Significant Rise in HPV-Related Throat Cancer in Men

June 1, 2011 — -- Philip and Joanne Keane, of Newtown, Conn., never thought twice about having their daughters immunized against strains of the human papillomavirus that could cause cervical cancer.

"I thought it [HPV] was a women-only disease, a virus only they should worry about," said Philip Keane. But when Keane, 52, was diagnosed with stage 4 HPV-related throat cancer, the Keane's decided their 12-year-old son should be vaccinated too.

"You don't want them waking up in 20 or 30 years and finding out they have stage 4 throat cancer. That's where I am now," said Keane.

HPV appears to be linked to a rare but treatable form of throat cancer in men that's on an uptick. If the trend continues, the annual occurrence of HPV-related oropharyngeal cancer among men will surpass that of cervical cancer among women by the year 2020, according to a study that will be presented this week at the American Society of Clinical Oncology's annual scientific meeting.

According to researchers, in 2004 there were nearly 4,000 to 4,500 cases of HPV-related oropharynx cancer in men and women. The number of cases is expected to double to 8,500 by 2020, with the increase occurring primarily in men.

"I think it's safe to say that we are on the cusp here of a pandemic. An epidemic that's about to begin," said Dr. Eric Genden, chairman of the department of otolaryngology at Mount Sinai Medical Center in New York, who's treating Keane.

HPV, a common virus whose strains are believed to be the primary cause of most cervical cancer, has been linked to some head and neck cancers too.

It's unclear why some who carry the virus overcome it naturally while others develop cancer. Doctors believe it is most commonly spread through sexual contact and some doctors believe an increase in unprotected oral sex is the cause for the rise in throat cancer. But can it be transmitted through saliva by kissing, even sharing a spoon? Doctors still don't know.

In 2009, the U.S. Food and Drug Administration approved the HPV vaccine Gardasil for males between the ages of 9 and 26, to reduce the risk of genital warts, and was approved in December 2010 to prevent anal cancers in males and females. Gardasil was first approved in 2006 for females, beginning at age 9, to prevent strains of HPV that could cause cervical cancer.

However, it's unclear whether the vaccine can prevent oral HPV infections. But many experts say it's likely, since the vaccine protects against some of the same strains found in HPV-related throat cancer.

According to Dr. Chris Sullivan, assistant professor of otolaryngology at Wake Forest Baptist Medical Center, the increasing instances of throat cancer "emphasize the need for head and neck screening even in patients without traditional risk factors of tobacco and alcohol use."

Previous studies suggest that head and neck cancer patients whose tumors test positive for HPV tend to survive longer and respond better to chemotherapy and radiation than those who test negative for the virus. As for Keane, he did not undergo chemotherapy, though he did have radiation treatment.

"This is preventable, there are clear signs and symptoms and it's curable if treated early," said Genden. Genden said that 85 to 90 percent of HPV-related cancer is curable.

Keane's cancer was removed last July through robotic surgery, and he's showed no sign of cancer since.

While the rise in HPV-related oropharyngeal cancer is mostly found among older adults who were not offered a vaccine and now do not qualify for it, Genden said immunizing against HPV would prevent younger adults -- both men and women -- from later developing HPV-related cancers.

"There's a good chance that if Phil got the vaccine earlier, he probably would not have developed the cancer," said Genden.