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HPV Linked to Head and Neck Cancer

Virus responsible for more than 60% of oropharyngeal disease

Tobacco and alcohol use may be the most common cause of head and neck cancers, but a new culprit has come on the scene in recent years.

The human papillomavirus (HPV) is now responsible for more than 60% of the cases of oropharyngeal cancer diagnosed at Pennsylvania State University’s Milton S. Hershey Medical Center, according to Dr. David Goldenberg, professor of surgery and medicine, and director of head and neck surgery.

Oropharyngeal cancer can affect the back third of the tongue, the soft palate, the side and back walls of the throat, and the tonsils.

“Infection with certain kinds of HPV is a growing risk for some types of head and neck cancer in those who have never smoked,” Goldenberg said.

HPV is the most common sexually transmitted infection — so common that most sexually active people get some variety of it at some point in their lives. There are many types of HPV, however, and only some of them cause warts or cancer. Even people who get the type of HPV that can cause cancer may never develop the disease.

In general, head and neck cancers are twice as common among men as they are among women, and most of those cancers are diagnosed in people 50 years of age and older — with the exception of cancers caused by HPV. Those are showing up in younger people.

Head and neck cancers begin with abnormal changes in the squamous cells that line the moist surfaces inside the head and neck, including the throat, nose, mouth, and swallowing passage. People who use both alcohol and tobacco heavily are at much greater risk compared with those who only smoke.

“There is a synergistic effect with the combination of alcohol and tobacco together,” Goldenberg said.

Head and neck cancers sometimes show up as neck lumps, mouth sores, ill-fitting dentures, or loose teeth. In other cases, the cancer is identified by hoarseness, a sore throat, or a feeling of something stuck in the throat.

Treatments for head and neck cancers include surgery, radiation, chemotherapy, or a combination of these. The appropriate treatment approach depends on the location and size of the cancer, and on the patient’s health and preference. Goldenberg said certain areas are more amenable to surgery, while others are better treated with a combination of chemotherapy and radiation.

Like most cancer, the “garden variety” head and neck cancers have a poor prognosis if they are not caught early, he said. HPV-induced cancers, however, have a much better prognosis. For all types, Goldenberg said, early diagnosis is the key.

Source: Medical Xpress; April 3, 2015.

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