Misunderstandings about how head and neck cancer is related to human papillomavirus (HPV), which has been historically thought of as a cause of cervical cancer, has been debunked by nationally known expert Tom Thomas, MD, MPH on the World Head and Neck Cancer Day 2020.
Dr. Thomas is medical director, Head and Neck Reconstructive Surgery and Transoral Robotic Surgery, Leonard B. Kahn Head and Neck Cancer Institute at Atlantic Health System's Morristown Medical Center and Carol G. Simon Cancer Center. He is one of the leaders of the Atlantic HPV Center.
"The fact is, that HPV has increasingly become one of the major causes of head and neck cancers, particularly oropharyngeal cancer," says Dr. Thomas. "We are seeing an increasing number of HPV-associated oropharyngeal cancers, which affect the back of the tongue and tonsils."
1.HPV-associated cancers of the head and neck have tripled in the past several decades, while other types of head and neck cancers have declined. According to the National Cancer Institute, HPV is now responsible for 70% or more of oropharyngeal cancers.
2.Cancer of the oropharynx used to affect older men - longtime heavy smokers or drinkers. Many of today's patients with HPV-associated throat cancer are men in their 40s and 50s.
3.The incidence of head and neck cancers associated with HPV is expected to outnumber that of cervical cancer this year.
4.There are no early warning signs that are specific to HPV-associated throat cancer. Symptoms can mimic a typical upper respiratory infection that is not getting better. Sometimes patients can have earache, hoarse voice and/or burning pain with swallowing. Other times there may be a painless lump in the neck or ulcer on a tonsil. When any of these symptoms persist for more than three weeks, it's time to seek help.
5."HPV" includes a family of over 200 viruses. It is transmitted through direct contact. Most of us are exposed to these viruses once we become sexually active. Usually, we clear the virus through our immune system without even realizing its presence. In a minority of individuals, the virus evades our detection system and stays inside our cells for years. It may then cause warts, benign tumors or on rare occasions, cancer.
6.The U.S. Food and Drug Administration (FDA) recently approved expanding the HPV vaccine's use to include women and men aged 27 through 45 years. The first HPV vaccine was approved in 2006, to be given to children 9 to 12 years old.
7.Despite widespread recognition of the effectiveness of the HPV vaccine within the medical community, we still need to overcome the embarrassment and stigma associated with head and neck cancers caused by HPV - the most common sexually transmitted disease.
8.We are many years into this growing silent epidemic, and the stigma shows no signs of abating. If you get HPV-associated cancer, or suspect you may have it, you are not alone. Do not be afraid to speak with your physician and your significant other.
9.More importantly, get your children vaccinated.
Treatments for these cancers have significantly improved in recent years, and may include minimally invasive robotic or laser surgery done through the mouth, targeted radiation therapy that spares healthy tissue, and chemotherapy or immunotherapy.
10.The best treatment for HPV associated head and neck cancer is prevention through the HPV vaccine. Early detection may also result in effective treatment, and possibly a cure. If a physician discovers a lump or ulceration in your throat, he or she should refer you to a specialist: an otolaryngologist (ENT) or head and neck surgeon. Dentists can also detect suspicious-looking lumps or ulcers in the mouth.
"If you do not have symptoms, but you or someone you have been intimate with has a history of sexually transmitted diseases, ask your physician to examine your throat and neck area carefully," adds Dr. Thomas.