HPV and Throat/Oral Cancer

Eric Genden, MD, Chief of Head and Neck Surgery at the Mount Sinai Health System in New York City, has seen his practice change dramatically over the past decade, from waiting rooms filled with smokers and drinkers to those with young men who were never smokers or drinkers. This “new set of patients” is presenting with cancers of the head and neck, particularly in the tonsils and at the base of the tongue. The culprit: the human papillomavirus, or HPV, a sexually transmitted disease. At least one strain of HPV (HPV-16, which also causes cervical cancer) is leading to what’s known as oropharyngeal cancer (the part of the throat that includes the base of the tongue, soft palate, and tonsils) in patients who are in their 40s or 50s and mostly male.

In the U.S., among 20 to 49 year-olds, there was an increase between 1975 and 2007 of 1.4 percent a year in the tongue cancer rate, and of two percent per year in the oropharynx and tonsil cancer rate. This shift is associated with changing sexual mores. “With the sexual revolution and HIV scare, there’s been an increase in the rate of oral sex, and it’s directly proportional to the onset of this phenomenon,” says Genden. Vaccines such as Gardasil are considered an important defense in women (and increasingly men) since they guard against several HPV strains.

HPV is one of the most common virus groups in the world to affect the skin and mucosal areas of the body, infecting the epithelial cells of skin and mucosa. The epithelial surfaces include all areas covered by skin and/or mucosa such as the mouth, throat, tongue, tonsils, vagina, penis, and anus. Infection with the virus occurs when these areas come into contact with a virus, allowing it to transfer between epithelial cells.

“We now have an 85 percent success rate at Mount Sinai for the treatment of HPV-related throat cancers,” notes Marshall Posner, MD, Medical Director of the Head and Neck Oncology Program, “As we continue to learn about the biology of head and neck cancer over the next decade, I expect we will see a host of new vaccines, immune modulators, and other targeted therapies, which may actually allow for the elimination of chemotherapy or radiotherapy as treatments for the population of intermediate- and advanced-stage patients with certain cancers, such as HPV.”

About Mount Sinai’s HPV Program for Men

The Mount Sinai Center for Head and Neck Institute’s Cancer’s HPV Program for Men is one of the few programs in the U.S. dedicated to providing comprehensive services in the diagnosis and treatment of throat/oral cancer related to HPV, and in educating young men about how to minimize their risks of contracting HPV and oral cancer. This includes practicing safe sex, limiting sexual encounters to one other person (and they with you), and limiting or abstaining from alcohol and tobacco.

If you are at risk for oropharyngeal cancer, we can help. The Mount Sinai Health System excels in treating all types of cancer. Our oral cancer specialists and HPV Program for Men function as part of a multidisciplinary research and clinical care institution whose membership encompasses all Mount Sinai physicians and researchers whose work involves cancer. Our physicians are located at Faculty Practice Associates, 5 East 98th Street, New York, NY. Call us at 212-241-9410 to schedule an appointment.