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HPV viruses are commonly known for causing cervical cancer in women. However, HPVs, the most commonly sexually transmitted infections in the U.S., are now also known to be a major culprit for head and neck cancer.
Lon Petchenik, MD, attending ear, nose and throat physician at Northwest Community Healthcare (NCH), and Najeeb Mohideen, MD, radiation oncologist at NCH, answer common questions on HPV-related head and neck cancer.
Dr. Petchenik: The incidence of tobacco-related cancers has been going down while the incidence of HPV-associated cancers has been going up. This may be attributed to fewer tobacco users over time.
Dr. Petchenik: HPV tends to cause cancers in the oropharynx, which includes the tonsils and base of the tongue. These cancers afflict structures that are critical to day-to-day function, such as swallowing, speaking and breathing.
These head and neck cancers are much more common in men, by about a 2-1 ratio.
Dr. Petchenik: Unlike tobacco- and alcohol-related head and neck cancers, which can cause pain, bleeding, sores, or discomfort swallowing, HPV cancers often do not have symptoms. Sometimes, you can see a neck mass or asymmetry. For example, one tonsil may be larger than the other. Due to minimal symptoms, HPV cancers are often at stage 3 or 4 when diagnosed.
Dr. Mohideen: At NCH we have an advanced radiation technology called Intensity-Modulated Radiation Therapy with Image Guidance, or IMRT, that conforms radiation precisely to the 3-D shape of tumors. Image guidance helps us make sure the radiation dose is being delivered exactly where it is intended to go.
Dr. Mohideen: Most HPV-positive cancers have spread to lymph nodes in the neck. This means the shape of the tumor is complex. IMRT helps "shape" radiation doses around the cancer while preserving critical structures in its path, such as the spinal cord, glands that produce saliva, and muscles responsible for swallowing, thus reducing the major long-term side effects of radiation therapy for these patients.
Recent reports suggest that IMRT may also improve patient survival in head and neck cancer; however, these findings need to be further tested.