I'm sorry for your troubles, past and present. Where is the positive margin, tonsil or lymph node. You're a fighter, like me, so this is just another hurdle to jump, and is still treatable. 37 T-cells wete low then, and you were lucky, and the viral load can be more significant. I'm from nyc and know of many who lost this battle. Anyway, positive margins doesn't necessarily mean cancer will return, but high chances it will between 30-50%, and to have locoregional control, surgery with Chemoradiation or chemoradiation alone is necessary. Previously radiated patients have a better chance with salvage surgery if done with radiation, however, there are more toxicities, and complications with this, but may be possible. Maybe look into Brachtherapy or similar like HD-IORT, which I'm having, which has better control, and can be done safely for a cure. Basically they will respect the Tumor, if possible, do radiation during surgery, probably with a pec or free flap, so they then can do more Chemoradiation. This is really my 8th recurrence, and went through multiple treatments, surgeries, and will be my 2nd IORT, and still going for a cure. If interested, maybe your doctors can contact mine, who is an expert with this, radiation, and the head and neck, and may make suggestions. If going to NYC you can go there or let you know of the places in Ca doing this or any other location since you can always stay at one of the 26 hope lodges in the US for free.

I saw a clinical phase one trial just starting with a vaccine for patients with HIV, HPV positive, who failed treatment, and believe it is to reduce the HPV, and recurrences. I'll try to find it tomorrow.

Rest up, and good luck with the doctor. What one doctor may not treat, another one may with their training and experience. See you at McDonald's