Source: The Boston Channel
Author: Staff

Boston cancer specialists are trying to learn what’s behind an “epidemic” spike in oral cancer cases that they say is caused by the human papillomavirus, commonly known as HPV.

“What you’re seeing here is a five-fold increase in the numbers that we would expect,” said Dr. Marshall R. Posner, of the Dana Farber Cancer Institute. “So that, to me, is an epidemic.”

NewsCenter 5’s Heather Unruh reported Thursday that most adults have been exposed to HPV. Doctors say it can be sexually transmitted, even through deep kissing.

What doctors don’t know yet is why in some people, such a common virus develops into cancer.

“Most people who get infected with HPV naturally clear the virus,” said DFCI’s Dr. Karen Anderson. Anderson and her team of researchers are trying to isolate who’s at risk for oral cancer from HPV, and why.

“Because then,” Anderson said, “we can focus on more aggressive screening approaches for people who are at higher risk and start to look at more therapeutic interventions earlier on.”

Posner said that at least 20,000 cases of oropharyngeal cancer are diagnosed in the United States each year. Most patients are young. Three in four occur in men.

Tony is one face among the statistics. Five days a week he psyches himself up for radiation to treat the cancer that grew at the base of his tongue, where it meets his throat.

“What I say,” he said, “is, ‘It is not of me, or a part of me. Dissolve and go away. And I just repeat that.’”

Tony’s cancer was caused by HPV. Doctors said he was likely exposed decades ago.

“It’s unfortunate that this is something that probably could have been avoided, “ he said.

“It’s very treatable,” said Posner. “The cure rate is very high.”

Tony and his wife have joined a spousal clinical trial at DFCI.

“People need to know,” he said. “And to be here and be a part of this study, that feels really important to me.”

Doctors at Dana Farber want to see a comprehensive approach to preventing future cancers from HPV.

“The message is monogamy is good,” Posner said. “We don’t really know how to prevent it in adults who are already infected. We know how to prevent it in children and that’s by giving them the HPV vaccine.”

Two vaccines have been approved to protect against the spread of HPV. Gardasil, for sale for several years, protects against the four most common strains of HPV. A second vaccine, Cervarix, was approved by the FDA last October. Cervarix helps block the two types of HPV that cause most cervical cancers.

Gardasil is now being marketed to protect boys, too.

“If my son were 12 to 18 today, I’d want him vaccinated, without hesitation,” said Posner.

It will take 20-30 years for the Gardasil vaccine to affect the incidence of oropharynx cancer. In the meantime, DFCI scientists are about two years from human testing of a therapeutic vaccine for adults infected with HPV.