| Joined: Jan 2013 Posts: 65 Supporting Member (50+ posts) | OP Supporting Member (50+ posts) 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
| | | | Joined: Jun 2007 Posts: 10,507 Likes: 6 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) Joined: Jun 2007 Posts: 10,507 Likes: 6 | 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. ChristineSCC 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 | | | | Joined: Dec 2003 Posts: 2,606 Likes: 2 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Dec 2003 Posts: 2,606 Likes: 2 | 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
| | | | Joined: Jan 2013 Posts: 1,291 Likes: 1 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Jan 2013 Posts: 1,291 Likes: 1 | 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 | | | | Joined: Jul 2012 Posts: 3,267 Likes: 1 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Jul 2012 Posts: 3,267 Likes: 1 | 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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