Jay- First of all, HPV+ and new primary possibility are good news. When my husband's spread was found in late April, the doc said it could be (1)a new primary (best case scenario), (2)a metastasis of the previous SCC, or (3) oligometastatic disease (a metastasis that stays confined to one or two areas). It was confirmed metastasis thru p16 staining of pathology slides. Followup CT with contrast showed no mets to lungs. The metastasis is confined to the lymph node(s). I do not know when you say Jen's is in the lobe if that means it's in the lung itself or if it's confined to lymph node. (is the lobe a lymph node or part of lung?) Because my husband's is confined to lymph nodes, and because it is slow moving (benefit of HPV+) the docs at Johns Hopkins have set a course of 6 weeks of radiation with chemo sensitizer to the chest area.

A very plain-speaking MO at Hopkins said cancer spreads thru lymph system and/or through blood. My husband's is presently confined to lymph. The RO said, "HPV is a gamechanger. Ten years ago we wouldn't have been talking about treating toward cure in lung mets" We have gone from utter devastation to much hope in the last 10 weeks.

I've rambled on way too much, but I am still "high" on the prospect of having a plan in place (as of 18 hours ago) to beat this thing down. Please feel free to send any questions. What Hopkins (and also University of Maryland) are doing is somewhat cutting edge, so am happy to share what I know, if it applies to Jen's case. Can you push to find out if testing is available to determine if it's metastatic or new primary??
Mary