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>> My name is Karen Choi.
I'm a head and neck surgeon in the department of otolaryngology, head and neck surgery at
Penn State Health.
I treat patients with head and neck cancers.
HPV is the human papillomavirus.
This is a family of more than 150 related viruses, and there are many different types.
And the most common types are six, 11, 16, and 18.
It's the most commonly-transmitted sexual disease, and is transmitted through direct
skin-to-skin contact, through vaginal, anal, and oral contact.
It's usually a virus that, once someone is infected with it, it normally clears itself
from the body.
However, in some people, this virus can remain latent, and stay in the body for even up to
20 to 30 years after the initial infection.
And at some point, it then incorporates its DNA into our own cells' DNA, and activates
these proteins that we call oncoproteins, that then disrupt the normal cell cycle, and
cause cancers to form.
And so, this happens in various areas like the cervix, anus, and the vagina, and there's
been an increase in the incidence of HPV-related cancers as well in the past 30 years.
Gardasil-9 is an FDA-approved vaccine in the U.S. to prevent against HPV infections, and
it does include protection against nine different types of HPV, including the more common types,
six, 11, 16, and 18.
Of those four, the HPV type 16 and 18 are known as the high-risk types that are associated
with the development of cancers, and the HPV type six and 11 are known as the low-risk
types.
And these are more associated with the non-cancer types of infections that result in things
like genital and oral warts.
So HPV vaccination is incredibly important to talk about with your family and friends,
especially if they have young children.
The incidence of HPV-related oropharyngeal cancer has been increasing over the past 20
to 30 years, and it's estimated that over 70% of these cancers are related to the HPV
virus.
Because of that, you know, having the HPV vaccine is the single most important method
that we have to try and prevent against this cancer.
The incidence and the rates of HPV-related cervical cancer have been documented to be
decreased after this vaccine was introduced.
However, the data related to the HPV-related oropharyngeal cancers is less well-known,
because it's just not as well-studied at this time.
So HPV-related head and neck cancer can be treated by several different ways, including
either surgery, chemotherapy, or radiation, and oftentimes, a combination of both.
If it's an early-stage cancer, this may be able to be treated with surgery, followed
by either radiation or no treatment at all.
However, the majority of patients would be treated with chemotherapy and radiation.
The interesting thing with HPV-related oropharyngeal cancers is that it often presents once the
cancer has already spread to the lymph nodes in the neck.
So oftentimes, the initial presentation is that someone notices that they have a neck
mass.
At that stage, you know, it is technically a cancer that has already spread to the lymph
nodes.
However, what we know about these cancers is that these patients do really well with
the treatment, and over 80% of these patients are cured with whatever treatment they end
up getting.
About two years ago, the American Joint Cancer Committee actually released an updated staging
system for these patients, and so now, patients, even though they've had cancer that spread
to the lymph nodes -- these would typically be staged as stage III or IV cancers.
But these patients are now being considered early stage, stage I and II.
A lot of the side effects during the treatment are the most acute side effects, and those
include things like decreased energy, fatigue, as well as the effects of radiation, including
pain and mucositis inside the mouth, difficulty swallowing, also decreased taste related to
the effect of the radiation on the mucosa in your mouth and throat.
Oftentimes, patients, because of these side effects, have difficulty eating and drinking
during the treatments, and many patients get feeding tubes placed temporarily to help supplement
their nutrition, so that they have enough calories and energy to get through all of
the treatment.
A lot of these acute effects start to subside within a few weeks to months after you finish
the treatment, but some of the other effects like the decreased taste, thickened secretions
-- these can last for up to a year, even for the rest of your life.
The biggest thing with encouraging parents to talk to their sons, and not just their
daughters about the vaccine for HPV, is just increasing our knowledge about the different
cancers that the HPV can cause.
This includes just increasing knowledge about other cancers like HPV-related oropharynx
cancers, and just having an understanding that men, more than women, are more likely
to develop this cancer.