Now all we have to do is figure how many tumours that test positive for HPV actually caused the cancer rather than the smoking and drinking which just confound everything.

Alex and I are blaming his positive HPV status even though he had a 2 pack a day and heavy drinking history for the last 30 odd years (better hope for the future if it was the HPV that did it)

According to Dr Trotti (Moffitt), my RO and someone that has taken an interest in HPV since I was treated, he points to the more favorable prognosis of an HPV+ diagnosis but also says that when tobacco use is added to that patient's profile the chances of a recurrence increase over a HPV+ patient without tobacco use.

@David / Klo

RTOG study of Tobacco Use and HPV+OC was released at the ASTRO conference last June by Dr's Ang (MD Anderson) and Gillison (Ohio State):

PER THE STUDY: the risk of death and cancer progression increased by 1% for each pack-year of tobacco smoking.

**************

ASCO Abstract # 5510: Analysis of the effect of p16 and tobacco pack-years (p-y) on overall (OS) and progression-freesurvival (PFS) for patients with oropharynx cancer (OPC) in Radiation Therapy Oncology Group (RTOG) protocol 9003

...RTOG researchers led by K. Kian Ang, M.D., Ph.D. of the University of Texas M.D. Anderson Cancer Center, who is the lead
author of the study being published in the NEJM, and Maura L. Gillison, M.D., Ph.D. of The Ohio State University, who directed
the HPV analysis, found that oropharyngeal cancer patients with HPV-positive tumors had a survival rate 25 percentage points
higher at three years (82.4% vs. 57.1%) than patients on the study with HPV-negative tumors. This survival benefit was seen
irrespective of the assigned cancer treatment and traditional prognostic factors such as tumor stage and age. The researchers
also found that tobacco smoking was independently associated with survival for both groups of patients and the risk of death and cancer progression increased by 1% for each pack-year of tobacco smoking.

nice post.... am I finally relieved from being the person that watches the hard data and posts it here?

I have questions around such a high rate of oral cancer being attributable to HPV.

I can see that 64% of all patients could test positive for HPV (and have read figures much higher), but how can one say that the HPV caused the oral cancer? And surely if this is what is being suggested, the patient group would have to be non-smoking otherwise, how could one relate the cancer to HPV and not smoking? I would also suggest this figure might be possible in young patients under 50 (or even 60)?

Waiting for the publication with bated breath.

Also, DonB, I needed your skills a few months ago when I took 3 (very long) emails to convince our RO to test my Alex for HPV (RO was convinced HPV status was irrelevant because Alex had a smoking/drinking history). My attempt to summarise the abstract was long winded and convoluted in making the point you make so eloquently. Will call on you the next time I have to go into battle for something.

The HPV virus invades the squamous cells found in the BOT and tonsils and basically overrides 2 "built in" cellular safe guards that prevents a normal cell from reproducing too soon and too often, i.e., the now defective cell reproduces at a fast rate and can not be stopped (without radiation) and that is a very basic definition of the oral cancer caused by HPV.