By Larry N. Silverman, MD, 21st Century Oncology –
Approximately 50,000 new cases of head and neck cancer are diagnosed in the U.S. on a yearly basis. This represents 3% of all newly diagnosed cancers.
Major Risk Factors and Symptoms
The major risk factors are tobacco and alcohol usage. Typical symptoms caused by head and neck cancers include sore throat, feeling of a lump in the throat, hoarseness, difficulty swallowing, pain, bleeding, and weight loss.
Since the 1980’s, a steady decline in the incidence of head and neck cancer has occurred. This has been associated with a decline in tobacco usage. More recently, however, there has been a significant rise in one type of head and neck cancer linked to HPV.
What is HPV?
HPV is responsible for 70 – 80% of the cancers which are located in the back of the throat. HPV, or human papillomavirus, is the most common sexually transmitted infection affecting both men and women. In 90% of cases, the infection goes away within two years without causing any health problems. Most people don’t even know that they are infected because no symptoms are present.
Approximately 20 million Americans are currently infected with 6 million more becoming infected each year. Fifty percent of sexually active men and women will be infected at some point in their lives. Certain high risk strains can cause noncancerous growths, precancerous growths, or cancer. HPV strains 16 & 18 are responsible for the majority of HPV related cancers.
The Link Between Cancer and HPV
Cancer is caused by HPV when it infects cells of the human body. Once inside a cell, it blocks normal cellular functioning enabling uncontrolled growth of the cells. Mutations then occur which can lead to formation of a cancer. The process is slow and 10 to 20 years can elapse from initial infection until cancer develops. Infections progress to cancer 50% or less of the time.
The most well established association between HPV and cancer is with cancers of the female reproductive tract which are almost all HPV related. Other cancers caused by HPV include male urinary tract cancers, anal cancer and, more recently, head and neck cancers of the back of the throat.
Those Most Affected by HPV Head and Neck Cancers
HPV positive head and neck cancers differ in many ways from HPV negative head and neck cancers. HPV 16 is the primary type associated with their development. Within the head and neck area, they primarily arise within the base of tongue or tonsil. They are typically found in white males of higher socioeconomic class. Those affected don’t have the typical risk factors of tobacco and alcohol usage. By history, they have a higher number of sex partners and more oral sex partners. The cancers themselves are smaller at the primary site but more advanced in the lymph nodes. They have a better prognosis and are less likely to develop distant spread.
Treatment for head and neck cancers typically includes radiation, chemotherapy, and/or surgery. The stage of the cancer dictates the specific treatment or combination of treatments. Currently, HPV positive head and neck cancers are treated the same as HPV negative head and neck cancers.
Ongoing research is currently evaluating whether or not these cancers may require less aggressive forms of treatment. There are currently two vaccines on the market for HPV. For girls, Cervarix and Gardasil, and for boys, Gardasil.
To learn more, please contact Larry N. Silverman, MD, at 21st Century Oncology, (941) 364-8887 or visit us online at www.21stcenturyoncology.com.