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HPV and Head & Neck Cancer: What Do I Need to Know?

This information explains the relationship between HPV and some head and neck cancers.

What is HPV?

Human Papilloma Virus (HPV) is a virus that can infect the skin and the mucosa (lining) of the mouth, throat, genitals, and anal area. Infections with HPV are common. Most people infected with HPV will not have any symptoms, and their immune system will get rid of the HPV infection without any treatment. In some cases, however, HPV can lead to cancer. We do not know why some people are able to get rid of their HPV infection before it causes cancer, and why others cannot.

Are there different types of HPV?

Yes, and different types of HPV can cause different kinds of infections. Some types of HPV cause warts on the skin, mouth, or genitals. There are other types of HPV that can cause cancer. These are known as high-risk types. The most common type of cancer caused by HPV is cervical cancer. This is why women get Pap smears, which include checking for HPV. High-risk HPV can also cause head and neck cancer in both men and women.

How is HPV spread?

HPV can be spread when the skin or mucosa comes into contact with an infected person's skin or mucosa. For high-risk HPV types, this usually happens through sexual contact. While we do not know for sure, we think most HPV infections that cause head and neck cancer are spread through oral sex, and possibly by “open mouth” kissing. Because HPV is so common, it is hard to know exactly when the infection started or who passed it on.

How does HPV cause head and neck cancer?

We don't know for sure. Most people who are exposed to high-risk HPV will not get cancer. However, some people are unable to get rid of their HPV infection, and the virus creates damage that eventually causes a tumor to grow. It often takes many years for the HPV infected cells to become cancerous. We cannot predict whose infection will disappear and who will develop cancer. Most head and neck cancers that happen as a result of HPV infection occur in the part of the throat that includes the the base of the tongue and the tonsils.

How do I know if HPV caused my cancer?

When a head and neck cancer is diagnosed, the tumor itself can be tested for HPV. This is currently the only way to test if a cancer in the throat is related to HPV.

Does my HPV status change my treatment or my chance of being cured?

In general, patients with HPV positive head and neck cancer have better outcomes than patients with head and neck cancer that is not related to HPV. However, both types of cancers are currently treated in the same way whether or not they are caused by or related to HPV. Treatment decisions are made based on the size and location of the tumor, the stage of the disease, the overall health of the patient and the wishes of the patient Researchers are studying if cancer treatments should be changed based on whether or not HPV is involved.

Am I contagious?

HPV is not spread through routine physical contact (i.e., touching, kissing on the cheek or lips), however HPV is a contagious virus that is extremely common among sexually active people. This means if you have been diagnosed with HPV it is likely that your sexual partners have also been exposed. Since most people get rid of the infection on their own, the chance of your partner getting an HPV- related cancer is very low, even when exposed to high-risk types. If you have cancer caused by HPV, there are no special precautions or specific changes in your sexual practices that are currently recommended.

Should my partner be screened for HPV?

If your partner is female, she should follow normal women's health guidelines, which include having a routine Pap test. If your partner is male, he does not need any special exams or tests because there is no routine or standard HPV screening offered for men. In addition, there is no effective screening test for head and neck cancer. No other special precautions are necessary, as your partner's chance of getting cancer as a result of HPV infection is extremely low. Your partner should discuss any specific symptoms or concerns with his or her doctor.

What about tobacco and alcohol?

People who abuse alcohol or use tobacco are more likely to get head and neck cancer. However, HPV related cancers can develop whether or not you drink alcohol or use tobacco products. Patients with cancer who do not use tobacco or alcohol live longer and are less likely to develop new cancers. For this reason, all patients with head and neck cancer should quit using tobacco and should minimize their use of alcohol. If you need help changing these habits, MSK can help you. Ask your doctor or nurse for more information about our programs, or call the Counseling Center at (646) 888-0100.

Can HPV be cured?

At this time there is no way to cure HPV. Most people infected with HPV will get rid of the infection without any treatment.

Can I get another cancer from HPV?

The risk of getting a second cancer from HPV is low, but your doctors will continue to examine you regularly. Be sure to tell your doctors about any new symptoms or concerns.

Should I get the HPV vaccine? Should my family get the vaccine?

The HPV vaccine is currently recommended for all boys and girls between ages 11 to 14, before sexual exposure. The main goal of the vaccine is to prevent genital warts and cervical cancer. We think the vaccine might also protect against HPV-related head and neck cancer, however this has not yet been proven. The vaccine is effective only if given before HPV infections occur. As a result, there is no proven benefit from the vaccine for people with HPV-related cancer, or for their partners.

Where can I find more information?

The best place to get more information is from your doctors. There is a lot of information about HPV and cancer on the Internet and some of it is confusing and inaccurate. We recommend the American Cancer Society website, www.cancer.org. Information is also available from the organization Support for People with Oral and Head and Neck Cancer (SPOHNC), www.spohnc.org.

You can also visit the MSK Library online at http://library.mskcc.org. Do not hesitate to contact reference staff at (212) 639-7439 or by using the “Ask-a-Librarian” email link (http://library.mskcc.org/scripts/portal/forms/ask_librarian.pl).