In the last decade, cases of head and neck cancer diagnoses have dramatically increased in the United States and around the world. Researchers at the OSUCCC – James are actively investigating the causes of this increase. Experts believe one of the main reasons for the rise of head and neck cancer cases is due to more human papillomavirus (HPV) infections in people. Over 36,000 people will be diagnosed with HPV-related cancer this year, several of which are head and neck cancers.
If you or a loved one have been diagnosed with HPV-related head and neck cancer, we know you may have many questions. OSUCCC – James experts will help you understand your condition and will work with you to create a customized treatment plan to meet your needs.
What is Human Papillomavirus (HPV)
Many head and neck cancers are thought to be caused by the human papillomavirus. HPV is the most common sexually transmitted infection (STI) and is the broader term for a group of over 200 viruses in the HPV family. These viruses can cause cancer in some (oncogenic) or may cause outbreaks of warts (non-oncogenic) in others.
HPV can be classified into high-risk or low-risk categories, depending on the HPV type. Some types, which are high-risk, can lead to an increased likelihood of developing into cancer like HPV 16. Others are low risk, which usually don’t cause cancer, but may cause an outbreak of warts, such as HPV types 6 and 11. Not all HPV infections lead to cancer or outbreaks. Most infections will resolve on their own in about two years.
People get HPV through close skin-to-skin contact or through vaginal, anal or oral sex. A person with an HPV infection often won’t have any symptoms of the virus but can still spread the disease even if they’re feeling well. Currently, there’s no cure for HPV.
Because there’s no cure, those who have high-risk types of HPV are more likely to develop certain cancers, including head and neck cancers.
Who is at risk of HPV head and neck cancer?
Some people may be more at risk of developing HPV head and neck cancer when compared to others. A risk factor is anything that can increase your chance of developing a disease. There are some factors that you can influence and others you can’t.
For HPV head and neck cancers, risk factors include:
- HPV infection status: Those with high-risk HPV, usually type HPV 16, are at an increased likelihood of developing HPV head and neck cancer.
- Sex: Males assigned at birth are more likely to get HPV head and neck cancer when compared to females assigned at birth.
- Number of sexual partners: When a person has multiple sexual partners, there’s an increased chance of developing these types of cancer.
- Age: People aged 50 and older are more likely to develop HPV head and neck cancer.
- Oral health: Poor dental hygiene increases the risk of developing these cancers as well.
It’s important to remember that just because you may have one or more risk factors doesn’t mean you’ll get the disease. Talk to your doctor if you’re concerned about your risks.
Diagnosis of HPV head and neck cancer
If your doctor suspects that you may have HPV-related head and neck cancer after a physical exam, they’ll order additional testing to rule out an exact cause of any symptoms you may have. This may include either imaging or biopsies.
The diagnostic tests they may use include:
- Computed tomography (CT) scan (with or without contrast)
- Magnetic resonance imaging (MRI) scan
- Positron emission tomography (PET) scan
- Flexible nasal endoscopy
- Laryngoscopy
- Needle biopsy
- Blood test for circulating tumor DNA (ctDNA)
Your doctor can take a biopsy (tissue sample) during an endoscopy or laryngoscopy. A specially trained OSUCCC – James pathologist will study the biopsy under the microscope to determine if the tissue sample is cancerous. If it is, the pathologist will communicate that with your physician to determine an appropriate treatment plan.
What types of head and neck cancer are linked to HPV?
There are several types of head and neck cancers; however, HPV causes over 70% of oropharyngeal cancer cases. Oropharyngeal cancers include those found in the throat. These cancers include the base of the tongue, tonsils, soft palate and the walls of the throat.
Cells are important building blocks in our bodies. Our cells contain “instructions,” called DNA, to tell them how to replicate and grow. In healthy people, cells tend to grow and replicate normally in the throat. However, in those who have HPV infections, the virus can change these instructions and, therefore, can cause cells to grow abnormally. Eventually, these abnormal cells can form a cancerous tumor (called a mass) in the throat, tonsils or at the base of the tongue.
How can I protect myself from HPV?
While not all cancers can be prevented, there are some steps you can take to reduce the chance of developing HPV and in turn, head and neck cancer. There are no screening tests for HPV cancers of the head and neck, but taking some of the steps below can help reduce your risk.
- Get the vaccine. The Gardasil 9 vaccine can help protect you against nine types of HPV that can cause cancer, including head and neck. The vaccine can be given to female assigned at birth and males assigned at birth from ages nine to 45. It’s given in either two or three doses, depending on your age and health status. There are side effects to the vaccine, so it’s important to talk to your doctor if you’d be a good candidate for it.
- Practice safer sex. Reduce the number of sexual partners you have and use barrier methods of contraception, such as condoms, to reduce the risk of getting HPV. Condoms don’t fully protect against getting HPV, but they can reduce the likelihood.
- Get regular dental exams. See your dentist regularly for cleanings and checkups. They can perform an oral cancer screening exam to check your mouth and throat for any concerning signs of cancer.
- See your doctor regularly. You should see your doctor regularly if you have any concerning symptoms or are at risk of developing head and neck cancer, or if you know you currently have a positive HPV infection.
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