Connection between HPV infection and mouth, throat cancer

You may have heard about the connection between HPV infection and certain types of cervical cancer, but did you know there also is connection between HPV infection and a higher risk of throat and mouth cancer, as well?

The Centers for Disease Control and Prevention (CDC) recommends that children 11–12 should be vaccinated for HPV before they are exposed to the virus.

What is HPV?

HPV is a viral infection that commonly causes skin growths or warts. It's the most common sexually transmitted infection in the U.S., with over 79 million infected. While it affects men and women, men are twice as likely to be diagnosed with oropharyngeal cancer.

HPV infection occurs when the virus enters your body, usually through a cut, abrasion or small tear in your skin. The virus is transmitted sexually or through skin-to-skin contact. There are more than 100 types of HPV. In most cases, your body's immune system defeats an HPV infection before it creates warts, so it is easy to have HPV but not realize it.

Cancer connection

Some types of HPV infection cause warts, while some can cause different types of cancer. For example, nearly all cervical cancers are caused by HPV infection, and this is the most well-known connection. HPV can cause throat and mouth cancers, as well, which tend to be less aggressive than cancers in these areas that are unrelated to HPV.

An HPV infection can infect the mouth and throat, and cause cancer of the oropharynx, which includes the back of the throat, base of the tongue and tonsils. About 54,000 adults in the U.S. are diagnosed with oral or oropharyngeal cancer each year.

Men are twice as likely to be diagnosed oropharyngeal cancer, primarily due to common habits that increase their cancer risks, like tobacco use, excessive alcohol use and poor diet. Also, men are more likely to be exposed to toxic substances at work, which increases their risks.

Nonspecific symptoms

A challenge of diagnosing throat and mouth cancer is that many symptoms are common to other diseases or conditions, and not specific to the cancer. This includes a sore that won't heal, cough, sore throat, ear pain, difficulty swallowing or voice hoarseness. It is easy to believe that these symptoms are due to a common cold, seasonal allergies or an overzealous celebration.

HPV treatment options

Treatment options for oropharyngeal cancer vary, and they are based on many factors, such as the location and stage of your throat cancer, the type of cells involved, whether the cells show signs of HPV infection, your overall health, and your personal preferences. Your care team will discuss the benefits and risks of each option and work with you to determine the best plan for your case and goals.

Treatments can include:

• Radiation therapy
• Surgery to remove cancer that has not spread to other areas
• Surgery to remove part of your throat, voice box or lymph nodes
• Chemotherapy
• Drug therapy
• Immunotherapy

Preventing throat, mouth cancers

While there is no proven way to prevent throat and mouth cancers from occurring, you can take these steps to lower your risk:

• Get vaccinated for HPV.
  The CDC found that an estimated 92% of cancers caused by HPV could be prevented by vaccination. The CDC now recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart. Teens and young adults up to age 26 also can be vaccinated. Some adults ages 27 through 45 years may decide to get the HPV vaccine based on discussion with their health care providers. If you are unable to get vaccinated for HPV, you can lower your risk of HPV infection by limiting your number of sexual partners and using a condom or dental dam every time you have sex.
• Don't smoke or use tobacco.
  If you smoke or use smokeless tobacco, quit. It can be difficult to stop, so talk with your health care team about smoking cessation strategies, such as medication, counseling and nicotine replacement products.
• Drink alcohol in moderation, if at all.
  If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
• Eat a diet full of fruits and vegetables.
  The vitamins and antioxidants in fruits and vegetables may reduce your risk of throat cancer. Eat a variety of colorful fruits and vegetables.
• Use a respirator if around hazardous chemicals.
  Lower your exposure to chemicals by using a respirator and other personal protective equipment approved by the Occupational Safety and Health Administration.

You should visit your health care provider if you notice any common respiratory symptoms that persist, such as cough, sore throat or swollen neck glands that won't go away.

Gregory Jones, M.D., is an ear, nose and throat specialist in Owatonna, Minnesota.