Actually the current rate for non-smokers to have SCC (per Johns Hopkins data) is 50% or more. At Hopkins they are finding 70% of their new HNC patients are
HPV (human papilloma virus-16) positive (some of these are also smokers). These cancers present first in tonsil and base of tongue, almost none are oral (outer or lateral) tongue cancers. Most of these folks are also a lot younger than the "traditional" oral cancer patients, who also tended to be smokers. This changing demographic is pretty well documented throughout the country -- our ENT (in private practice now) says about 50% of her patients are in their 20s and 30s. And most never smoked.
The usual treatment protocol is chemoradiation, hopefully (as noted) with IMRT and then, if necessary, a planned neck dissection post-treatment. If your daughter has a base-of-tongue cancer she really should not have surgery beforehand, this can lead to a lot of permanent speech and swallowing problems and is not done by doctors at the top 3 CCCs, e.g. MDAnderson, Sloan-Kettering and Johns Hopkins. Whether she would need a ND afterwards depends on how well she gets through the chemoradiation, which is no walk in the park by any means but is very effective in controlling the cancer. My husband did not have a ND, it was not recommended by his medical or radiation oncologists, or his ENT surgeon, based on many tests after the end of treatment. He is now exactly one year from end of treatment and is doing great!
If your daughter has a base of tongue tumor, you can have a sample sent to Hopkins for
HPV-16 testing --
http://pathology.jhu.edu/labservices/hpv.cfm --this is of importance only because
HPV+ cancer tend to be more responsive to radiation and far less likely to recur. (It will not affect the initial treatment protocol.) Our dental oncologist, who is on OCF board, told my husband last week he has never seen or head of one spreading beyond the cervical lymph nodes (e.g. to lungs) although this is still montitored carefully by our hospital as they are super-conservative.
Hopkins is now testing a new therapuetic
HPV-16 vaccine, and my hisband just entered the trial. If effective, in years to come we may have another weapon in the arsenal against this nasty disease.
And yes, you should go through the OCF web pages as they are about the best I have ever seen (for comprehensivenes) on any cancer site.
Gail
