Hi,

I hear the anxiety in your voice that anything less than a CCC is compromising your outcome. There is a current debate here still about this topic.

Here are a couple thoughts which would offer you comfort for selecting a non-NCI CCC.

1) Only about 10% of cases are handled by NCI CCC facilities, meaning 90% of population "suffer and make do" at regional and local facilities.

2) Although the main CCC can attract and retain top talent, that does not mean that non-CCC only have second rate talent. My ENT-surgeon at John Muir completed his FELLOWSHIP at MSKCC (Memorial Slone Kettering Cancer Center), a highly prestigious center. It does not get better than that to have have someone who has shown significant passion, interest, and brains to have such an achievement.

3) CCC do tend to get and do much better at the very complex and unusual cases, as the regional-local facilities just do not get the volume of rarer conditions. In this case, referral to CCC makes sense.
The flip side of this is the CCC look for and take extra interest in these unusual cases. They offer new challenge and increased interest among the CCC staff.

How excited do you think they get treating a run of the mill non-complicated SCC with node mets? Do not be surprised to not be getting the top talent of the facility nor someone who is passionately involved in your symptoms and treatment. This may get a lot of reaction but the truth is these centers do lots of research and on the cutting edge of finding new therapies and pioneering and advancing the science. The fact is the unusual cases fulfill this more than run of the mill cases.

4) Although HPV+ SCC survival rates are still be computed, numbers north of 90% are often quoted. My own common sense tells me that if ever a study of our type of cancer is done, the difference would be a few points at most. Still, you want the very best outcomes but if you are at 92% and the other 10% is at 95%, I'd look in the mirror and smile. Life can be a hella worse.

No matter what keep a positive attitude, knowing in the grand scheme you are lucky to be where you are with this cancer diagnosis, and will surely continue to have a great life.