The HPV vaccine has brought the link between HPV and cervical cancer to the attention of many Americans; and while women have been the focus of much of the talk around HPV and cancer, the sexual transmitted infection also puts men at risk for certain cancers.
HPV can lead to anal and penile cancers, as well as cancers of the oropharynx (the middle part of the throat, at the rear of the mouth, including the back of the tongue and the tonsils). In fact, says Memorial Sloan Kettering head and neck surgeon and scientist Bhuvanesh Singh, HPV-related oral cancers are the fastest-growing type of head and neck cancer in the nation, particularly among men.
In recognition of Head and Neck Cancer Awareness Month, we spoke to Dr. Singh about common questions related to oral cancers caused by HPV.
How does HPV infection affect my risk for getting head and neck cancer?
Typically, it can take years, even decades, for HPV to promote the development of head and neck cancer. These cancers most often occur in the base of the tongue or the tonsils. Your risk for developing head and neck cancer depends in part on the type of HPV to which you were exposed. For instance, some strains cause warts on the skin, mouth, or genitals, and rarely, if ever, cause cancer. Other strains are higher risk and have a greater association with cancer formation; those most commonly associated with head and neck cancer are HPV-16 and, less commonly, HPV-18.
Thankfully, for most people, including those with high-risk HPV, the body will get rid of the infection on its own. Unfortunately there is no way to predict which individuals infected with high-risk strains such as HPV-16 will go on to develop cancer.
Will alcohol or tobacco use increase my risk for developing HPV-related head and neck cancer?
Alcohol and tobacco use are major risk factors for head and neck cancer; however, they do not appear to affect the development of HPV-related head and neck cancer. In fact, people who smoke or drink heavily and have been infected with HPV tend to have a tumor that behaves more like one caused by alcohol and tobacco use. That said, heavy alcohol or tobacco use can certainly have an impact on your prognosis and your overall health.
How do I know if HPV caused my cancer, and if it did, what are my chances for a cure?
When head and neck cancer is diagnosed, the tumor can be tested for HPV using one of several methods. At Memorial Sloan Kettering, this type of testing is standard for all cancers of the oropharynx.
Generally speaking, patients with HPV-positive head and neck cancer have a very high cure rate — around 90 percent. In part this is because people who develop the disease are typically younger than the average head and neck cancer patient and therefore are better able to tolerate treatment.
Another reason these patients do well is that HPV-associated cancers respond better to currently used treatments than head and neck cancers associated with alcohol and tobacco use.
Current research at Memorial Sloan Kettering is looking at ways to minimize the side effects of treatment for patients with HPV-related oral cancers. For example, we are currently studying ways to use robotic technology to remove HPV-associated cancer with the hope of avoiding chemotherapy and/or radiation therapy. The challenge of current research is to decrease the treatment intensity without affecting a patient’s chances for a cure.
Should I get the HPV vaccine to prevent head and neck cancer?
The HPV vaccine is only useful before a person is exposed to the virus; it is currently recommended prior to any onset of sexual activity for boys and girls between ages 11 to 14.
The main proven benefit of the HPV vaccine is that it prevents cervical cancer and genital warts. The data on head and neck cancer prevention doesn’t exist yet, but certainly the hope is that once the benefits of the HPV vaccine begin to take effect, we’ll see a significant reduction in the incidence of HPV-positive oral cancers.