The role of HPV in head, neck, and throat cancers
Today it is well-known that HPV (Human papilomavirus) causes cervical cancer in women and genital warts in men. Less well-known is that the virus causes other cancers such as throat, anus and penis. This threat to men received much publicity when actor Michael Douglas told of his throat cancer and the connection to the HPV infection.
Incredibly over 109 different types of HPV have been identified. Types 6 and 11, which are the root causes of genital warts, are considered to be of lower risk. Those “higher” risk HPV cause different types of cancers in women and men. The virus causes normal cells which are infected to turn abnormal. Most of the time, you cannot see or feel these cells change. In most cases, the body fights off the infection naturally and infected cells return to normal. Unfortunately in some cases the body cannot fight off this virus, causing visible changes to the skin, some leading to cancer.
HPV-related cancers make up over 5% of total diagnosed cancer cases worldwide. Among developing countries this rate is even higher. It is estimated to cause almost half a million cases each year. High-risk types, including HPV-16 and HPV-18, are associated with 99.7% of all cervical cancers and an increasing number of incidents of head and neck cancer.
Traditionally it was thought that throat cancers typically came from tobacco and alcohol use, but now we know that infection with HPV increases the oropharyngeal cancer, the middle part of the throat that includes the base of the tongue, the tonsils, the soft palate and the walls of the pharynx. This cancer is independent of tobacco and alcohol use.
It may come as a surprise to many, given that most associate HPV with women, to discover that current findings indicate this head, neck, and throat cancer turns out to be much more prevalent in men. Among these types of cancers it is also now common to find them in both younger populations and adults aged 40 to 65. Thankfully even though genital HPV may be transmitted from mother to child during birth, the instances of genital HPV transmission to newborns is rare.
It is also important to understand the risks and protection. If a woman attending university has at least one different partner per year for four years, the probability that she will leave college with an HPV infection is greater than 85%. One of the main reasons for this is not promiscuity but the unfortunate reality that condoms are unable to provide adequate protection from the virus. Without covering areas around the genitals, including the inner thigh area, the infection is able to be passed by exposing these areas to the infected person’s skin.
What are the signs of infection?
Some of the common signs and symptoms that an HPV infection has occurred are persistent sore throat, earaches, hoarseness, enlarged lymph nodes, difficulty and pain when swallowing, and unexplained weight loss. While for some these symptoms will set off alarm bells that something is wrong, for others the infection will have no noticeable signs or symptoms.
What about prevention?
Today there are many steps for prevention. Aside from keeping your lifestyle healthy, HPV vaccines are now on the market that were developed to prevent cervical and other less common genital cancers. Newer vaccines have been developed to protect against other types of HPV infection, but given the variety of strains it is only possible to vaccinate against some of them. It is possible that current vaccines may prevent oropharyngeal cancers, since the vaccines prevent an initial infection of HPV types that can cause oropharyngeal cancers. Not enough studies have been done yet to determine if the current vaccination will prevent these cancers.
- Cervarix is one of two HPV vaccines that can be given to prevent cervical cancer (caused by HPV types 16 and 18). It is given to females only.
- Silgard is used in males and females from the age of nine years to protect against HPV types 6, 11, 16, and 18. It shields against HPV viruses that are low risk and cause genital warts.
- Gardasil 9 – protects against five additional virus strains; types 31, 33, 45, 52 and 58. Three doses are recommended for maximum protection over the course of a year. Recommended for both males and females, it is routinely given at 11 or 12 years of age. The safety of Gardasil 9 was studied in clinical trials with more than 15,000 participants before it was licensed and continues to be monitored.
Men and women can be vaccinated in FirstMed with all of these treatments. Contact us for a consultation.