The FDA is to be applauded for its recent approval of the expanded use of a human papillomavirus (HPV) vaccine for individuals up to age 45.
We need to overcome the misunderstanding, embarrassment and stigma associated with head and neck cancers caused by HPV – the most common sexually transmitted disease. We must do this not just for the sake of those who suffer today, but for the next generation, says , says Tom Thomas, MD, MPH, is director of head and neck reconstructive surgery and transoral robotic surgery at Morristown Medical Center.
“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. A vast majority of us, through our immune system, clear the HPV without even realizing its presence. In a minority of us, the virus can evade our detection system and stay inside our cells for years.
It may then cause warts, benign tumors or, on rare occasions, cancer. HPV-associated cancers of the head and neck have tripled in the past several decades, while other types of head and neck cancers have been declining. Cancer of the oropharynx (back and side of the tongue and the tonsils) 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.
According to the National Cancer Institute, HPV is now responsible for 70% or more of oropharyngeal cancers. The incidence of head and neck cancers associated with HPV will, if not already, outnumber that of cervical cancer in 2020.
Symptoms and Treatments
If a physician discovers a lump or ulceration in your throat, he or she should refer you to a specialist such as an otolaryngologist (ENT) or head and neck surgeon. If you do not have these 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. Dentists can also detect suspicious-looking lumps or ulcers in the mouth. Treatments for these cancers have significantly improved in recent years. Therapies may include minimally invasive robotic or laser surgery done through the mouth, targeted radiation therapy that spares healthy tissue, and tried-and-true chemotherapy.
The best treatment for HPV-associated head and neck cancer is prevention. We have effective HPV vaccines that prevent infection with cancer-causing HPV types. In general, the vaccine must be given before a person has become sexually intimate. 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. More importantly, get your children vaccinated.