ALCON,
This could really be a constructive post to help people form fundamental assumptions about how to view the condition from a long term lense, and to know whether to be vigilant, or not. Many of us have only have anectdotal evidence to present (which has some value), but others collect real empirical data or have extensively studied the issues which now should be brought forward.
Skynet has asked us, "Do I need to worry about my son's mother?" He also communicates that the patient is Stage 4b. (a sizable primary, with presence regional multiple nodal disease) I believe my ENT surgeon would be highly vigilent in wanting to monitor the patient's condition. The initial treatment outcome, at only one year out, is not fully known.
In reality this message board is saturated with the feel good expressions of many and that is great, but not when someone is asking for information. The consequence is that a new poster, like Skynet will be distracted from the problems he should focus on and lose confidence in this message board as a source of information. While the feel good clap-trap has a place on the board, make attempt to comply in satisfying the requests people, or, please start you own thread and label it "three monkeys".
This board prospers in part because the real medical literature is squirreled away on paid information sites despite the fact that the studies were often funded with taxpayer funds (a different issue).
Given that NIH funded SEER outcome studies don't parse out HPV, can somebody at least provide Skynet with the basic recognized factors which are suspected as impacting HPV SCC oropharyngeal re-ocurrence?
Here is my first brush at it:
1) First not everybody survives this condition. Hidden in the SEER tables is a 8-10% death rate of those who do not survive treatment. The traditional factors affect this number, poor nutrition, lack of care, adverse reactions, suicide etc. (Skynet's spouse one year out has thankfully cleared this hurdle) The currently published 10 year SEER table for head and neck cancer for all causes combined is 19% (data from 1994-2004)
2) Effectiveness of treatment generally impacted by the selected treatment modality. i.e. Surgery, Radiation, Chemo
3) Stage of disease, not necessarily as important how many nodes, but how low the infected nodes appear in the neck.
4) The quality of the patients immune system. HPV SCC cancer is expressed more often in patients with immune system problems. HPV cancer does re-occur more often in patients with comprimised immune systems.
5) Oropharyngeal cancer is recognized as a lower outcome than some other expressions (like base of tongue) due to the nodal path being shorter supporting progression of disease.
6) While re-occurance is an uncommon outcome, at one year out, you do not yet have full knowledge of the success of the initial treatment.
Please excuse my frustration, but I don't wish to see the propogation of ignorance to the primary caretaker of cancer patient only one year out.
Mark