[3 MIN READ]
In this article:
- More than 100,000 Americans are diagnosed with oral, head and neck cancer every year.
- Human papillomavirus (HPV) has replaced smoking as the leading cause of throat cancer.
- Researchers are studying a troubling increase in oral cancers among younger women.
- A Swedish head and neck cancer specialist answers some common questions about these cancers.
The human papillomavirus is now responsible for the majority of throat cancer, causing more than 12,000 new cases every year and comprising a significant portion of the more than 100,000 diagnoses of oral, head and neck cancers annually, according to the American Academy of Otolaryngology–Head and Neck Surgery. These cancers start in the cells that line your mouth, throat, lips, nose, voice box, or salivary glands. If caught in their initial stages, oral, head, and neck cancers can often be treated successfully. To learn more we spoke with Blake Golden, M.D., a head and neck surgeon at the Swedish Cancer Institute for answers to some of your most common questions about head, neck and oral cancer.
How do oral, head and neck cancers differ? How are they the same?
All oral cancers are head and neck cancers, but not all head and neck cancers are oral cancers. The term “oral” refers to a specific part of the mouth from the lips back to the back of the teeth. Between the back of the teeth and the voice box is an area called the oropharynx, and then from the voice box down to the entrance of the esophagus is broadly referred to as the larynx. Cancers can arise in any of these zones. Head and neck cancer can also refer to advanced cancers of the skin of the face and neck, cancers of the salivary glands, as well as more rare tumors of the bones, muscles, and sinus cavities of the face and neck.
What are the most common oral, head and neck cancers?
Thyroid cancer is the most common cancer seen in the head and neck, with about 24,000 new cases diagnosed in our country every year. Thyroid cancer is more common in women than men. Research suggests this may be because thyroid nodules are found more often in women, which leads to more diagnostic testing that can reveal cancer’s presence. The hormone estrogen may also play a role in the prevalence of women’s thyroid cancer. Squamous cell carcinoma is the leading type of cancer of the throat. It mainly affects the tonsils and tongue base. There are about 12,000 new throat cancers related to HPV every year and most are found in men. Reports indicate that may be related to the differences in how people develop protective antibodies to HPV.
What causes these types of cancers?
Thyroid cancer has been linked to some inherited conditions, but its exact cause is unknown. HPV has replaced smoking as the most common cause of throat cancers, accounting for roughly 80% of new diagnoses. Anyone sexually active is at increased risk for HPV-related cancer. These tumors now commonly present in patients in their 40s and 50s instead of their 70s, which was more common in past head and neck cancers caused by smoking. Other factors that can increase your risk of oral, head and neck cancer include:
- Smoking and tobacco use
- Heavy alcohol use
- Occupational exposure such as exposure to asbestos and other toxic substances
- Radiation exposure
Who is at risk? Have we seen any recent trends among who is at risk, like a jump in younger people for example?
The main expansion in head and neck cancer population over the last 20 years has resulted in a growth of human papilloma virus driven cancers of the tonsils and base of tongue. These cancers typically affect slightly younger adults than cancers that are not related to the human papilloma virus. The HPV driven cancers are a bit more common in men, and these patients do not typically have a strong tobacco or alcohol history, unlike the non-HPV driven cancer population. We have unfortunately also seen an increase in the number of young women with oral cancers. There are several working theories as to why this has occurred, all of which are subject to active research, and none of which have been definitive yet. It is clearly not linked to HPV infection, or tobacco consumption.
How do you advise patients to reduce their risk? Is there any hereditary factor?
The two main preventative measures that patients can take are to stop consuming tobacco products and HPV vaccination. The U.S. Food and Drug Administration currently authorizes HPV vaccination up to age 45. The well-powered studies that have looked at effectiveness of this vaccine for preventing cancer show that it gets its best benefit if used before sexual activity begins. So may be better advice is to get your kids vaccinated ASAP!
What are some warning signs to watch for?
Among the most common signs of throat and thyroid cancers is a lump or mass in the neck. Sore throats or ear pain that does not go away can also be potential throat cancer warning signs. You should see your doctor about a neck mass or swelling that lingers for more than 2 weeks.
Are there any new and innovative diagnosis or treatment options?
The main advances in treatment for head and neck cancer over the last 5 years have taken place in the chemotherapy realm. With the advent of immunotherapuetics across multiple different cancer subtypes, patients who previously would have had no treatment options now have another weapon to use against their cancer. There have also been improvements in tumor-specific targeted systemic therapies. There are also blood tests coming onto the market for surveillance of HPV driven cancers. These have not quite hit the level of the standard of care at this point, and numerous large studies are going on at multiple institutions right now to nail down the best way to use them. I would suspect we will see incorporation of these blood tests into the decision-making and surveillance process of these patients within the next 4 or 5 years in a widespread fashion.
Are there cures for these types of cancer?
The good news about HPV-related cancer is that it has much better treatment outcomes than non-HPV-related cancers. Almost 95% of HPV-related cancers will completely respond to treatment. However, if a patient smokes and then develops an HPV-related tumor, the prognosis is not as good as in a non-smoker.
Learn more and find a practitioner
If you or a loved one have questions about cancer diagnosis, treatment or care, the experts at Swedish Cancer Institute are here for you. We can accommodate both in-person and virtual visits. To talk to someone or make an appointment, call 1-855-XCANCER.
With Swedish Virtual Care, you can connect face-to-face with a nurse practitioner who can review your family and health history. To find a provider, search our provider directory.
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Additional resources
Unlocking the mysteries of cancer
Lung Cancer: Early detection is critical to successful treatment
A recent study found rising cancer rates among younger adults. What to know.
Today is the Great American Smokeout. It's a good day to be a quitter.
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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