Good topic, and one really not touched on. I think most hope, if it's not spoken the dark cloud will pass their door. Having had 5 recurrences myself, I have no problem discussing it, but as time gors on you'll think less sbout it, and I never reslly reached that point. We may be similar in thought? I like to know the good, the bad, and the ugly, have a game plan in place, A, B and C, records in place, treatment options, doctors, and if that time comes, there is no panic, since you've already prepared for this, and can be fine tuned as you go along or a different direction, like driving a car with a GPS, to avoid some obstacles, traffic. That's what homeland security does, and just about every public facility, is plan worst case scenarios, practice, and act when necessary. Even knowing this, I was caught off guard initially, thinking I was stronger than cancer, chemo, and underestimated the opponent, and went in blindly, not even knowing what chemo I was getting, and didn't for more than a year later, and this caused many set backs, which I may touch on another time.

I guess the oropharyngel related cancers, recurrences can be separated by smoking related vs. HPV related. Yours is HPV related, my status is unknown, probably HPV, with tonsil as primary, but is a good post for others either way.

I'll touch on HPV related. Your IC is very much responsive to HPV, and probably blew the cancer to the next universe, and thankfully not you. I did 5 days of it, and that killed all my cancer by itself for 8 months, but we know chemo doesn't kill cancer alone, and prevented me from further treatment for 1.3 years, another long story. Anyway, HPV related has a 15% failure rate, 85-90% cure, I like the words they make up, as opposed to tobacco related, which is much higher, and would say around 47%, not sure the numbers the first year, but that's probably several years, numbers get foggy, and failure rates levels off after 2 years. Most tobacco related failures occur the first two years, and levels off. On the other hand, some HPV, maybe a more aggressive viral type, has been suprisingly recurring or have failure rate, after 5 years, and in distant locations not normally associated with metastases, like bone, liver, I believe.

There are other factors that have a role on recurrences, wether HPV or not. Like the location of the tumor, BOT can be a resistsnt atea, due to the deep musculature, lymphatics. Also the size of the tumor, tumor histology, thickness, and then the lymph nodes, number, any negative findings like ECE, LVI, PNI, treatment lapses.

HPV is of different biology, so does not progress like Tobacco related cancer, with the leukoplakia, dysplasia to the elliptical lining of the aerodigestive tract, no field cancerization, and most times, has no symptoms, and confined to one structure, and usually not noticed until in the lymph nodes. As discussed before, once infected with HPV-16 you have an antibody for it, and can't catch it again, so that is some hope. Wether or not one can catch it simultaneously is the oropharynx, and anogenital area at the same time, might be unlikely, ands better chance hitting lotto.

I also heard of HPV-16 studies in patients already with the disease, but with DNA, and saying the existing Guardasil vaccines will not work with those already with the virus. Who knows?