The FDA is to be applauded for its recent approval of the expanded use of a human papilloma virus (HPV) vaccine for individuals up to age 45. We must be aware, however, that if someone has been exposed to certain strains of HPV, the vaccine may not work for them.
We also 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.
The term “HPV” includes more than one hundred subtypes of the virus. Most of us are exposed to these viruses once we become sexually active. A vast majority of HPV viruses are cleared from our bodies. If not cleared the virus can stay inside our cells for years. It may then cause warts, benign tumors or on rare occasions, cancer. HPV-related 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 of the tongue and area surrounding the tonsils) used to affect older men – long-time 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 Institutes of Health, HPV is now responsible for 70% or more of oropharyngeal cancers. The incidence of oral, head and neck cancers associated with HPV is likely to overtake that of cervical cancer by 2020. There is no early warning sign that is specific to HPV-associated throat cancer. Symptoms can be the same as in a common cold or upper respiratory infection. Sometimes patients can see an ulcer in their tonsil or feel a lump in the neck that is not painful. However, when any of these symptoms do not go away for more than two to three weeks, it’s time to seek help.
If 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 head, neck and throat area carefully. Dentists can also detect suspicious looking lumps or ulcers. Treatments for these cancers have improved in recent years. Therapies include minimally invasive robotic surgery done through the mouth, highly targeted radiation therapy that spares healthy tissue, and immunotherapies that harness the immune system to destroy cancer cells.
There are different HPV vaccines available that are effective at significantly decreasing the HPV infection rate. 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. Don’t be afraid to speak with your physician and your significant other. And get your children vaccinated.
- Tom Thomas, MD, director, Head and Neck Reconstructive Surgery and Transoral Robotic Surgery, Leonard B. Kahn Head and Neck Cancer Institute, Morristown Medical Center’s Carol G. Simon Cancer Center.
Source: Daily Record