Understanding HPV-related oropharynx, head and neck cancer

As we age, staying informed about health risks becomes increasingly important. One such risk that has gained attention in recent years is human papillomavirus (HPV)-related oropharynx (upper throat) cancer of the head and neck. Contrary to popular belief, this type of cancer isn't just a concern for the younger population; individuals aged 55 and older are also at risk. Therefore, it's crucial for this age group to understand the connection between HPV and these types of cancers, as well as the preventive measures and early detection methods available.

HPV and the risk of cancer

HPV is a common virus that can be transmitted through various forms of intimate contact, including oral sex. While the body's immune system can often clear the virus, in some cases, it can persist and lead to various health issues, including cancer. In recent years, there has been a notable increase in HPV-related oropharynx cancers, particularly among older adults.

One of the challenges with HPV-related cancers is that they may not present symptoms until the disease has progressed. However, there are certain signs to watch for, including persistent sore throat, difficulty swallowing, ear pain and a lump or mass in the neck. If you experience any of these symptoms, it's important to consult with a healthcare professional promptly.

How to lessen your risk

Prevention plays a crucial role in reducing the risk of HPV-related cancers. Practicing safe sex and limiting the number of sexual partners can reduce the risk of HPV transmission. However, it’s important to note most HPV infections do not lead to cancer. To learn more, speak with your primary care physician.

Regular screenings are also essential for early detection and treatment. During routine dental and medical check-ups, discuss with your healthcare provider about including screenings for oral, throat, and head and neck cancers as part of your preventive care plan. These screenings may involve a visual examination of the mouth, throat, and neck, and additional tests if needed.

Treatment options

Fortunately, HPV-associated oropharynx is very treatable. Both nonsurgical treatment via chemotherapy and radiation and surgical treatment are highly effective treatment methods. 

Transoral robotic surgery (TORS) is a robotic surgery technique that allows for removal of tumors in difficult-to-reach areas of the back of the throat and voice box. It is a minimally invasive procedure with access through the mouth. The procedure is performed under general anesthesia. A surgeon operates specialized robotic arms. This allows for grasping and precise incisions (small cuts) in the tissue. It also gives 3D and magnified views of the affected area. Our team at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel and I were the first in Indiana to perform this robotic surgery with the newest, state-of-the-art robotic platform that uses a single port for the robotic instruments, and we are the only providers of this advanced surgical technique in Indiana.

The IU Health Schwarz Cancer Center is also conducting a clinical trial, led by me, for qualifying patients with HPV-related oropharynx cancer. Participants undergo transoral robotic surgery followed by no radiation or reduced radiation, depending on the pathology findings and aggressiveness of the disease, and do not receive chemotherapy. The goal is to maintain high cure rates for patients while decreasing long-term side effects and treatment toxicity. 

At IU Health, patients are evaluated by head and neck surgical oncologists. Their cases are then discussed in a multi-disciplinary head and neck tumor conference attended by head and neck cancer experts across many specialties. These providers come to an agreement about the best treatment options for patients. This allows for the highest level of care possible for the best outcomes. Learn more about IU Health’s Head and Neck Cancer program here.

Written by Dr. Michael Sim, surgical oncologist specializing in Head and Neck Oncology and Microvascular Reconstruction at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel