p16 positive

RogerRN43

I just found out my removed left tonsil came back p16+ which I understand is a protein marker for HPV and not necessarily mean that HPV is active in me now.
I'm in Canada, is the p16 test used in the U.S. to determine HPV positivity?

I'm trying to understand if that really means my SCC can be classified in the HPV prognostic group.

michdjp

My dads also came back
My dads also came back p16ink4 positive and he was diagnosed as hpv positive. Our drs. Here said it did not change the treatment course but did give it a better outcome as this responds very well to the treatment.
Hope all goes well for you
Michelle

jtl

HPV
It occurred to me that being HPV positive and having a better outcome with treatment is only valid if you have never smoked or consumed alcohol. The latter may have been the cause of the cancer. Does that make any sense?

fisrpotpe

Help
I have heard many times the success rates are much higher with the HPV. My understanding is the treatments do not change. There is talk going on that lesser treatments might work. One question I would have is am I the one that wants to risk taking the lessor of the treatments.
I do believe sometime we have to learn more than we really need to. Cancer is cancer and kicking cancers back side is hard. SCC is bad is associated with HPV.

My I ask why you are needing to know?

Praying for success and continued survivorship.

John

Skiffin16

HPV16
Are you sure that the biopsy didn't come back as HPV16+...

HPV16+ is the more common tpye of HPV for H&N Cancer?

Best,
John

robinleigh

good news
My husband was p16 positive as well. All doctors said that is a "good thing" because the cancer is more responsive to treatment. I think that you would be considered HPV positive with those results.

BTW...My husband is a very rare case, in that his cancer has metastasized. But, as far as what we've been told by 4 doctors, HPV positive SCC is considered 97% CURABLE! Sooooo....we are in a rare 3% that was not cured.

Won't give up, still fighting, gonna beat it!!!

Robinleigh

longtermsurvivor

robinleigh said:

good news
My husband was p16 positive as well. All doctors said that is a "good thing" because the cancer is more responsive to treatment. I think that you would be considered HPV positive with those results.

BTW...My husband is a very rare case, in that his cancer has metastasized. But, as far as what we've been told by 4 doctors, HPV positive SCC is considered 97% CURABLE! Sooooo....we are in a rare 3% that was not cured.

Won't give up, still fighting, gonna beat it!!!

Robinleigh

Hi Robin
Your husband is a good example of how, on an individual level, statistics don't mean that much. I've never had my malignancies HPV tested. Even if positive, I am who I am. And as someone posted above, since I used to smoke, I could obsess on the statistics till I went crazy if I just put all this information in a pot and stirred.

Hope things are going well.

Pat

RogerRN43

Skiffin16 said:

HPV16
Are you sure that the biopsy didn't come back as HPV16+...

HPV16+ is the more common tpye of HPV for H&N Cancer?

Best,
John

Found something on p16
From a journal article in IJC:

"P16 expression was found to be a strong independent prognostic factor for 5-year disease-free survival and showed a tendency for better 5-year overall survival. In multivariate Cox analysis, p16 remained to be an independent prognostic factor. The prediction for disease-free survival of p16 expression was superior to all clinicopathological parameters normally used for treatment decisions and assessment of prognosis."

I guess that's why they used the p16 test. I briefly mentioned HPV cause at my initial appt back in Oct, it was my rad onc's interest to have the test done, I didn't push for it. He did say it would not change the treatment, it only had prognostic value.

I dislike stats, we are not stats, we are individuals that can fall on any part of the spectrum whether the stats are for or against us, but at least now I can use this as a part of my personal hope.

Whether our SCC has an HPV cause or not, we all have a chance to be blessed, it has been proven by the different survivors.

jtl

robinleigh said:

good news
My husband was p16 positive as well. All doctors said that is a "good thing" because the cancer is more responsive to treatment. I think that you would be considered HPV positive with those results.

BTW...My husband is a very rare case, in that his cancer has metastasized. But, as far as what we've been told by 4 doctors, HPV positive SCC is considered 97% CURABLE! Sooooo....we are in a rare 3% that was not cured.

Won't give up, still fighting, gonna beat it!!!

Robinleigh

Cure?
Are you sure that the 97% isn't a one year survival rate?

jtl

RogerRN43 said:

Found something on p16
From a journal article in IJC:

"P16 expression was found to be a strong independent prognostic factor for 5-year disease-free survival and showed a tendency for better 5-year overall survival. In multivariate Cox analysis, p16 remained to be an independent prognostic factor. The prediction for disease-free survival of p16 expression was superior to all clinicopathological parameters normally used for treatment decisions and assessment of prognosis."

I guess that's why they used the p16 test. I briefly mentioned HPV cause at my initial appt back in Oct, it was my rad onc's interest to have the test done, I didn't push for it. He did say it would not change the treatment, it only had prognostic value.

I dislike stats, we are not stats, we are individuals that can fall on any part of the spectrum whether the stats are for or against us, but at least now I can use this as a part of my personal hope.

Whether our SCC has an HPV cause or not, we all have a chance to be blessed, it has been proven by the different survivors.

P16
Just spoke to my Onc about this. He said the common procedure today is to test for the P16 marker. I then read online that the range is from from P16+1 to P16+3 the latter being almost a given for positive HPV. However P16+1 is considered to be a sign of HPV just not as high a correlation. Testing directly for HPV is more time consuming and expensive because the test is done in a lab whereas the staining for the P16 antibody can be done by the pathologist. This may be the test we are getting these days and then it is extrapolated to HPV positive or negative. Anyway I am having it done.

RogerRN43

jtl said:

Cure?
Are you sure that the 97% isn't a one year survival rate?

97% seems high
From what I've read, 85-90% disease free 5y is the common range.

"Eric Genden, chief of head and neck oncology at Mt. Sinai Medical Center, tells the Health Blog that when treated appropriately, patients with HPV-positive cancers have an 85% to 90% disease-free survival rate over five years."

http://blogs.wsj.com/health/2011/05/31/with-hpv-related-head-and-neck-cancers-rising-focus-on-treatment-and-vaccination/

Marty36

RogerRN43 said:

97% seems high
From what I've read, 85-90% disease free 5y is the common range.

"Eric Genden, chief of head and neck oncology at Mt. Sinai Medical Center, tells the Health Blog that when treated appropriately, patients with HPV-positive cancers have an 85% to 90% disease-free survival rate over five years."

http://blogs.wsj.com/health/2011/05/31/with-hpv-related-head-and-neck-cancers-rising-focus-on-treatment-and-vaccination/

I was told 90-93%. While my
I was told 90-93%. While my ENT suggested maybe a less agressive treatment, post-surgery, may be possible my oncologist and radiology onc said they felt be as aggressive as necessary to increase the chances of success.

While it may not impact treatment, I think it does help frame the treatment for the patient. I won't forget being told by the resident that although this is very scary having oral cancer, being HPV+ (and a non-smoker and non-drinker) meant all the statistics I was going to read on the Internet don't really apply. That kind of framing can be very comforting as one begins treatment or contemplates the future. For some people, statistics and quantifying the reality can mean a lot to how they approach having cancer.

jtl

RogerRN43 said:

97% seems high
From what I've read, 85-90% disease free 5y is the common range.

"Eric Genden, chief of head and neck oncology at Mt. Sinai Medical Center, tells the Health Blog that when treated appropriately, patients with HPV-positive cancers have an 85% to 90% disease-free survival rate over five years."

http://blogs.wsj.com/health/2011/05/31/with-hpv-related-head-and-neck-cancers-rising-focus-on-treatment-and-vaccination/

Roger
Agree. No question that HPV+ is the thing to have. Now I hope my test comes back at a high 16+ but I'm afraid that my many years of smoking are going to haunt me even though I quit a dozen years ago.

Baygal

RogerRN43 said:

97% seems high
From what I've read, 85-90% disease free 5y is the common range.

"Eric Genden, chief of head and neck oncology at Mt. Sinai Medical Center, tells the Health Blog that when treated appropriately, patients with HPV-positive cancers have an 85% to 90% disease-free survival rate over five years."

http://blogs.wsj.com/health/2011/05/31/with-hpv-related-head-and-neck-cancers-rising-focus-on-treatment-and-vaccination/

Study on HPV 16 positive Cure rates
Found this study that may held.

http://oralcancerfoundation.org/hpv/pdf/NEJM_Gillison.pdf

jtl

Baygal said:

Study on HPV 16 positive Cure rates
Found this study that may held.

http://oralcancerfoundation.org/hpv/pdf/NEJM_Gillison.pdf

Cure rates
I don't belive there really are "cure" rates only multi-year survival rates. Hopefully time will prove them to be one and the same.
Regards,
John

Baygal

jtl said:

Cure rates
I don't belive there really are "cure" rates only multi-year survival rates. Hopefully time will prove them to be one and the same.
Regards,
John

Miss wrote
I ment to say survival rate...sorry. Were you able to read the article?

jtl

Baygal said:

Miss wrote
I ment to say survival rate...sorry. Were you able to read the article?

Article
I read most of it, confirms that if you have this type cancer may as well be HPV+ to have a better outcome.
John

robinleigh

statistics
WOW!!! I went to the Oral Cancer Foundation website and used their search engine for "survival rates". To say the least, it is an extremely complicated process the way they come up with these numbers. It actually made me feel even better about the wisdom in not considering yourself a statistic at all.

I hope that my quoting the 97% cure rate wasn't totally inaccurate. I do know that from day 1 our doctor at Mayo said this cancer was curable but that if there is a recurrence (which is most common in the first 2 years) that it becomes a treatable cancer.

My husband falls in the category of having a treatable cancer and it is frightening to say the least. As time goes on, we both embrace the hope that he will "beat the odds". We received a 4th opinion at Johns Hopkins recently because so much of the HPV pos. cancer research has come from there and I didn't want to leave any stone unturned. The oncologist there said that she has patients with the same metastasis as Andy who are 6 years out. A lot depends on how well he can tolerate ongoing systemic treatment. So far, so good.

He began a clinical trial last week and it is a double-blind, randomized Phase III trial. If any of you are interested, google Reolysin to read about this virus that they are studying. We hope and pray that he actually received the trial drug.

OOPS...Didn't mean to hijack the thread. Maybe I'll start a new one on people's experience with clinical trials...

Back to your subject, Roger! You sound like you have a very good prognosis with being p16 pos. I think of you often because of your photos with your darling children and know that you will be there to see all of their milestones in life! You are a rockin' Dad!

Robin