It is not a given that just because you are HPV + you don't need a ND. I wasn't tested for HPV until after my Tx was over and after months of my persistence and insistence.

Moffitt, almost 2 years ago, told me that their thinking was that the Radiation is the only effective killer of my SCC and they saw no benefit of doing a ND to take out my lymph nodes (at least 2 were Dx as cancer) and wait for me to heal before they started the rad which they said should kill the cancer in the LN's anyway. They also said they could always remove a LN that wasn't cooperating after my Tx was over. I am also sure that their recommendation considered the size of my LN's as well.

As far as HPV, a recent study has concluded that the HPV+ SCC is different from HPV- SCC and that it responds better to the conventional Tx and re occurrence is less likely. My RO told me shortly after that study was published that if he had known this he MAY have Tx me differently. Didn't ask him what he meant but I'm not sure I would want to be a Guinea Pig.