HPV-Related Oral Cancers

Human papillomavirus (HPV) is a sexually transmitted infection. While many types cause nothing more than genital warts, others are more serious and can lead to head and neck cancers.

Every year, 9,000 people are diagnosed with cancers of the oropharynx that may be caused by HPV. It is three times more common in men than women.

For diagnosis and treatment of HPV-related oral cancers, call our board-certified UCI Health otolaryngologists for an evaluation at 714-456-3021 or request an appointment online ›

About human papillomavirus (HPV)

HPV is a group of more than 150 related viruses, about 40 of which are transmitted through sexual contact. Infections can occur in the oral cavity, cervix, anus or genital tract. 

They are so common that nearly everyone will get at least one type of HPV infection in their lifetime.

The sexually transmitted viruses fall into two categories:

• Low-risk HPVs, which cause skin warts on or around the genitals and anus
• High-risk HPVs, one of which is commonly linked to head and neck cancer (HPV 16)

Most of these HPV infections go away within a year and don't require treatment.  

About 70 percent of oropharyngeal cancers are caused by HPV 16 or oral HPV. Studies have found that although 7 percent of people have oral HPV, only 1 percent have the type found in oropharyngeal cancers.

HPV vaccine

Sexually transmitted HPV is now preventable through a vaccine, but the vaccine must be given before exposure. It does not help clear an active infection.

The vaccine was introduced for girls in 2006 and boys in 2011. The Centers for Disease Control (CDC) recommends that two doses of HPV are sufficient for children age 14 or under, as long as the vaccines are given at least six months apart.

Anyone can get the vaccine up to age 26.

HPV cancer symptoms

Oral HPV causes cancers in the back of the throat, most commonly in the base of the tongue and the tonsils in an area known as the oropharynx. 

Although some people will have no signs or symptoms of oropharyngeal cancers, the most common are:

• Persistent sore throat
• Earaches
• Hoarseness
• Enlarged lymph nodes
• Pain when swallowing
• Unexplained weight loss

Causes

Oral HPV is sexually transmitted. It is not transmitted through hugging, bathing, light kissing or general family contact.

Studies have found that 7 percent of people have oral HPV, but 1 percent of those have the type found in oropharyngeal cancers, HPV type 16. The virus infects normal, health squamous cells and can potentially make them cancerous.

For most people, the infection goes away on its own. Many don't realize they were ever infected.

For this reason, it's difficult to know when exposure occurred. It's estimated that the progression of oral HPV infection into head and neck cancer is 10 to 30 years.

Diagnosis

Diagnosis of oral HPV head and neck cancer starts with a health history and physical exam.

If a mass or lesion is found, a biopsy will be done. Your physician may also order imaging to evaluate the size and involvement of the mass, as well as determine whether there are any enlarged lymph nodes.

After your imaging is reviewed, you will have a direct laryngoscopy with biopsy, which is a thorough examination of all areas of your mouth and throat. This procedure is done under general anesthesia.

If oral cancer is diagnosed, a CT-PET scan will be done to determine if cancer has spread anywhere else in your body. The information from this scan is helpful in determining what type of treatment options will be most effective against your type of cancer.

Treatment

Treatment decisions are made based on:

• Size of the tumor
• Location of the tumor
• Stage of the disease
• Your overall health
• Your personal wishes

In some cases, HPV cancer can be treated with surgery.

However, the majority of oral HPV cancers are treated with a combination of chemotherapy and radiation. You will work with a medical oncologist and radiation oncologist, who will support you during your treatment. 

Prognosis

In general, patients with HPV-related head and neck cancers have better outcomes than patients with head and neck cancer that is not related to HPV.

If you're concerned about unexplained symptoms, call our head and neck cancer specialists for an evaluation at 714-456-3021 or request an appointment online ›