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AN epidemic of mouth and throat (oropharyngeal) cancer caused by infection with the human papillomavirus (HPV) is under way in the United States, which could become more common than cervical cancer by 2020, says the July 2012 issue of the Harvard Medical School’s Harvard Men’s Health Watch.
“The phenomenon is really quite striking,” says Dr. Lori Wirth, an assistant professor in medicine at Harvard Medical School and the medical director on the Center for Head and Neck Cancers, Massachusetts General Hospital.
Overall, HPV-linked oropharyngeal cancer is uncommon — for instance, 18 times more individuals will be diagnosed this year with colorectal cancer than with oropharyngeal cancer associated with HPV.
Nevertheless, in a recent study in the Journal of the American Medical Association (JAMA) where researchers screened nearly 5,600 individuals ages 14 - 69, results showed an estimated 10 percent of American males are infected, or about three times as many men as women.
The number of individuals infected peaked at ages 30 - 34 and 60 - 64.
Sexual contact, oral sex and deep kissing transmit oral HPV — the likelihood of contracting oral HPV is directly associated with the number of sexual partners.
Oral HPV is eight times more common in individuals who reported ever having sex and one in five individuals with 20 or more lifetime partners is infected, according to the JAMA study.
HPV-related cancer targets the oropharynx region, which includes the back of the throat, the base of the tongue, the soft palate and the tonsils.
Unfortunately, there is no HPV-based screening test approved by the Food and Drug Administration (FDA) to identify men at risk of head and neck cancer, the same way a Pap smear identifies women at higher risk of cervical cancer, says the health letter.
Thus, men should stay alert for early signs of disease and seek immediate evaluation, since with standard treatments, cure rates are 75 percent to 80 percent.
Whereas in the past, the “face” of head and neck cancer was a man in his 60s with a history of heavy smoking and alcohol consumption, the men diagnosed with HPV oropharyngeal cancer do not smoke heavily and may still be in their 50s or younger, although older men are also affected.
Dr. Wirth explains that HPV cancers show a specific pattern as to where they arise.
The warning signs of head and neck cancer include:
• Sore throat that does not go away
• Trouble swallowing
• Lump in the neck - “The most typical presentation is an asymptomatic palpable mass in the neck a man might notice while shaving,” Dr. Wirth explains.
• Weight loss for no known reason
• Ear pain - A tumor can also trigger referred pain in the ear.
• Lump in the back of the throat or mouth
• Change in voice
A man may not recognize these symptoms as a reason to consult a doctor - He may blame a swollen gland from a cold he had recently and delay seeing a doctor for months, according to Dr. Wirth.
“The good news in all this is that these types of cancer are much more curable,” Dr. Wirth says.
Thus, catching a tumor in the early stages is so important because HPV-caused oropharyngeal cancers can be treated more successfully than those associated with smoking and drinking.
Typically, treatment consists of chemotherapy and radiation, and sometimes surgery. However, the cure can come at a cost, such as persistent dry mouth and changes in swallowing.
Meanwhile, researchers are working on treatments that can cause less collateral damage, such as HPV oropharyngeal cancers which may need less aggressive treatments, and that would mean fewer side effects.
As far as prevention, doctors don’t know if the HPV vaccine is effective against oral HPV infection and therefore it cannot be offered yet as a way to prevent oral cancer.
Meanwhile, “the most important thing is increased awareness of this kind of cancer,” says Dr. Wirth.
“If you have symptoms, don’t let them go ignored,” she concludes.
Dr. Margot Watson answered:
How long after first oral sex will HPV vaccine help prevent transmission?
it will not prevent HPV is spread through oral sex. It is found in the mouth/throat of about 7-14% of sexually active adults and causes mouth/throat cancer. The vaccine does not prevent transmission of the virus and it does not treat the virus that is already acquired. It greatly reduces the chance of catching the strains of the virus most likely to cause cancer if given before exposure. HPV is spread through oral sex. It is found in the mouth/throat of about 7-14% of sexually active adults and causes mouth/throat cancer. The vaccine does not prevent transmission of the virus and it does not treat the virus that is already acquired. It greatly reduces the chance of catching the strains of the virus most likely to cause cancer if given before exposure.
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