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Joined: Jan 2013
Posts: 65
LilyFoo Offline OP
Supporting Member (50+ posts)
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Joined: Jan 2013
Posts: 65
I really don't understand the connection between HPV and head and neck cancer. Is HPV related head and neck cancer treated the same way as non-related head and neck cancer?

This evening I got home to the "Getting Ready for Surgery" packet. I could be hyper sensitive due to stress. On the treatment calendar i can tell they are finally going to test Charles for HPV during pre-op the day before his scheduled surgery. Plus his surgery appointment only has "Selective Neck Dissection." On our last appointment with his surgeon the plan was a partial laryngectomy, partial glossectomy, and some reconstruction.

It could be that the little calendar in the packet only had space for "Selective Neck Dissection" or could it be they will make a decision based on HPV testing and node margins?

Monday can't get here soon enough.


Wife/caregiver to Charles
ENT diagosed SCC Rt Tonsil Stage IV, MET 6 lymph nodes in neck 1/2001
Tonsillectomy, RND and six weeks RADS 2/2001
ENT diagnosis from CT scan, SCC in Rt tongue 2/13
25% of tongue removed 2/13 (clear margins)
SCC BOT with mets to 2 level 2 nodes and Lt. Delphian node 8/2014
Surgical biopsy shows cancer in larynx 9/2014
Laryngectomy, resection & rebuilt tongue w/ pectoral muscle, selective neck dissection 11/2014
Recurrences '16 HPV Neg No EGFR Mutations Detected
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At this time, treatments are the same weather the patient is HPV+ or HPV-. There are some trials being conducted to determine if lesser treatment will have the same results. The future for HPV+ patients likely will see slightly different treatment, but that could take years to happen.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Some recent studies have indicated a better response to chemo and potentially less radiation required for HPV+ oral cancers.


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
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Patient Advocate (1000+ posts)
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Lily,

If the topic of participating in a trial is offered, think through the benefits vs the risks to you. Trials are using patients as guinea pigs of sorts.

In the case of deescalation trials, one arm may be to use the current standard of care protocols while the other arm tests using less rads or whatever. It is random who gets which treatment, so you need to decide if you are comfortable testing a new, unproven protocol.

Naturally, if nobody participated there would be no advances so it is a bit of a moral dilemma.

But as stated earlier, current treatment options are not influenced by HPV status.


Don
Male, 57 - Great health except C
Dec '12
DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes
1 tooth out
Jan '13
2nd tooth out
Tumor Board -induction TPF (3 cycles), seq CRT
4-6/2013
CRT 70gr 2x35, weekly carbo150
ended 5/29,6/4
All the details, join at http://beatdown.cognacom.com
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Patient Advocate (old timer, 2000 posts)
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Also, there are a few studies that say the benefits for being HPV positive apparently doesn't extend outside the oropharynx (tonsil, bot mainly), so these deescalation trials are only for HPV positivity in the oropharynx, I believe.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs







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