I continually have discussions with my RO at Moffitt, who is highly regarded in his profession, about HPV and what it means to the Tx. While today most CCC's don't alter the Tx they do recognize HPV's different attributes when comparing it to HPV- SCC. Trotti is also working with many others to develop one or more trials that may lead to changing the Tx for HPV+ SCC but as you can imagine, it's not easy. The overall goal is to cure the patient with the minimal amount of damage both short term and long term. To that end Trotti thinks that when the trials are established the 3 things he hopes to include would be no chemo; eliminate ND's and perhaps less radiation. Certainly one aspect that may stand in their way is finding willing participants who may be putting their life in harms way.

Even 3 years ago and before Moffitt confirmed I was HPV+, their feeling was not to do unnecessary ND's, that the radiation/chemo would kill the cancer and if not, the surgery was always available post Tx. After I was confirmed HPV+, Trotti remarked to me that he was even more positive about their decision not to do the ND pre Tx.

Agreed it's a complicated issue but IMO one worth looking into before I would allow someone to open up my neck, pre or post Tx.