Human Papillomavirus and Head and Neck Cancer: A Growing Concern
A common misperception is that all head and neck cancer results from longstanding abuse of tobacco or alcohol, but many as 25% of head and neck cancer patients have little exposure to these substances. This points to the role of other factors. Some estimate up to 25% of all head and neck cancers and 60% of tonsil cancers, are actually due to an infection of high-risk human papillomavirus (HPV).
Compared to other head and neck cancers, the profile of HPV-positive head and neck cancer is unique. HPV-positive head and neck cancer is not associated with tobacco and alcohol exposure, but with oral sexual contact, the number of lifetime vaginal sexual partners, and a younger age at first sexual contact.
The signs and symptoms of these cancers include sore throat, a non-healing mouth or throat ulcer, neck mass, enlarged tonsil, swallowing difficulty, or change in speech. HPV-positive head and neck cancers may also have a strawberry-like appearance (Figure 1). This type of cancer occurs predominantly in the tonsil and base of tongue.
On a positive note, patients with HPV-positive head and neck cancers have a better chance of disease-free survivability than similarly staged HPV-negative patients. This may be due to greater response of HPV-related tumors to radiation therapy. Because of this, the HPV status of head and neck cancer is now recognized as a major variable when determining likelihood of treatment response.
Head and neck surgeons and researchers in the MUSC Department of Otolaryngology-Head and Neck Surgery and the MUSC Hollings Cancer Center have joined forces to study the unique characteristics of HPV-related head and neck cancer. MUSC currently performs HPV testing on all head and neck tumors thought to be at risk for the virus. Knowing the HPV-status of a head and neck cancer helps to determine the best course of treatment and may allow HPV patients to receive new therapies and vaccines as they become available.
MUSC researchers are currently investigating whether there are certain immune deficiencies in HPV-positive head and neck cancer patients that allow these tumors to develop. They believe that their investigations may lead to breakthroughs in treatment for patients with HPV-positive head and neck cancers.