I have a quick question relating to my diagnosis. The hospital is beating around the bush and will not confirm whether my cancer was from HPV or not. My surgical oncologist mentioned that HPV is only related to cancers at the BOT and neck. Should I push to have them test for this? Is there anyone out there who had SCC in the front of tongue who was HPV +?

Thanks!

If they did not test for HPV then they have no answer. If they did, they should be able to tell you the results. My understanding HPV status does not factor into the treatment plan, so some doctors may feel it is not critical info to have. I may be way off base but that is my understanding of it.

Overall survivability is greatly influenced by HPV status so it is something you may or may not wish to know.

From what I gather base of tongue is more associated with HPV+, front of tongue tends to be more common in smoker related oral cancer.

Don

No expert here, but we're specifically talking about HPV-16, which 90% of the time it is if HPV cancer related, and to a lesser extent, HPV-18, which effects the oropharynx. There are cases of HPV-16 occurring in the oral tongue, to what extent is not sure, and some thought is it may be a misdiagnosis as oral tongue or a metasteses when it was in fact the oropharynx, BOT all along. HPV-16 can occurr in the nasopharynx and larynx also, but majority of cases is the oropharynx, and is where they should look for the primary. Treatment is pretty much the same for HPV positive or negative in the oropharynx, but in the oropharynx there is better response to treatment and prognosis, but that's only in the oropharyx, and no positive change in survival or response is seen outside this area. There are trials for treatment deescalation for HPV positive oropharynx cancer. If they did a surgical biopsy, they should still have a sample on file, frozen section, which can be tested for HPV.

agreed. Usually oral tongue is NOT related to oral tongue cancer. But this does have bearing on treatment. HPV related cancers often respond very well to rads and chemo because of this they often avoid doing surgery. (Unless it's in the tonsils or a massive tumor they want to debulk) usually non HPV related oral tongue cancer is treated with surgery first (hemiglossectomy possible flap - and nodes) or cheek or gum cancer is often treated the same way.

Hugs

The NCCI standard of care does not differentiate different courses of therapy based on HPV status. We all know it will change once sufficient studies are fully vetted and the medical community coalesces around the finding that the etiology of HPV p16+ is different and is treated differently.

In addition, NCCN guidelines recommends tumor HPV testing as part of the initial work-up for oropharyngeal cancer, for prognostic purposes, but there is no recommendation for HPV testing in the oral cavity, elsewhere, in the head and neck.

If you want your cancer cells tested, TELL THEM.

Mr. Fish (aka Se�or Pesce), is there a particular reason you want to know? I suspect the bean counter in you is looking at numbers. That's just what we do. If you zero in on the recurrence rate of HPV+ as a predictor of future problems, you discount the massive benefit you received from early detection. That alone is a huge factor!

Keep on...you rocked it up to this point and no reason to believe that will change.

Ed

Gawd...I love the last phantom post.

Copy & Paste = Phantom Posts = No-No.