, sub-centimeter cancerous nodes in the right side of my neck.

I am being treated at Stanford and need to decide between two optins: 1. Induction chemo (some combination of cisplatin, taxotere, and 5FU- (TPF)) followed by Cisplatin/XRT or, 2. Ciplatin/XRT alone. My Onclogist and my Radiation Oncologist are divided on which course of treatment they would choose for themselves. My case is also going before the UCSF tumor board this week for review and recommendation. I am scheduled to get fitted with a mask for XRT Tuesday and then it will take them 1 1/2 - 2 weeks to plan my treatment. That seems like a long time but they say they need that time to properly plan the procedure. I had the silver fillings in my lower teeth replaced with enamel yesterday and am ready to begin. With either choice I make I will receive the radiation.

MD Anderson would recommend the induction therapy followed by the concurrent cisplatin/xrt. This is based on conversations my sister in law, a lung cancer doctor, has had with former colleagues at MD Anderson. I also know that Johns Hopkins would not do the induction therapy but would recommend Cisplatin/XRT.

Apparently there is a considerable current controversy within the Oncological community regarding the correct therapy. Some argue that delaying radiation negatively affects the cure rate. Some say the data clearly indicates that the induction therapy controls distant metastisis. I wish there was more compelling data and case studies. One day there will be.

Has anyone else done some variant of the TPF treatment?

Also, has anyone delved deeper into what it means to have a p16+ test? I guess that just because you get p16+ test doesn't mean you have HPV. While I don't believe it will impact my eminent decision, is there any value in determining if you are really HPV positive? If so has anyone else tried to determine what specific strains? I want to beat this cancer and then work to get rid of the virus that caused it.

I am 43 years old. This cancer needs to die. My Oncologist told me I would live to see my grandkids. My oldest child is 14 so I hope that means many years into the future.

I am a new cancer patient and this is my first posting to this site. Any help and ideas would be appreciated.

Thanks,
Frank