UT Southwestern, Baylor College of Medicine Target HPV-Related Throat Cancer In Clinical Trials
Out of more than 20,000 new cases of throat cancer in the U.S. each year, about 14,000 or so are caused by the sexually-transmitted human papillomavirus, or HPV. Throat cancer has surpassed cervical cancer as the leading HPV-related cancer in the country. But questions remain about detection and treatment.
Dr. Andrew Day is leading clinical trials at UT Southwestern Medical Center. The assistant professor of otolaryngology spoke with KERA's Sam Baker about HPV-related throat cancer.
- For some reason, men — predominantly middle-aged and elderly men — are six times more likely to get this throat cancer than women.
- Smoking is probably a risk factor for this.
- And we know the number of lifetime oral sex and lifetime vaginal sex partners is linked to the likelihood of getting this cancer.
How It Develops:
A lot of people think that people who get this cancer were exposed to HPV in their teens or in their 20s. And then it just kind of hung out and was latent, maybe like chicken-pox, which then later become shingles. And so in that case, the virus is for some reason, dormant, and then just arises.
Maybe it's because the immune system of the more elderly individual is not as strong. So we think that there's probably a component of that resulting in cancer. The virus has been around for decades and then for some reason becomes cancer.
And there's probably another component in which some middle-aged men have new sexual partners, get new exposure to HPV and then develop cancer.
Why The Clinical Trials Study Only Men:
This is not as common as breast cancer, prostate cancer, lung cancer. ithout a really high number of people getting this, we have to be very specific about trying to identify a very high-risk group.
We're trying to test whether or not we can screen at-risk individuals for HPV-mediated cancers. Can we use blood-based biomarkers and oral rinse biomarkers to identify a high-risk population that we then evaluate clinically to see? Is there cancer in the throat or in the neck? Or in the penis or the anus? And then follow those people.
About 50% of the patients present with a neck mass and maybe 20% to 30% present with a sore throat. Other patients are fairly asymptomatic.
Pain, which is such a common symptom for many people with cancer, is just not that common of a symptom for this. The most common story I hear is from men who say they were shaving and they noticed this neck mass. That's evidence that cancer that has started in their throat has already spread.
We're able to successfully treat this fairly well. I would say we’re able to cure 85% of patients right now on average, depending on the stage that you present at.
But the treatment is morbid for at least 80 to 85% of patients. We have to give either a surgery followed by radiation, radiation with chemo, or even surgery with radiation, with chemo. And that really does a number on your body.
What About The HPV Vaccine?
The HPV vaccine is preventative. We think we don't think it’s going to treat an existing infection. That's why the governing bodies say people should get vaccinated up through age 26, and then from 27 to 45 with shared decision-making with their primary doctors, because they don't think that that's going to be as effective. People have already been exposed to the virus and the vaccine at those ages won't be effective then.
What You Can Do To Help Prevent HPV-Related Throat Cancer
The best thing that we can do is vaccinating our kids. Unfortunately, vaccination rates for kids are really poor in the U.S., like barely over 50% of kids who could be getting vaccinated are getting vaccinated, and then just safe sex practices.
Interview highlights were lightly edited for clarity.
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