Is HPV- more aggressive than HPV+ tumors?

I am not sure if HPV- is more aggressive, I just know that studies have shown HPV+ responds much better to treatments than HPV-. What I just read was that the HPV hijacks the host cancer cell leading to expression of a viral antigen on the surface, causing the patient's immune system to ramp up and fight the cancer.

According to the many studies the non HPV+ version of HNC has much higher morbidity, there is no controversy over this as the different stats are quite similar: 50% ish for HPV- and 90% for HPV+

Probably should have said harder to kill vs more aggressive. Both HPV+ SCC and HPV- SCC are aggressive.

Hi okay - sorry I'm in Italy so I've been out of touch otherwise I would have weighed in before now. - YOU DO NOT WANT TO WAIT! Sorry - this cancer can be VERY aggressive particularly in young people who have no precursors - this is a new demographic - in the past it was primarily an old man's disease, and those afflicted were heavy smokers and drinkers. I'm thinking this is not the case with you so....
It doesn't make sense your surgeon wants to wait for you to heal, firstly an area of tissue with cancer present tends not to heal all that well - if at all, and secondly why would he let you heal only to go back in and cut you open again? No only that, in the time that the cells are still in situ they continue to grow, and can potentially seed to the nodes. This is not a sprained ankle or broken leg, time will not help matters it can only get worse - this is cancer.
The primary treatment for non HPV related tongue cancer is surgery, it should all be removed with good margins. Your dr. needs to go back in asap. Some drs make the mistake of thinking "well its gone we're good" only to discover it in the nodes later. This is a tricky disease, by waiting you risk the potential of it spreading, and not only having to have a piece removed from your tongue - but also having a neck dissection and removal of a bunch of nodes. And possibly a need for follow up rads and chemo. All of this because your dr. wanted to wait. No one wants to go back into surgery, I totally get it, but better this than the potential for more aggressive treatment at a later date.
In the past 18 months we've lost three young members to oral cancer, two were tongue and one was gum or cheek, Samantha Kemper 22, Nate Johnson 27 (I think) and MTlisa (26/27 - I believe) - Samantha had 3 recurrences in 18 months. This disease is aggressive, it has a high mortality rate. Another friend who was a few months ahead of me in treatment had a very small one mm superficial cancer, her dr. - obviously very familiar with oral cancer had a feeling despite it being superficial - it was aggressive so he removed lymph nodes as well. Sounds like overkill right? he found cancer in one of her nodes and it had moved outside, she did 33 radiation treatments and 3 chemos even though she was a stage one cancer. 1cm is a stage one, it doesn't sound big, but its big enough. Best of luck... Sorry I didn't want to scare you but you need to know how aggressive this can be. Hugs.

My doctor told me its impossible for carcinoma in situ to spread, and many doctors consider it pre-cancer, and not actually cancer.

Carcinoma in situ is an early form of cancer, so it is cancer, and can spread. I had carcinoma in situ in the tonsil, and look at my singnature, which is only half of it lol. Sounds like they did an excisional biopsy, instead of an incisional biopsy, which is sometimes preferred, since the excisional may not have clear margin sometimes, such as yours, if true, and need for another surgery to get clear margins.

A biopsy by an oral surgeon of a small bit of a leukoplakia (white patch) on my husband's mobile tongue came back with a diagnosis of moderate dysplasia (not cancer, but not normal, either) -- but by the time of an ENT's excisional biopsy a month later (hey, the first diagnosis wasn't cancer, so what's the rush?) it had turned into squamous cell carcinoma in situ with a small bit superficially invasive.

I gather that what is left on your tongue has been diagnosed as dysplasia, not cancer (as the 1-cm area already removed from your tongue was). Not all dysplasia turns to cancer -- but you've already been diagnosed with cancer once, so it's more likely than not, I'd think, that what's left could also turn to the dark side. Carcinoma in situ is cancer, and it does spread. The cancer journey of every patient here began with carcinoma in situ; in the seven years that I've been here, only a few were lucky enough to have it identified, removed and diagnosed at that stage.

If I were in your situation, I'd get what's left taken out pronto. This isn't something you want to sit on and see what happens. An appointment ASAP with a comprehensive cancer center that see a LOT of oral cancer would be prudent.

Josh,
Where was your tumor and could you tell me what it looked like?

Hi Leslie thanks for the info, so far the only information that hasn't given me a mini heart attack, I did have a partial glossectomy, did everything go well with your husbands surgery?