Over the past three decades, a dramatic increase in a new form of throat cancer has been observed in the industrialized world. The good news is that this can be avoided if parents vaccinate their children.
The disease appears mainly in men, usually between 45 and 70 years old. Affected individuals often lead healthy lifestyles. They do not have much history of smoking or alcohol consumption, risk factors for traditional throat cancer.
The rate of this new cancer has increased by 5% per year and today it is more than three times more common than in the mid-80s. If you think this scenario sounds like a contagious medical drama and slow (think of Contagion or World War II), you would be right.
Human papillomavirus (HPV) is the virus that causes cancer of the cervix in women. It is well known that parents should vaccinate their daughters. Now, with the resurgence of oral HPV cancers, especially among men, parents should also have their boys vaccinated.
Currently, HPV vaccination is recommended by the Centers for Disease Control for children and young adults aged 9 to 26 years. Vaccination includes a series of two or three injections; side effects are mild.
Ideally, vaccines should be given before someone becomes sexually active. This is because HPV is spread through sexual activity. The risk of HPV infection and throat cancer increases with the number of partners over the course of life.
The immune response of men to the virus is lower than that of women, which explains the predilection of this disease in men. It is unclear whether a person has an active HPV infection orally because there are no symptoms. At present, there is no widely accepted test for HPV in men.
Chronic infection causes cellular changes in the lymphatic tissues of the throat, especially the tonsils and the base of the tongue. Over a period of 20 to 30 years, these changes can lead to the formation of cancer.
Throat cancer caused by HPV is insidious. The primary tumor in the tonsils or the base of the tongue often causes little or no symptoms. The first signs of this cancer may be a mild sore throat, occasional oral saliva tinged with blood, or increased or new snoring.
The first sign of cancer is often a lump in the neck after it has spread to the lymphatic system. The size may appear quickly and then shrink to varying degrees, causing self-satisfaction.
Cancer at an early stage can be treated by surgery or radiotherapy. More advanced cancers are treated with combination therapy such as surgery followed by radiotherapy or chemotherapy in combination with radiotherapy.
Finally, good news. Treatment of HPV-related throat cancer is effective in approximately 90% of cases and significantly more than treatment for non-HPV-related throat cancer.
But even though medicine has been successful in treating this cancer, even better prevention is prevention through vaccination. Early studies showed that vaccination produced an immune response to HPV and reduced the rate of HPV infection. With time and good immunization coverage, a decrease in throat cancer is expected.
In summary, here are some simple messages to remember: If you have a lump in your neck or a chronic sore throat, do not delay. Ask your doctor to check. If you are the partner of a person with these symptoms, strongly encourage him to consult his doctor.
If you have children aged 9 to 17, discuss HPV vaccination with your pediatrician. If you are between 18 and 26 years old, talk to your doctor. These simple steps can save your life or that of your loved one.
Dr. Bryan Fong is the lead surgical oncologist at Kaiser Permanente in Northern California. He practices in Walnut Creek and Oakland.