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Robr Offline OP
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Brian,

I have read several publication's reagarding the link between HPV & HNC.

I saw this article in this in this months issue of Cure.
Please read below.

I remember reading that you feel this is how you contracted this disease.
Please share you thoughts and suggestions. I am going to be forwarding this information to the staff at University of Chicago and try to get some feedback from them.

I think if this real and if it is applicable, we (everyone here) should push hard to get to Clinicals going on this!


HPV Vaccine Filed for Approval

Merck submitted a biologics license application (BLA) for Gardasil to the
FDA in early December. The drug company is seeking priority review for the
cervical cancer vaccine, which means the FDA would review and act on the
filing within six months of receipt as opposed to the standard 10 months.
In a phase III trial, Gardasil prevented 100 percent of cervical precancers
and non-invasive cervical cancers associated with human papillomavirus (HPV)
types 16 and 18, which combined account for approximately 70 percent of
cervical cancer cases. The vaccine also protects against HPV types 6 and
II, which combined account for about 90 percent of genital wart cases. For
more information, visit www.merck.com.


SCC 1.6cm Right Tonsil 10/3/03, 1 Node 3cm, T1N2AM0, Tonsil Removed, Selective Neck Disection, 4 Wks Induction Chemo (Taxol,Cisplatin), 8 Weeks Chemo/Radiation (5FU,Hydroxyurea,Iressa), IMRT x 40, Treatment Complete 2/13/04.
41 Years Old At Diagnosis
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I am in communication with these companies, and almost weekly with the primary researcher on HPV and oral cancer Dr. Gillison at Johns Hopkins. The studies linking the virus to oral cancers are published. The data coming out of JH indicates that HPV may be present in more than 50% of all oral cancer patients including the smoking population of patients. It is a big deal, perhaps even epidemic. The companies are already considering the oral connections and that is on their plate for near future exploration. Clinicals are very expensive and in every commercial endeavor this is a consideration. The fact is that when the vaccine begins to be used here in the US (it is primarily slated for introduction in 3rd world countries that do not do cervical exams first) there will be inevitable long-term changes in the head and neck world as a result. This will happen regardless of their not targeting oral specifically. In my conversations with both them and GSK, my objective has been to show them that the market opportunity as well as need is there, as again market and return drive efforts.

By the way, this article in CURE is really old news, we have been following this in the OCF news section for over a year, and for over two years I have been working with doctor Gillison related to the introduction of an oral HPV test.

A major obstacle here in the US that NOBODY had considered, is how strongly the US religious right has come out against the vaccine. Like their rejection of information about condoms and sex education in junior high schools, they wrongly believe that all this will encourage premarital sex. I cannot begin to tell you how frustrating this is to the science people and to me that have been trying to make headway in these issues. The vaccine would have to be administered BEFORE sexual activity begins. The REALITY is that in practical terms that means before age 12. No parent wants to acknowledge that this number could be correct, but the facts are there to substantiate it. We need to educate our young people, and that means more than "just say no"...to drugs or sex. Information combined with involved parents will help all things. Denial and avoidance will not help anyone.


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
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Posts: 218
Robr Offline OP
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Thanks Brian,

I did not know that this was old news. And, I must say that the religious right comments are very discouraging to put it mildly.

Dr. Bruce Brockstein at Northwestern University's Evanston Northwestern Hospital system and a former attending physician that helped develop the current treatment protocol with Dr. Everett Vokes and Dr. Daniel Haraf at the University Of Chicago has become a personal friend and business colleague. He made the following comments regarding this.

Bob,
This is intriguing. In cervical cancer, its MUCH easier to study, as most (70-80%) are caused by HPV, and you can find PRE cancer on a reproducible, reliable site, the cervix. In the head and neck there are multiple sites and a much smaller contribution, so the target population for the study would be quite huge--though it still bears pursuing.

Just thought I would share. Bruce is a great guy and a fabulous doctor. He is interested in pursuing this. Any suggestions?

Also, Is this something that goes away on it's own, or do you and I stand a chance of recurrance do to it still being in our system? In your opinion (I will ask Bruce as well) would a vaccine do you and I any good what so ever? I am fairly certain that I contracted HNC through HPV.

Thanks again Brian. Good things.
Robert Hamilton


SCC 1.6cm Right Tonsil 10/3/03, 1 Node 3cm, T1N2AM0, Tonsil Removed, Selective Neck Disection, 4 Wks Induction Chemo (Taxol,Cisplatin), 8 Weeks Chemo/Radiation (5FU,Hydroxyurea,Iressa), IMRT x 40, Treatment Complete 2/13/04.
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If you have him contact me I will make the introductions to Dr. Gillison for him and the two can exchange information and ideas, she is the source water for most of the recent data. Actually HPV 16/18 accounts for more than 95% of all cervical cancers. As to its involvement in the oral cavity, it appears that in tonsillar and oropharangeal cancer it is a causative agent, and there is news story up recently in the OCF news section about the fact that these particular cancers are very different from SCC in other parts of the mouth and in the demographics of those who get them. It is a unique subset disease in actuality, and appears to have different long term outcomes and recurrence rates. This does not mean that HPV 16, 18, and perhaps 33 are not factors in other oral cancers, even in smokers. They are probably resident in as many as 70% of the population of all oral cancers though in smokers they appear to act as facilitators and co factors rather than causative agents. What all this means is there is the potential for a real world HPV test of the tonsillar pillar and the oropharanyx like that used in the cervical region. Gillison is working on this now.

HPV can be shed by some individuals, and having at one point tested positive for it, they may be free of it on a subsequent tests months later. The issue is reinfection through sexual partners which is why this is so prevalent today.

I might add that the precancerous lesions that occur on the cervix and which are visible there, are the exact same ones that occur in the mouth, leukoplakia and erythroplakia as the main ones. So early diagnosis via an annual oral exam, actually no different than that for cervical cancer (visual, tactile, and if a suspicious area is found, brush biopsy or incisional biopsy) is possible. Oral cancer death rates would decline due to discovery as stage one and two cancers just as cervical cancer did in the early 50's if there were a national program of opportunistic screenings of all individuals, (opportunistic meaning those without any symptoms or reason to feel something was wrong) we wouold have the same reduction in death rates enjoyed by cervical cancer, which was about 70% over the first ten years that women began to get annual exams.


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.

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