I was recently diagnosed with stage IVA SCC with an tonsil origin. I'm starting concurrent radiation (IMRT) + chemo (cisplatin) next week. Cancer has spread from the tonsil down to the back of the tongue and the same side lymph node. Ready to get started, I feel that the waiting is the hardest part. The other issue was that there were so many different opinions on my treatment plan. Some doctors recommended surgery with radiation (but no chemo). Others recommended radiation (some both sides of neck, some only one side of neck) with chemo. After a PET, my cancer center of choice recommended against surgery due to potential issues with the tonsil margins, which made it easier to get the ball rolling.

I'm enrolled in a clinical trial using a special type of cyclotron for hypoxic cell detection in HPV+ cancers, with the potential for radiation deescalation if there are no hypoxic cells (with a small neck dissection/lymph note check up if deescalated.)

HPV status is questionable. A recent FNA was not positive for HPV, but I had a core biopsy to diagnose the cancer, so that is being tested currently. Hoping for good news from the HPV stains in the next few days as docs have mentioned they have seen FNA fail to detect HPV because smaller scope of cells extracted. My bio (non-smoker except wedding cigars, social drinking), young age (25), athletic, and the look of the cancer cells on tongue (? - mentioned by the 1 surgeon who saw the cancer on the tongue as well) all supported a HPV diagnosis. All of the doctors have said they are almost certain its HPV, with the caveat that I'm very young to have an HPV viral infection which results in cancer.

All the information I've read here, both on the site and the forum, have been very helpful. Thanks everyone for your contributions. I'm sure I'll have more questions as we get down to business.

Been eating like a champ, now its time to kick some cancer butt.