Eileen,

Well when you put it that way it does sound stupid to think that there couldn't an HPV+ patient with a tobacco history. I guess I have just been blinded by the thought that if I had SCC and I was not a tobacco user then HPV was likely my cause and the reverse seemed logical that if I had SCC and I was a tobacco user then tobacco was the likely cause. I guess it's even a logical conclusion that a tobacco user could have 2 different Oral cancers going on at the same time. One HPV+ and one HPV-. The more I think I understand, the less I really know.

David,
One person with two primaries, one from HPV and the other potentially from smoking sound possible enough, but so far non of the studies have reported this.

They do seem to routinely find that at least 20% of the HPV caused SCC is found in people who also happen to smoke.

The percentage of HPV caused OC found in smokers should closely parallel the smoking rate, and (guess what!) that rate is also about 20% of US adults.

My MO is working on the "she's only 40 it's probably caused by the HPV16" theory. Stating that it wont make a bit of difference on how we treat you. What will be different is the reoccurance rate. I have to say. This was the only time in my life I HOPED to be positive for an STD.
Amy

I'll drink to that...although since this surgery .....they may not be far off lol

Don,

I wonder if they ever look beyond finding one or the other? So many variables to consider and I'm still stuck in the marvels of our Universe.

David,
For Oropharynx OC, I believe the percentage attributed to other "unknowns" was roughly 15% in the May 2007 study:

Case�Control Study of Human Papillomavirus and Oropharyngeal Cancer (Maura L. Gillison, Johns Hopkins et al...)

The way the study presents this "slice of the pie" using odds ratios and seemingly very broad Confidence Intervals for each of these possible (but perhaps unlikely) risk factors makes it hard for me to be sure if I am understanding it properly.

("Unknowns" being genetic, various dental hygiene factors, diet, low BMI, and others mentioned in the study)

It's like trying to debate the chicken and the egg theory. You will just spin your wheels, chase your tail and drive yourself mad. Too many veriables and with humans there will always be.
What is important is fixing it. IMO

Hi Amy,

I did not have the same treatment you are having but I did have a panic attck and it is scary!!! I was in a meeting at work and had to leave. My fiancee took me to the hospital and they said I was fine. Now every time I go my oncologist I'm scared. I started seeing a therapist and that has helped me a lot. I'm sure you feel overwhelmed with doctor appointments and can't think about another one, but seeing therapist is the only thing that has helped me. I go every 2 weeks and I take Lexapro. They gave me Xanex and it did not help. Lexapro (and other meds) are taken daily and keep you on a even keel so you can cope. You should talk to your doc about it. It has been a miracle for me.