When most people think about throat cancer they know that smoking and alcohol are behaviors that increase the risk of developing throat cancer. What most people don’t know is that the majority of people in the United States who develop cancer in the back of the throat (known as the oropharynx) develop it due to infection by the Human Papilloma Virus (HPV). Since 1990, HPV associated oropharyngeal cancer has increased by 5% per year and currently causes over 70% of today’s cases. The majority of these patients are younger and healthier and have little tobacco exposure. Fortunately, HPV associated oropharyngeal cancer is highly responsive to treatment and carriers an excellent prognosis.
Discussing HPV related oropharyngeal cancer can be a sensitive topic as HPV is a sexually transmitted disease. Renowned Hollywood actor Michael Douglas helped bring awareness when he developed HPV related oropharyngeal cancer in 2013. He admitted that oral sex caused his throat cancer instead of smoking or drinking. HPV is the most common sexually transmitted infection. More than 50% of sexually active people will have genital infection at some time during their lives. Fortunately, only a small percentage will have an oral infection and of these only 1% have cancer causing potential.
As a medical community we have been pushing for increased vaccination against the HPV virus. The current recommendations are for both boys and girls to receive vaccination beginning at ages 11 and 12 respectively. Previously it had only been recommended for girls as HPV was known to be a risk factor for gynecologic malignancies. However, now that oropharyngeal cancer has become prevalent in both men and women, both genders should be vaccinated. If your child is older than 11 or 12, they can still receive the vaccination. Recently the FDA even approved HPV vaccination for adults up to the age of 45.
Due to the sexual route of transmission of the HPV virus, some parents are hesitant to allow their children to be vaccinated believing that it would never affect their children. I would delicately ask that parents think of the vaccine as an anti-cancer vaccine. Although the cure rates for HPV are very favorable compared to other types of cancer, it doesn’t make going through the treatments any easier. As a radiation oncologist I have seen many patients suffer through the side effects of surgery, chemotherapy, and radiation. When the cancer is cured many patients continue to live with the long term side effects of therapy. If this could have been avoided by a simple vaccination when they were 11 or 12 years old, imagine much different their quality of life would be today.
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