What to Know about HPV and Throat Cancer

At the start of the new year, tennis great Martina Navratilova revealed that she has been diagnosed with stage 1 breast cancer and stage 1 throat cancer. Navratilova shared that the throat cancer type she has is caused by human papillomavirus, commonly referred to as HPV.

While many people who contract HPV do not show symptoms and usually clear the infection without any medical intervention, some more severe types of the virus can lead to cancer, including head and neck cancer or oropharynx (throat) cancer. Nearly 80 million Americans are infected with HPV, considered one of the most common sexually transmitted infections. Of those millions, nearly 38,000 will be diagnosed with an HPV-related cancer this year.

According to American Cancer Society data, the number of throat cancers caused by HPV infections is increasing, primarily in younger people who don’t smoke or drink alcohol. In the U.S., HPV is estimated to cause 70% of throat cancers.

Bringing awareness to HPV and cancer, Fatemeh Momen-Heravi, DDS, MPH, PhD, a faculty member of the Herbert Irving Comprehensive Cancer Center (HICCC) who specializes in head and neck cancer treatment and research, sheds light on this important topic and shares facts about risk factors and prevention.

What is human papillomavirus (HPV) and how is it treated?

HPV is a virus that can cause a variety of illnesses in humans. It is one of the most common sexually transmitted infections and estimated that about 80% of sexually active adults will become infected with HPV at some point in their life. There are many different types of HPV and most of them do not cause any health problems. But some kinds of HPV can lead to genital warts or certain types of cancer, including cervical cancer, penile cancer, head and neck cancer, and anal cancer. For instance, two strains of the virus (HPV16 and HPV18) are known to cause more than 70% of cervical cancers, and also contribute to head and neck cancer.

There is no cure for HPV but the availability of an HPV vaccine has proven safe and effective in preventing people from contracting the virus.

How do some cases of HPV lead to cancer, and to throat cancer specifically?

HPV is estimated to cause 70% of throat cancers in the U.S HPV-related oral and throat cancers occur when abnormal cells in the throat grow out of control and form tumors. The exact mechanism of HPV-related cancers are still under investigation, but we believe it involves the virus's ability to infect and persist in epithelial cells by altering their regulation. Through this process, infected cells can accumulate genetic mutations that lead to uncontrolled cell growth and cancer formation. Additionally, some types of HPV are capable of producing oncoproteins that can cause further damage to cellular DNA, leading to greater risk for cancer development.

Are there warning signs people should be aware of?

Warning signs of throat cancer may include a persistent sore throat, difficulty swallowing, pain in the throat or neck, constant coughing, hoarseness, lumps in the neck or mouth and changes to the voice. Additionally, some people may experience weight loss or earaches. If you experience any of these symptoms for an extended period of time it is important to contact your doctor as soon as possible. Early detection and treatment can greatly improve prognosis for people with HPV-related throat cancer.

An initial diagnosis will involve a physical examination, along with imaging tests such as X-rays and MRIs. A biopsy may also be done to confirm the presence of cancer cells. Treatment options depend on the stage and type of throat cancer, but may include surgery, radiation therapy, chemotherapy or a combination of these treatments.

What are other cancers linked to HPV?

In addition to head and neck cancers, such as throat cancer, HPV is linked to a number of different types of cancer, including cervical and vulvar cancers in women, penile cancer in men and anal cancer in both men and women. All of these forms of cancer are treatable if caught early so it is important to be aware of the risks and take preventive measures against HPV-related cancer, such as getting vaccinated against the virus .

What else should we know about HPV and cancer?

That there is an available HPV vaccine that is safe and effective against the virus. The HPV vaccine is recommended for people between the ages of 9 and 26 as it can help reduce the risk of HPV related illnesses and certain cancers. Make a point to talk to your doctor about what measures you can take to reduce your risk for HPV related diseases.

Additionally, safe sexual practices are a way to decrease your risk for HPV infection in general. Regular screenings for oral and throat cancer and pap tests can help identify any early signs of cancer before they become serious. Always remember that early detection and diagnosis are key when dealing with HPV-related throat and oral cancer or other types of head and neck cancer.

In general, to reduce risk of head and neck cancer some lifestyle changes such as quitting smoking, limiting alcohol consumption and maintaining a healthy diet with plenty of fruits, vegetables and whole grains, and low in processed meats can decrease the risk of head and neck cancer. I can’t stress enough how important it is to talk to your doctor about any potential risks associated with head and neck cancer (both HPV related and unrelated) and what measures you can take to reduce these risks.