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Head and Neck

Attitude is a little thing that makes a big difference - Winston Churchill

The incidence of head and neck cancer is going down. The bad news is another type of head and neck cancer is on the rise and is related to a common STD...HPV the same virus implicated in cervical cancer. 60 to 70% of all tonsil cancers in the U.S. are linked to HPV whereas other studies report that 45 to 95% of oropharyngeal tumours are HPV-positive.

One of the first reports that suggest the involvement of HPV in head and neck cancer dates back nearly two decades ago and it was “greeted with incredulity.” Although there have been more scientific papers reporting that head and neck cancer, especially around the oral cavity is linked to HPV, there has been little information available to the public mainly due to the sensitivity of the issue. This is because the HPV-head and neck cancer connection would surely touch on the topic of oral sex.

So, who is getting HPV related head and neck cancer? Generally it’s the healthy and well-off segment of the population - in other words, people who are not your typical chain smoking alcoholics or junkies. Although not well-publicized until recently, the risks for developing HPV-positive head and neck cancer is closely linked to sexual behaviour and practices such as having multiple sexual partners and oral sex. This may be attributed to the widespread practice of oral sex among the younger generation, which can be traced back to the early 70’s.

The silver lining behind the cloud is that the prognosis for most HPV-positive oral tumors is generally better than those that are HPV-negative. Clinical outcomes and survival are usually positive regardless of treatment strategies. This may be partly due to the fact that patients with HPV-positive tumors tend to be young and in good health.

The take home message is...modifying sexual behavior is the key in preventing HPV and HPV-related cancers. Oral sex seems to be the main mode of transmission of oral HPV that leads to cancer although transmission by mouth to mouth contact through French kissing cannot be ruled out.