6 Surprising Facts About Head and Neck Cancer
Published March 2020
HPV-Linked Cancer on the Rise
The culprit is none other than the most common sexually transmitted infection: human papillomavirus (HPV). HPV, particularly HPV type 16, is a risk factor for some types of head and neck cancers, particularly oropharyngeal cancers of the tonsils and base of the tongue.
Here is what you need to know about this type of cancer, and the link to HPV.
HPV is responsible for the rise in certain head and neck cancers.
Oral HPV is typically transmitted via oral sex, but it can be transmitted in other ways. And while it often will be resolved within one to two years with no symptoms, the HPV infection can persist in some people.
There are high-risk and low-risk types of HPV. High-risk strains, especially type 16 and 18, are among those that are associated with an increased risk for cancer, including oropharyngeal cancer. In fact, HPV is thought to cause 70 percent of oropharyngeal cancers in the U.S. This includes cancer located near the base of the throat, tonsils or tongue.
“Oropharyngeal cancer is now clearly tied to HPV. That was not the case 20 and 30 years ago when this type of cancer was mostly related to smoking and drinking,” says Northwestern Medicine Head and Neck Surgeon Urjeet A. Patel, MD.
Oropharyngeal cancer differs from other types of head and neck cancers.
There are several different types of head and neck cancer. They are categorized by the area where the cancer begins. Oropharyngeal cancer linked to HPV occurs further back, towards the throat.
Other types of head and neck cancer include:
- Oral cavity, including your lips, lining of your cheeks and your gums
- Larynx (voice box)
- Paranasal sinuses and nasal cavity
- Salivary glands
Alcohol and tobacco use are the two most important risk factors for head and neck cancers. In fact, at least 75 percent of cancers are caused by alcohol and tobacco use. Other risks factors for head and neck cancers include history of oral lesions, family history of thyroid cancer and a history of radiation therapy.
HPV-related cancer can take years to develop.
HPV can lay dormant, undetectable, for years before developing into cancer. “Most people become infected with HPV when they're first sexually active,” explains Dr. Patel. “And then, given that long latency period before the cancer develops, people all of a sudden develop a cancer related to HPV from 30 years ago.”
“In the last 10 to 15 years, there's been a significant rise in the incidents of patients with cancer that is caused by HPV infection that the patient may have sustained sometime in early adulthood,” adds Sandeep Samant, MD, Northwestern Medicine Head and Neck Surgeon.
Head and neck cancers often spread to lymph nodes in the neck.
As with any cancer, early detection can provide more treatment options. Symptoms of throat cancer in particular include:
- A lump in the neck
- A persistent sore throat
- Pain or difficulty swallowing
- Unexplained weight loss
- Voice changes
- Coughing up blood
Cancers of the mouth and oropharynx can spread to your lymph nodes. Once cancer is in the lymph nodes, it can more easily spread throughout the body. The prognosis and treatment options will depend on several factors, including the number of cancerous lymph nodes, which part of the neck they are in, and your age and general health.
The Northwestern Medicine Head and Neck Program offers comprehensive care for throat cancer, which includes experienced surgeons with recognized expertise in robotic surgery, and access to leading-edge treatment and clinical trials.
HPV cancers are typically much more curable.
“One of the things about HPV-associated oropharyngeal cancer is that it generally is much more curable than the other types of cancer not associated with HPV,” says Dr. Samant. However, Dr. Samant adds, individuals with HPV who also smoke may have a greater risk for treatment failure.
You can reduce your risk with the HPV vaccine.
HPV transmission can be reduced in a number of ways, including using condoms with sexual partners. But the HPV vaccine is also encouraged as a key to prevention. Three different types of HPV vaccines are offered, but all of them prevent infection from HPV types 16 and 18, which are most commonly associated with head and neck cancer.
“It's a reflection that what we do in our early days can sometimes come back to haunt us later in life, and this is part of the reason that there's such a strong national push towards vaccination,” says Dr. Patel. “It really could help prevent a whole generation from getting certain types of cancer in the future.”