Hi all, I am new here this month, and starting a regimen of radiation & cisplatin on July 10th, to treat my lymph node Squamous Cell Carcinoma (HPV16). Petscan indicated BoT origin, but surgical biopsies all came back negative, so, primary site is considered unknown.

On June 26th I got a second opinion at Dana Farber Cancer Center:

I had the good fortune to meet with a panel of four oncologists (including Dr. Robert Haddad, Dr. Charles Norris, & Dr. Roy Tishler) at Dana Farber on Thursday. Though they said the team treating me had done everything they would do, there was a slight difference of opinion from the radiation oncologist, Dr. Tischler. He takes a more aggressive approach with radiation, and would treat the nasal pharanx as well as the tongue, lymph nodes and tonsils that Dr. Bill O'Meara is aiming for.

Tishler says O'Meara's approach is the standard that most would give. O'Meara says the nasal pharanx is not implicated in many HPV16 cancers among non-smokers of causcasian ancestry. He (after treating hundreds of HPV16 H & N cancers)has very rarely seen a pharanx origin, and when he had it was before the testing for separating HPV16 from other types. In O'Meara's take, if one is not asian (subject to other viruses) and does not consume major amounts of smoked meat and fish, then pharanx is unnecessary, and he suggests if I want that to go to Tishler (which is impractical- the ride in during the day is horrendous, so I would face rather than a ten minute commute, more like 2-3 hours of travel time to and from appointments).

What is the thinking here on this question?

Part of this is redundant from my intro thread, but I thought it best to post here with a dedicated title to get the best response. Apologies for The Dept. of Redundancy Dept. ;-)