The scary reason doctors say kids need HPV vaccinations

Source: www.washingtonpost.com
Author: Sarah Vander Schaaff

When actor Michael Douglas told a reporter that his throat cancer was caused by HPV contracted through oral sex, two themes emerged that had nothing to do with celebrity gossip. The first was incredulity — since when was oral sex related to throat cancer? Even the reporter thought he had misheard. The second was embarrassment. This was too much information, not only about sexual behavior but also about one’s partners.

Douglas apologized, and maybe the world was not ready to hear the greater truth behind what he was suggesting.

That was four years ago.

Today, there is no doubt in the medical community that the increase in HPV-related cancers such as the one Douglas described — which he later explained was found at the base of his tongue — is caused by sexual practices, in his case cunnilingus. And there is an urgency to better treat and prevent what is becoming the one type of oral cancer whose numbers are climbing, especially among men in the prime of their lives who have decades to live with the consequences of their cancer treatment.

The number of people diagnosed with HPV-related oropharyngeal cancer, tumors found in the middle of the pharynx or throat including the back of the tongue, soft palate, sides of throat and tonsils — is relatively small — about 12,638 men and 3,100 women in the United States each year, according to the Centers for Disease Control and Prevention. But these numbers are expected to continue to rise, overtaking incidence of cervical cancer by 2020. One study revealed the presence of HPV in 20.9 percent of oropharyngeal tumors before 1990, compared with 65.4 percent in those sampled after 2000.

Alarming trend
It’s an alarming trend considering HPV, or human papilloma­virus, is the most common sexually transmitted infection in the country. The CDC estimates that nearly all sexually active men and women will get a form of the virus at some point. Although most HPV infections go away on their own, they are causing 30,700 cancers in men and women every year, including cervical, vaginal and penile cancers along with oral cancers.

Health agencies are pushing hard for HPV vaccinations, which they say could prevent most of those cancers. The CDC says all 11- and 12-year-olds should be ­vaccinated. And last year, the Food and Drug Administration approved a new two-dose series for children ages 9 to 14. And the American Academy of Pediatrics recently updated its vaccine recommendations to reflect that two-dose schedule, a reduction from the three shots previously required. (Children over 14 still need three shots.) The hope is to increase rates of completed vaccinations, which have lagged in the decade since the vaccines were released, averaging 42 percent for girls and 28 percent for boys, far below the Healthy People 2020 goal of 80­ percent.

The patients showing up in Ben Roman’s office at Memorial Sloan Kettering Cancer Center in New York, where he works as a head and neck surgeon and ­health-services researcher, came of age not only before these vaccines hit the market, but also before HPV and its link to cancers was fully understood. These cases, experts say, probably reflect several separate but interconnected factors: the sexual revolutions of the 1920s and 1960s that introduced more HPV into the general population, the changing sexual practices of young people who report more histories of oral sex, and that it can take 10 to 30 years for tumors to develop after an infection.

Roman has seen an increase in a new type of head and neck cancer patient. They are typically white, middle-aged men, ­otherwise healthy, who have no history of smoking or drinking. They may have first noticed a mass in their necks or lymph nodes while buttoning a shirt or shaving. An ear, nose and throat doctor has determined the primary source of the cancer: the tonsils or base of the tongue.

“Most people are familiar with tonsils in the back of the throat,” Maura Gillison, a leading expert in HPV-related cancers at the ­University of Texas MD Anderson Cancer Center, said. “But we also have them in the base of the tongue.”

The palatine tonsils are on the sides of the throat, and there are also lingual tonsils on the back of the tongue. Both areas are made of the same lymphoid tissue at particular risk for HPV infection, and are part of what specialists call Waldeyer’s Ring.

Experts are not sure why an HPV infection in the tonsils is more likely to lead to cancer. It could be because of their anatomy, which has crypts and crevices, making it harder to clear an infection. Gillison said it could also be because of where the tonsils are in the body, an area that serves as a transition from the outside to the inside, much like the genital tract and cervix.

German researcher Harald zur Hausen identified the types of HPV that cause cervical cancer 34 years ago, work that earned him the Nobel Prize in 2008 and contributed to the development of the HPV vaccine. One of those types, HPV-16, is identified in more than half of cancers in the oropharynx, according to the National Cancer Institute.

But there are important distinctions between men and women when it comes to HPV-related cancers. Cervical cancer deaths, for example, have been greatly reduced through early detection with the use of Pap smears. The same screening for precursor lesions or pre-cancer is not yet possible for the oropharyngeal cancers, commonly referred to as OPC or OSCC, for oropharyngeal squamous cell carcinomas.

The male risk
Another difference is how men and women respond to infection. The majority of women develop antibodies to clear HPV when exposed vaginally. These antibodies remain in the body so that a woman is protected from a subsequent oral infection. Men, in contrast, are much less likely to develop antibodies after genital exposure to the virus. When tested, their titers — a measurement of antibodies — are lower, leaving them five times more likely than women to have an oral infection.

HPV is considered an unusual virus because it does not travel through the bloodstream. Infection is localized, meaning it stays at the place where contact occurs. In tonsil cancer, then, oral sex becomes a relevant risk factor, so significant that in an article in the Journal of Clinical Oncology, Gillison and her colleagues stated that the number of these oral sex partners in a lifetime is the behavior measure that is, “. . . most strongly, consistently, and specifically associated with OPC (tonsil and base of tongue).”

Treating a cancer related to a sexually transmitted infection brings up sensitive questions. Roman said a patient’s spouse will often pull him aside to ask: “When did he get this? Was he cheating?” He suggests the patient was probably exposed years ago. But from the viewpoint of prognosis, the HPV-related cancers respond better to treatment.

That fact has prompted rapid changes in treatment protocols that were as recently as five years ago based on heavy smoking and drinking. These new strategies back down from the aggressive radiation, chemotherapy and surgery that exposed patients to high toxicity and could damage the ability to speak and swallow.

When Gillison started her research in 2000, there was little awareness that sexual behavior contributed to cancer of the throat, and fellow researchers were skeptical.

“People were laughing. They thought it was absurd,” she said. Now, Gillison is credited with formally putting together the behavioral data and biomarkers to quell any skepticism, Carole Fakhry, an associate professor of otolaryngology and surgeon at Johns ­Hopkins, said.

Others had noted HPV in oral cavity cancer, but no one was sure whether it was a fluke or more significant. So Gillison reviewed tumor specimens collected by a colleague and then set out to study all of the available ­literature, presenting an analysis in 2009 that compared the ­survival rates of those with HPV-positive and -negative oropharynx cancers. Gillison describes her work — a confluence of observations in the lab and clinic — as an act of serendipity.

“I have always been interested in the association between ­infectious diseases and tumors because there are so many ­opportunities to intervene. If an infection causes a cancer, you can try to prevent infection in the first place, or screen, or if it’s developed you can use the fact that it’s associated with a virus — you can treat cancer by treating infection.”

As far as vaccination’s effect on preventing OPC in men, data is still under review. Officially, the vaccine is recommended for boys and young men to prevent genital warts and anal pre-cancers. But those focused on pediatrics, such as Margaret Stager, director of adolescent medicine at MetroHealth medical center in Ohio and an official spokeswoman for the American Academy of Pediatrics, say that HPV vaccination clearly decreases spreading of HPV through the community, offering immediate, midrange and long-term benefits. And the current vaccines do protect against HPV-16, one of the high-risk types of the virus found in both cervical cancer and a majority of OPC.

New, easier vaccine
The new two-dose vaccination is designed to reach children when their antibody response is highest and make completion less cumbersome, as are electronic medical records that cue physicians when a vaccine is due. The District of Columbia is one of the few areas that has made the vaccine a required immunization for students in grades six through 12, although families may opt out.

There is still a gap in knowledge among some general ­practitioners and dentists, according to Gillison.

It is not uncommon for her to hear a story from a patient who comes to her after six months or so after going to his doctor.

“He told me not to worry ­because I was fighting off an infection. He gave me antibiotics. They were not working. Then ­another lump occurred next to that one . . . ”

The patient is young, healthy and doesn’t smoke. He has a sore throat and a neck mass that doesn’t respond to antibiotics.

Those in the front lines of ­medical practice, she said, should have in mind the question: Could this patient have head and neck cancer?

Curbing oral cancer

Source:.businessmirror.com.ph
Author: Henrylito D. Tacio

“Cancer is the third leading cause of death in the country today. Most of it can be prevented since its risk factors are lifestyle and environmentally related. Early detection of cancer is a crucial key to the survival and recovery of its victims. The earlier you detect the malignancy the higher the survival rate of the patient.”
—Dr. Vic Fileto Chua of Movement for Early Detection of Cancer

What’s the leading cause of oral cancer? Is it smoking or heavy drinking? Although smoking and drinking may cause oral cancer, the leading cause is oral sex, a sexual act that involves the stimulation of the genitalia using the mouth.

Studies have shown that 64 percent of cancers of the oral cavity, head, and neck in the United States are caused by human papillomavirus (HPV), which is commonly spread via oral sex. The more oral sex you have – and the more oral sex partners you have – the greater the risk of developing these potentially deadly cancers.

oral_cancer

“An individual who has six or more lifetime partners—on whom they’ve performed oral sex—has an eightfold increase in risk compared to someone who has never performed oral sex,” explained Dr. Maura Gillison, an oncologist at Ohio State University. Gillison headed a team of researchers who examined 271 throat-tumor samples collected over 20 years ending in 2004. They found that the percentage of oral cancer linked to HPV surged to 72 percent from about 16 percent.

The study, which was published in the Journal of Clinical Oncology, said that by 2020, the virus-linked throat tumors—which mostly affected men—will more common than HPV-caused cervical cancer.

“The burden of cancer caused by HPV is going to shift from women to men in this decade,” observed Gillison. “What we believe is happening is that the number of sexual partners and exposure to HPV has risen over that same time period.”

In his weekly column in Philippine Daily Inquirer, Dr. Rafael D. Castillo noted: “Previously, it was well established that smoking (three-fold increase) and drinking alcohol (2.5 times) increased the risk for oral cancer, but even if you combine them, the risk is no match compared to that seen in those who frequently engage in oral sex.”

The government doesn’t have any data on the prevalence of oral cancer in the country but what alarms Castillo is that oral cancer might be rampant among young people. A study done by the University of the Philippines Population Institute showed that more than four million teenagers and young Filipinos are already engaged in sexual practices.

The findings of the third Young Adult Fertility Survey revealed that a total of 4.32 million Filipinos aged 15 to 24 are already sexually active. Another finding is that oral sex has become a common practice “among most sexually adventurous teens.”

“Doing simple math, if the expected prevalence of oral cancer in the general population is 1.5 percent, and with a nine-fold increase in risk, that means that we have approximately 583,000 young Filipinos aged 15 to 24 who are likely candidates to develop oral cancer,” Dr. Castillo surmised.

“Today’s teens consider oral sex to be casual, socially acceptable, inconsequential, and significantly less risky to their health than ‘real’ sex,” said Gillison. Teens simply think oral sex is “not that a big a deal,” added Dr. Bonnie Halpern-Felsher, professor of pediatrics at the University of California, San Francisco. “Parents and health educators are not talking to teens about oral sex. Period.”

Members of the Philippine Medical Association (PMA) and the Philippine Dental Association (PDA) also noted that the practice of oral sex can lead to infections of the oral cavity, which may result to cancer of the tonsils, tongue or throat.

“Any lesion in the mouth should be seriously considered,” said Dr. Anne Camus, PDA’s Manila dental chapter president. “Not all can develop to cancer but malignancy must always be taken as an imminent possibility.”

A regular check-up with a dentist would help detect malignancies in the mouth. “The dentists are usually the first to see lesions in the mouth of our patients,” Camus said. “At this early point, if the lesion turns out to be malignant, then chances are it is still curable.”

Oral cancer, or cancer of the mouth, most commonly involves the lips or the tongue. It may also occur on the: cheek lining, floor of the mouth, gums, and roof of the mouth (palate). Most oral cancers are a type called squamous cell carcinomas, which tend to spread quickly.

Aside from oral sex, smoking, and drinking, other factors that add to the risk of oral cancer include repeated irritation from the sharp edges of broken teeth, fillings, or dental prostheses (dentures). “The research regarding their involvement is uncertain. It is likely that there is a complex interaction of many external and internal factors that play a role in the development of oral cancer,” points out the Oral Cancer Foundation in the United States.

“Oral cancers are usually painless for a considerable length of time but eventually do cause pain,” notes “The Merck Manual of Medical Information.” “Pain usually starts when the cancer erodes into nearby nerves. When pain from cancer of the tongue or roof of the mouth begins, it usually occurs with swallowing as with a sore throat.”

The early growth of salivary gland tumors may or may not be painful. “When these tumors do become painful, the pain may be worsened by food, which stimulates the secretion of saliva,” the Merck manual informs. “Cancer of the jawbone often causes pain and a numb or pins-and-needles sensation, somewhat like the feeling of a dental anesthetic wearing off. Cancer of the lip or check may first become painful when the enlarged tissue is inadvertently bitten.”

Discolored areas on the gums, tongue, or lining of the mouth may be signs of cancer. “An area in the mouth that has recently become brown or darkly discolored may be a melanoma (malignant tumor),” the Merck manual states. “Sometimes, a brown, flat, freckle-like area (smoker’s patch) develops at the site where a cigarette or pipe is habitually held in the lips.”

“Keep in mind that your mouth is one of your body’s most important early warning systems,” reminds the Oral Cancer Foundation. “Don’t ignore any suspicious lumps or sores. Should you discover something, make an appointment for a prompt examination. Early treatment may well be the key to complete recovery.”

According to the US National Cancer Institute, oral cancer treatments may include surgery, radiation therapy or chemotherapy. Some patients have a combination of these treatments.

2016-11-17T12:44:14-07:00November, 2016|Oral Cancer News|

Oral cancer in the crosshairs at San Antonio Dental School

Source: tpr.org
Author: Wendy Rigby

San Antonio researchers are working on a new therapy for a stealthy killer: oral cancer. Visits to the dentist are your number one protection against the disease. In a lab at the University of Texas Health Science Center at San Antonio, dental researcher Cara Gonzales, DDS, Ph.D., shared promising news on a new approach to healing.

“It was very exciting,” Gonzales said. “These patients have not had any new therapeutic options in 40 years.”

The discovery of a new gene that’s turned on in oral cancers gave Gonzales and her colleagues a new target at which to aim. It’s a gene that’s also found in lung cancers.

So-called nude mice are used in the oral cancer experiments. Webdt Rigby / Texas Public Radio

So-called nude mice are used in the oral cancer experiments.
Wendy Rigby / Texas Public Radio

Gonzales works in a sprawling space filled with lab equipment and cell lines used in many molecular biology projects. One of her research assistants brought in a cage of lab animals with some strange lumps on their backs.

“These are called nude mice because they don’t have a complete immune system,” Gonzales explained.

These mice are at the center of a successful experiment. First, scientists used human oral cancer cells to grow large tumors on the animals. They tried one oral cancer drug already on the market. Not much action. Then, they tried a lung cancer drug, also already approved by the Food and Drug Administration. Not that effective on its own. Finally, they used a combination of two drugs. What happened made the medical profession take notice.

“When we combined the two, then we saw a 50 percent reduction in the tumor volumes after 14 days,” Gonzales described.

That kind of success could help thousands of patients whose cancers aren’t caught until the later stage, patients like Paige Lewis of San Antonio who was only 35 when she got the results of a biopsy from her doctor.

“I walked in and she said the words I’ll never forget,” Lewis recalled. “‘Sweetie, it’s cancer.’”

Lewis had tried for a year to get various doctors and her dentist to examine and biopsy the strange spot under her tongue. But no one really thought she was at risk for the disease.

“I was told it’s most likely nothing because I’m young. I was only 35 years old. I was a female non-smoker, non-drinker,” Lewis said.

While smoking, drinking and age are big risk factors for oral cancer, so is the presence of the human papillomavirus in the body. Some cases, like Lewis’, are simply unexplained.

Since her cancer was so advanced, Lewis, a single mother of three children, faced a massive surgery and weeks of radiation. Paige still bears scars on her arm from a major surgery where doctors removed her tumor and rebuilt her tongue.

“They removed half of my tongue,” she described. “They harvested part of my arm in order to place a flap in my mouth. And then a part of my leg to cover part of my arm.”

Lewis spent 20 days in the intensive care unit. If her cancer had been detected earlier, or if doctors had the ability to shrink her tumor, her ordeal would have been less painful and less risky. Only slightly more than half of all oral cancer patients are alive five years after their treatment. Lewis is four years out.

U.T. Health Science Center researchers are trying to secure funding for human trials which may take place in San Antonio. The pills used in this new combination target tumors specifically, so patients would not suffer as many side effects as they do with conventional chemotherapy, side effects like hair loss and gastrointestinal issues.

Dr. Cara Gonzales’ oral cancer paper was published in the journal Oral Oncology.
“If we can find something that would treat these advanced tumors, we could potentially increase the survival rate of approximately 25 percent of all oral cancer patients,” Gonzales stated.

Lewis is coping well with the side effects of surgery and radiation, but it hasn’t been easy. “Cancer takes over your life during that period of time. And it affects every single person you know,” Lewis said. “All of this could have been avoided with an early diagnosis.”

An oral cancer screening at the dentist only takes two minutes, and checking for oral cancer should be part of a regular dental screening. Like Lewis and thousands of others, though, you may have to insist the hygienist or dentist examine your mouth, tongue and gums in detail. Having a medical professional look for signs and symptoms of the disease is still the best defense against oral cancer which claims an average of one American life every hour.

Alcohol consumption increases risk for seven types of cancer: Study

Source: perfscience.com
Author: Diana Bretting

An analysis of past health studies that have looked at the association between drinking and cancer has unveiled that having alcoholic beverages can increase the risk for seven types of cancer, including head, neck, esophageal, liver, colorectal and breast cancer.

The analysis carried out by Jennie Connor of the University of Otago, in New Zealand included comprehensive reviews conducted by the prestigious organizations, which include the World Cancer Research Fund and the American Institute for Cancer Research among others.

The researchers came to know that the risk did not go down even if there were different alcohol types like rum, whiskey, wine or beer. The risk increases with higher consumption, which as per the researchers is known as a dose-response relationship.

Connor was of the view that there is little evidence suggesting that the risk lessens for head and neck and liver cancers when consumption declines. Dr. Susan Gapstur, Vice-President of the Epidemiology Research Program at the American Cancer Society, said that the analysis has strengthened what is already known about the link between alcohol and cancer.

Dr. Gapstur said, “This is a review of an existing body of literature. Essentially the author has interpreted the literature to help people to understand. But it’s not a study of any new data. These seven cancer sites have long been established”.

Health officials were of the view that the study might help regular drinkers to cut their drinking habit. Dr. Jana Witt, of Cancer Research UK said that the best way would be to not have alcohol for few days in a week. It acts as a great way to cut down on drinking. One can swap alcoholic drink with soft drink, having smaller servings of alcohol and not to keep a stock at home.

According to a report in CBS News by Mary Brophy Marcus, “Drinking alcoholic beverages can raise the risk for seven types of cancer, according to a new study. Even moderate drinking is linked with a higher risk. The cancers include head, neck, esophageal, liver, colorectal and female breast cancer, according to the analysis of existing studies looking at the association between drinking and cancer. The findings are published in the journal Addiction.”

“Having some alcohol-free days each week is a good way to cut down on the amount you’re drinking,” “Also, try swapping every other alcoholic drink for a soft drink, choosing smaller servings or less alcoholic versions of drinks, and not keeping a stock of booze at home.” The study also found that the risk of certain mouth and throat cancers was even higher among people who both smoked and drank alcohol.

A report published in the Live Science said, “Previous studies have found an association between drinking alcohol and a higher risk of developing certain cancers, according to the study. However, it was not clear from the studies if drinking alcohol directly caused cancer.”

The link between alcohol and cancers of the mouth and throat were stronger than the link between alcohol and other cancers, Connor wrote. For example, drinking more than 50 grams of alcohol a day is was associated with a four to seven times greater risk of developing mouth, throat or esophagus cancer compared with not drinking at all.(The number of grams of alcohol in 1 ounce of a drink can vary. For example, there are 2.4 to 2.8 grams of alcohol in an ounce of wine, but there are 1 to 1.2 grams of alcohol per ounce of beer.)

“Health experts endorsed the findings and said they showed that ministers should initiate more education campaigns in order to tackle widespread public ignorance about how closely alcohol and cancer are connected. The study sparked renewed calls for regular drinkers to be encouraged to take alcohol-free days, and for alcohol packaging to carry warning labels,” according to a news report published by The Guardian.

Oral cancer less likely in women who have more sex; but not the same for men

Source: www.parentherald.com
Author: Diane Ting

Having more sex partners reduces the chance of oral cancer for women. Unfortunately, men are more likely to become infected as the number of oral sex partners increases.

A study suggests that women who have more vaginal sex partners appear to have a lower risk of oral human papillomavirus (HPV) infections. The information was released during the annual conference of the American Association for the Advancement of Science. Throat and mouth cancer are linked to HPV, which is one of the most prevalent sexually transmitted diseases. HPV is rather common, as most people are treated of the virus within two years.

According to the study published by the Journal of the American Medical Association (JAMA), oral sex may increase the risk of head and neck cancer by 22 percent. In the last 20 years, the number of oral cancer patients has risen to 225 percent.

Oral cancer is typically linked to lifestyle causes such as heavy drinking and smoking, according to Mirror. Two in three sufferers of oral cancer were men, which made experts question the imbalance.

HPV is the same cancer that causes cervical cancer in women. Research states that because women are first exposed to HPV vaginally, they may develop an immune response that prevents them from getting the infection.

Unfortunately, research suggests that this may not be the same for men as they are found twice more likely to develop oral cancer. As the number of oral sex partners increase, the risk of oral HPV infections also increases. It is believed that oral sex may be the main cause at which the HPV ends up in the mouth. “Our research shows that once you become infected, men are less likely to clear this infection than women, further contributing for the cancer risk,” according to Gypsyamber D’Souza, a professor at Johns Hopkins University in Baltimore.

Oral sex can dramatically increase a person’s risk of the common human papillomavirus (HPV) by 22 times, which can eventually lead to cancer, according to a study. While HPV is very common and easily treatable, HPV may not go away in some cases particularly with men. In some rare instances, the virus can lead to cellular changes in the mouth and throat, which can lead to cancer.

Middle-aged white men are particularly at high risk compared to other races, according to Daily Mail. The US Centers for Diseases Control and Prevention (CDC) has highly recommended all pre-teenagers to take the HPV vaccination before they become sexually active.

2016-02-18T14:27:17-07:00February, 2016|Oral Cancer News|

Salivary gland cancers rare, but sometimes deadly

Source: articles.baltimoresun.com
Author: Andrea K. Walker

Professional baseball great Tony Gwynn Sr., also known as Mr. Padre, died last month of salivary gland cancer, which he believed was caused by years of using smokeless chewing tobacco. The cancer is a rare form that begins in any of the salivary glands in the mouth, neck or throat. Two adults in 100,000 are diagnosed with salivary gland cancer each year. The chances of survival drop if the cancer has spread to other parts of the body. Dr. Patrick K. Ha, with Johns Hopkins Head and Neck Surgery at Greater Baltimore Medical Center, says new types of treatments and therapies are in the works to treat the disease.

What is salivary gland cancer and how common is it?
Salivary gland cancers are a diverse group of rare malignancies that can involve any of the major salivary glands (the parotid, submandibular and sublingual) or minor salivary glands, which are found within the lip, palate, tongue base, nasal cavity or sinuses. There are numerous different cancers that may arise from the salivary glands, and these may behave differently based on their cell of origin.

What causes it, and who is more likely to get it?
Little is known about the causes of salivary gland cancers. Unlike the more common head and neck cancers, which have a clear association with smoking, drinking or even the human papillomavirus (HPV), salivary gland cancers do not have such strong associations. There may be a link between significant radiation exposure (i.e., treatment level doses) in the development of salivary gland cancers, as well as with some environmental exposures such as nickel alloy, asbestos or woodworking materials. Tony Gwynn believed using chewing tobacco throughout his professional baseball career was the cause of his cancer, but salivary gland cancers aren’t as strongly linked to tobacco use as some other types of cancers. Nonetheless, we advise against smoking, using smokeless tobacco or even e-cigarettes. They are all addictive and tobacco products contain carcinogens relevant to other cancers.

We do know that men are more likely to get this type of cancer, with the average age of onset in the mid-60s.

What are the symptoms of salivary gland cancer?
Unfortunately, salivary gland cancers most often present as painless masses in the cheek, neck, or within the sinuses/tongue base. Because most of these masses are slow growing, the development of symptoms occurs relatively late. Depending on which gland is involved, the symptoms may include a visible lump, difficulty breathing, swallowing problems or pain. Late symptoms might include facial weakness/drooping, numbness or visual changes.

How is it diagnosed and is it hard to detect?
The ultimate diagnosis is made with a biopsy. A distinction can often be made between benign and cancerous masses with a small needle biopsy, but sometimes requires complete removal of the mass to make this determination. Imaging with a CT scan or MRI can be helpful, especially for operative planning. Depending on where the tumor is located, detection can be more difficult. For example, a mass on the outer surface of the parotid or submandibular gland will be more easily felt than a mass growing in the sinus.

How is it treated and what is the likelihood of survival?
Most salivary gland cancers are treated with surgery up front for complete removal, and possibly radiation afterwards, depending on how serious the disease appeared at the time of surgery and under the microscope. Chemotherapy is less well proven to be helpful in these cancers but could sometimes be considered as additional therapy along with radiation. While some forms of salivary gland cancer can be aggressive, most are relatively well treated, and the five-year survival rate can be upwards of 75 percent.

What new therapies are on the horizon for salivary gland cancers?
Currently, there are trials available to examine the role of chemotherapy in salivary gland cancer treatment. Additionally, work is being done to look into targeted therapy which can better treat the cancers without the significant side effects. Unfortunately, because these are rare cancers, we need to perform the basic research to understand how these cancers arise before we can really make significant advancements in their treatment.

Global trends in oral cancers

Source: www.dailyrx.com
Author: staff

It used to be that smoking and drinking alcohol were the biggest risk factors for cancers that develop in the mouth and throat. Those trends may be changing, according to a new study. That new study uncovered that cancers that appear in the throat right behind the mouth have increased, primarily in developed countries. The trend has been most prevalent in men under the age of 60, the researchers found. These increases, the authors suggested, may be linked to human papillomavirus (HPV), a sexually transmitted virus that’s associated with a number of cancers, including oral cancers.

Anil K. Chaturvedi, PhD, of the National Cancer Institute, led this study that examined incidence trends for oropharyngeal (part of the throat behind the mouth) and oral cavity (mouth) cancers in 23 countries across four continents. The researchers examined the countries’ cancer registry data for the years 1983 to 2002.

In the study’s introduction, the authors noted that oral cavity cancers (OCC) have declined recently in most parts of the world due to the declines in tobacco use. At the same time, oropharyngeal cancers (OPC) have risen over the past 20 years in some countries. OPC rates were compared to those of OCC and lung cancers to distinguish the potential role of HPV from smoking-related cancer trends.

The researchers tracked specific OPC sites, including base of the tongue, tonsils, oropharynx and pharynx (throat). OCC sites included the tongue, gums, floor of the mouth, palate (roof of the mouth) and other areas of the mouth.

Here’s what the researchers learned:

  • OPC increased significantly among men in the United States, Australia, Canada, Japan and Slovakia. Incidence trends for OCC in these countries were either not significant or there was a significant decline in OCC.
  • Among women, there was an increase in both OPC and OCC cases in Denmark, Estonia, France, the Netherlands, Poland, Slovakia, Switzerland and the United Kingdom.
  • In Denmark and the United Kingdon, both OPC and OCC increased significantly, with stronger increases seen in OPC than in OCC.
  • Increasing OPC incidence in men was accompanied by decreasing incidence in lung cancer.
  • For women, however, increasing OPC incidence occurred at the same time as increasing Lung Cancer incidence.
  • OPC incidence rose substantially more for younger men under the age of 60 than in older ages in the United States, Australia, Canada, Slovakia, Denmark and the United Kingdom.
  • For OCC, a similar statistically significant increase at younger ages was seen only in the United Kingdom, while OCC incidence decreased significantly at younger ages in the United States, Australia and Canada.

The authors of this study pointed out that recent research has suggested that about 60 to 70 percent of OPCs in the US are caused by HPV infection, compared with less than 10 percent in less economically developed areas. The researchers wrote, “Our results underscore the potential for increasing global relevance of HPV as a cause of OPC.”

They added that the reasons for higher increases seen in men are not clear and warrant more investigation.

“This male predominance also has important implications for male HPV vaccination policy in several countries,” according to the researchers.

Meanwhile, tobacco and alcohol use remain major risk factors for both OPC and OCC, with OCC incidence two to four times higher than OPC in most parts of the world, “…underscoring the need for prevention strategies targeted toward tobacco and alcohol use,” the authors concluded.

Note:

1. This study was published November 18 in the Journal of Clinical Oncology.
2. The research was supported by the National Cancer Institute and by a grant from the Institut National du Cancer.
3. One of the authors disclosed financial ties with two pharmaceutical companies.

2013-11-19T14:42:18-07:00November, 2013|Oral Cancer News|

Dental hygienist, consultant detects own oral cancer

Source: www.dentistryiq.com
Author: Shelli Castor

Dental hygienist and practice-management consultant Barbara Boland discovered at the young age of 41 that she had oral cancer. Boland is now a 10-year cancer survivor, and she hopes her story and experiences will serve to start a continuing dialogue about oral cancer, especially among dental professionals.

Boland graduated from Temple University in Pennsylvania in 1982 and has been working as a practice-management consultant for 24 years. In December 2002, she discovered a peculiar white spot on her tongue that she knew she hadn’t noticed before. She kept an eye on the spot for a month, and because it was changing, she showed her tongue to a head and neck surgeon. The surgeon responded that it couldn’t be cancer for various reasons: she didn’t smoke or drink, she was female, and she was “too young” — there was no way the spot could be cancer.

While such an almost flippant response to a patient’s concerns seems wildly out of place and unexpected today, Boland notes that 10 years ago, dental and medical professionals were not well-educated on the signs, symptoms, and risk factors of oral cancer. For dental and medical professionals 10 years ago, the most common risk factors included tobacco and alcohol use, age, and the fact that males had a higher incidence of oral cancer than females. Boland fit none of those categories, and so her concerns were not seen as pressing.
Still, the spot on her tongue “didn’t feel right” to her. By this time, not only had the white spot grown, but a red spot had appeared as well. In April 2003, she again went to the head and neck surgeon, but received the same response.

Through her consultant practice, Boland worked with about 30 dentists. After the head and neck surgeon’s second dismissal, she began to go around to her clients and asked them to take a look at the spots. The dentists had the same response as the neck surgeon. She didn’t fit the categories, so what chance was there that the spots would be cancer?

Throughout the time Boland was seeking advice, the spots continued to grow.

Finally, a breakthrough presented itself: One of her clients had information on a new procedure called a brush biopsy that wasn’t even on the market yet. The client offered to try out the product on her, and she had a biopsy performed on the white spot only, as she hadn’t shown the client the red spot. The white spot biopsy came back atypical, which meant she needed to have a scalpel biopsy. That biopsy came back on May 16, 2003, and the result confirmed Boland’s growing fears that something was very wrong: oral cancer.

On July 1, 2003, Boland underwent surgery to remove 25% of her tongue. She also had lymph nodes removed from her neck to see if they contained cancer. Since the lymph nodes came back cancer-free, she did not have to undergo radiation or chemotherapy.
For the next few months, Boland gradually regained full functionality in her mouth. It took eight months for her speech to return to normal. Ten years later, the only lasting effects are a significant lack of taste buds and sensation on the affected right side of her tongue, and the fact that the right side of her face continues to be numb. However, she says, she can live with that; those are small side effects compared to the gravity of cancer.

In the 10 years since Boland’s diagnosis and treatment, new discoveries about the causes of oral cancer have been made. HPV — the human papillomavirus — is rapidly becoming one of the most common causes of oral cancer. The HPV link was not known at the time of Boland’s diagnosis, but is becoming better known as researchers continue to conduct tests on the disease. The HPV link was also briefly featured in the news media when Michael Douglas mentioned he had had treatment for oral cancer linked to HPV. Boland says that it is unlikely that her cancer is HPV-related because of the location of her lesion—most HPV-related oral cancers appear at the back of the mouth, while hers was located under her tongue.

While HPV is now increasingly recognized as a possible cause for oral cancer, the major risk factors are still drinking and smoking. However, age is no longer as much of a concern because of the HPV link; the under-50 population is at growing risk for developing oral cancer. Males are still diagnosed at a greater rate than females, but females are catching up. Still, about 25% of people do not fall within the above major categories, and about 6% of cases have undefined causes. Even so, most oral cancer patients today do find out what caused the cancer—most cancer patients’ tumors get tested for HPV.

Boland’s story offers a chance for the general public as well as dental and medical professionals to become more knowledgeable about oral cancer. It is important to remember that, while oral cancer is more common than cervical cancer and about as common as leukemia, 95% of oral changes aren’t cancerous. However, Boland informs, you can’t tell with your naked eye whether an oral change is cancerous or not.

Since Boland’s diagnosis and treatment, she has been speaking to dental professionals on the topic of oral cancer. She laments, however, that there doesn’t seem to have been a changed response to early signs of oral cancer — most professionals respond the way the surgeon and her dentist clients did years ago. Boland attributes the lack of knowledge and seeming indifference to the topic of oral cancer to how dental professionals are taught about it in school. She said that dental schools feature photographs of large lesions and teach future dental professionals to search for those large lesions when discussing oral cancer. Boland says that this type of training is why the five-year survival rate for oral cancer is so low — by the time oral cancer is detected, the cancer is at an advanced stage, which reduces the survival rate. Instead, dental professionals should be taught to pay attention to things that probably are benign, but shouldn’t be there, such as tissue changes. Small spots like Boland’s should also be paid attention to — the earlier the detection, the greater chance of survival rate.

In addition to changed curriculum in dental schools, Boland advocates that states should mandate a continuing education course every couple of years on the detection of oral cancer. The combination of better information on oral cancer with a frequent refresher on that information would, in Boland’s words, keep the dental professional from “getting complacent” about oral cancer.

Since she has been both a patient and a dental hygienist, Boland has advice for both dental professionals and patients about how to promote awareness and/or be aware about oral cancer.

She says dental hygienists and dentists should talk to their patients about oral cancer at every checkup. New tools, such as the brush biopsy that first indicated the presence of Boland’s cancer, should be incorporated into the dental armamentarium. Since younger people are now more likely to develop oral cancer because of the HPV link, Boland advocates starting regular oral conversations and oral cancer screenings with patients at age 12. The CDC, she notes, has fact sheets about HPV that could be given to patients. As far as how often screenings should be given, every checkup would be ideal, but screenings should be given at least annually. She says she wants patients to get in the habit of scheduling an oral cancer screening every year, just as women of a certain age schedule their mammograms every year.

For professionals and patients worried about the extra cost of a screening, Boland states that cancer screening should be considered a part of a comprehensive exam, and that patients not be charged an extra fee for that procedure. If the patient needs or requests a procedure such as a brush biopsy, for example, that could be considered a separate exam, and that dentists could charge for it if they absolutely had to. Boland does admit that there is some cost for the screenings and procedures, but that they are not much. For her, dental professionals should have the goal to screen as many people as possible. Dental professionals “have the professional responsibility to get the word [about oral cancer] out there to people,” Boland says, and that “public awareness needs to be increased.”

When asked, Boland said that people could do a “self-exam” for oral cancer. She said people can check for unusual things. If a person does see something new (not something that’s been there for a long time) or a change, Boland says to keep an eye on it for a couple of weeks; most trauma (such as cheek or tongue bites or burns) will heal within that time frame. If two weeks go by and the unusual thing is still there and/or has gotten bigger, Boland advises people to have it checked out. She says not to let someone check you with his or her naked eye. As for how often a person should check their mouth for possible signs of oral cancer, Boland says to check monthly or every three months; if you notice something, then check every day.

Barbara Boland has taken her admittedly scary experience with oral cancer and turned it into an opportunity to educate others, especially dental professionals, on the new information surrounding oral cancer. Her persistence in trying to find an answer to the curious lesions on her tongue, even after countless dismissals, paid off, and saved her life. Boland herself says that if she wasn’t a hygienist, she wouldn’t have been diagnosed with stage 1 cancer — if she had been a regular patient without dental hygiene training, had gone to her dentist, and had received the same dismissal, she wouldn’t have been worried about it, she says. Boland hopes her story will educate others about oral cancer. She also hopes that it will lead to changes in dental education and practice regarding oral cancer so that more people will be diagnosed earlier and therefore have a better chance of survival. Boland’s 10-year survival rate is “the exception, not the rule” — but Boland hopes to change that.

Cancer waiting times ‘could cost lives’

Source: www.rochdaleonline.co.uk
Author: staff

Statistics released by the Department of Health reveal costly delays that could jeopardize the lives of suspected head and neck cancer patients.

According to the 2012/13 Cancer Waiting Times annual report1, 1,252 suspected head and neck cancer patients had to wait longer than three weeks to be seen by a specialist, a delay that could potentially cost lives.

With mouth cancer cases on the increase, campaigners the British Dental Health Foundation are calling for suspected head and neck cancer patients to be seen within the two-week referral target due to the very nature of the disease. Without early detection, the five year survival rate for mouth cancer is only 50 per cent. If it is caught early, survival rates over five years can dramatically improve to up to 90 per cent.

Between April 2012 and March 2013 over one million patients were seen by cancer specialists following an urgent referral. A total of 96.1 per cent of suspected head and neck cancer were seen within 14 days of referral, compared to 96.3 per cent in 2010-20112. More than 50,000 patients were not seen within 14 days of referral.

Cancer waiting times are monitored carefully by the Foundation, which organises the Mouth Cancer Action Month campaign, sponsored by Denplan also supported by Dentists’ Provident and the Association of Dental Groups (ADG), in November each year to help raise awareness of the disease and its symptoms. Tobacco use, drinking alcohol to excess, smoking, poor diet and the human papillomavirus (HPV), transmitted via oral sex, are all known risk factors for mouth cancer, which is forecast to affect 60,000 people in the UK over the next decade.

Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, said: “The challenge in relation to mouth cancer is to ensure that, due to the very nature of the disease, patients are seen quickly. Most people with mouth cancer present late as stage 4 – the most advanced stage where time is of the essence in potentially saving a life.

“It is pleasing to see such a high percentage of suspected cancer patients seen within two weeks, but mouth cancer patients in particular should not have to wait more than three weeks.

“More people died from mouth cancer in 2010 than from cervical and testicular cancer combined. Early detection saves lives, so be aware that ulcers which do not heal within three weeks, red and white patches in the mouth and unusual lumps or swellings in the mouth are early warning signs of mouth cancer.

“Our message to everyone is simple – ‘If in doubt, get checked out.’”

2013-09-04T07:03:39-07:00September, 2013|Oral Cancer News|

Celebrity confession linking sex to oral cancer raises local awareness

Source: www.vancouversun.com
Author: Pamela Fayerman

Michael Douglas is credited for raising awareness about the links between oral sex and oral cancer, but experts worry his disclosure could cause public panic and stigmatize the disease to the point of bringing shame to those afflicted. Or worse, prevent patients with symptoms from getting examined promptly.

Miriam Rosin, a BC Cancer Agency scientist, said the actor’s candid revelation that his throat cancer was caused by human papillomavirus (HPV), which he picked up from performing cunnilingus, is raising awareness of a growing problem around the world, and in B.C. “It’s created a lot of noise. I think it’s important to talk about this disease … but not in a headline-grabbing way, which may damage the cause by labelling it as a sexually transmitted disease,” said Rosin, who is also a Simon Fraser University professor.

Regardless, the public is finally getting the message that HPV, the most common sexually transmitted virus in the world – and the one that causes virtually all cases of cervical cancer – is accounting for the surge in throat cancers located at the back of the throat.

In B.C., if trends continue, HPV-caused throat cancers are expected to overtake cervical cancers in incidence. About 150 cases of cervical cancers are reported annually in this province. Of about 500 head and neck cancers, 115 are HPVcaused throat cancers, according to the BCCA.

Douglas’s interview with The Guardian newspaper last month was followed by an avalanche of sensational media reports that apparently gave the Hollywood celebrity a twinge of regret. Douglas’s publicist later claimed the 68-year-old meant only that oral sex and HPV were a potential cause of such cancers while not specifically referring to his own. The U.K. newspaper, however, stood by the story and released an audio of the interview to rebut Douglas’s backtracking. Excessive smoking and drinking alcohol are also risk factors for various forms of oral cancer, and when the actor was first diagnosed in 2010, he had previously blamed his cancer on many years of indulgence in those habits.

Up to 70 per cent of throat cancers are HPV-related. There are numerous places to get oral cancers – such as the lips, cheeks, gums, palate, tongue and tonsils – and while smokers and drinkers once fit the typical profile of an oral cancer patient, now, because of waning smoking prevalence, HPV infections have emerged as the dominant risk factor for throat tumours such as the one Douglas had.

Rosin said there was a whopping 300-per-cent increase in the age-adjusted incidence rate for throat cancers in B.C. between 1980 and 2010. It’s more commonly diagnosed in mid-life, and the ratio of males to females getting such cancers is three-to-one.

Earlier this year, the American Cancer Society issued a report showing the proportion of HPV-linked oral cancers has risen from 16 per cent of all oral cancers in the mid-1980s to 72 per cent two decades later.

Dr. John Hay, a radiation oncologist at the BC Cancer Agency and an expert in oral cancers, said HPV tumours are squamous cell clusters that surface in places where skin tissue is thin and delicate.

There are more than 100 strains of HPV. Some are benign, causing common skin warts, but high-risk strains cause cervical and oral cancers, vaginal and vulva cancers, penis and anus cancers, and genital warts. HPV infections and their links to cancer are a relatively new scientific area of study so there are many questions still to be answered, including whether the relatively new HPV vaccine will prevent future generations from getting throat cancers.

The Vancouver Sun has reviewed the latest research and developments to address expected curiosity on the subject.

How common is HPV?
Very. By age 25, a quarter of Canadian women are infected by it, and by age 50, about 85 per cent of sexually active people (males and females) have been exposed to it at one time or another. The vast majority of the time, the immune system knocks the virus out within a few years. In a minority of individuals, the virus persists, potentially leading to an HPV-linked cancer.

What is fuelling the rise in HPV over the past three or four decades?
Experts believe the advent of oral contraceptives. (The Pill) five decades ago unleashed sexual freedom and changes in sexual behaviours: more sexual partners and consequently more sexually transmitted infections, including HPV. Hay said before oral contraceptives came along, condoms were the common barrier method. “Condoms keep things in and they keep things out,” he said, referring to the fact that condoms can help prevent sexually transmitted infections while oral contraceptives do not.

Is the massive increase in throat cancers attributable to better detection methods or an increase in HPV infections?
Experts say they are seeing a true increase in the proportion of throat cancers caused by HPV. Hay said typical patients are 45 to 65 years old who may have been infected with HPV up to 20 years earlier.

Does oral sex really cause throat cancer?
The HPV virus is very common; nearly everyone who has sex will get it at one point or another. The HPV micro-organisms can reside in the cervix or other body canals (anus) and the virus can also be transmitted through skin contact and saliva. One Finnish study showed that HPV could even be detected in babies under one year, possibly through skin-to-skin contact during breastfeeding.

Men are more likely to get throat cancer and one theory is that there may be more HPV in vaginal fluid than other genital areas.

“We don’t well understand how oral HPV is transmitted except to know that oral sex is the most likely way of transmitting HPV to the mouth,” said Gypsyamber D’Souza, an epidemiologist and viral cancer expert from Johns Hopkins Bloomberg School of Public Health, at the recent annual meeting of the American Society of Clinical Oncology.

What are the risk factors for contracting HPV?
Studies have shown that men are three times more likely to get HPV-related throat cancers than women, but risk for both genders goes up in those with more sexual partners. Those who’ve had six or more oral sex partners over a lifetime are 8.6 times more likely to get HPV throat cancers, compared with those who have never had oral sex. HPV is more prevalent in sexually promiscuous individuals and those already carrying other sexually transmitted infections (STI). A B.C. study done on men attending a Vancouver STI clinic found that 70 per cent were HPVpositive.

What are some of the most common symptoms of throat and other oral cancers?
Hoarseness, chronic sore throat, pain or difficulty swallowing, a painless lump in the neck area, swollen lymph nodes in the neck, ear pain and mouth sores that don’t heal.

Who should get the HPV vaccine?
There are two HPV vaccines licensed for use in Canada: Gardasil and Cervarix. Neither will wipe out infections once individuals have been exposed, so it’s best to get the vaccine before becoming sexually active. B.C. research has shown that HPV is most prevalent in women under 20, suggesting that the risky period for getting infected is when females first start having sex.

Gardasil (which protects against multiple high-risk HPV strains as well as genital warts) is approved for women aged nine to 45 and males nine to 26. Health Canada approved the vaccine for girls in 2006 and for boys a few years ago. It’s part of school-based immunization programs, but the major focus of public funding is on Grade 6 girls in B.C. The series of three shots costs up to $500 if purchased at pharmacies by parents wishing to vaccinate boys or older children who missed getting vaccinated.

The vaccine is also licensed for males up to age 25. As with girls, experts recommend boys get vaccinated before they become sexually active. Only a few provinces are considering public coverage of the vaccine for males; B.C. is not one of them at this time.

Dr. Perry Kendall, chief medical health officer for B.C., said studies have not yet proven it would be cost effective to extend public funding for vaccination of boys. “Ninety-nine per cent of cervical cancers are caused by HPV, and 70 per cent of vaginal cancers,” he said, while noting that HPV is “attributable” to about twothirds of throat cancers. B.C. spends about $3 million a year on HPV vaccines and about 60 to 70 per cent of eligible girls (Grade 6 cohorts) have been vaccinated so far, but it could take decades for the vaccine to have a significant effect in reducing both cervical and oral cancers in the younger generations.

Is the vaccine safe and effective?
A Universit y of B. C. researcher Dr. Simon Dobson has called Gardasil an “excellent vaccine.” HPV-infection suppression rates range from 70 to 90 per cent, with the highest immunity response occurring in those who get the vaccine at the youngest age.

Minor side effects such as pain at the site of injection, swelling, dizziness, nausea and headache have been reported in about six per cent of subjects, according to Dr. Monika Naus of the B.C. Centre for Disease Control in a report in the BC Medical Journal. Rare, serious adverse effects – such as deaths, stroke, embolisms and seizures – have not been directly linked to the vaccine.

How can you get tested for HPV?
Doctors scrape cells from the cervix area, similar to the way specimens are collected during a Pap smear. The test is not covered by the public medical plan so private labs charge about $90. It is not possible to swab the back-of-throat area for HPV because of gag and vomit reflexes. Saliva tests are used to detect throat HPV infections only for research purposes so far.

In women and men, swabs can be taken of the anal cavity to detect pre-cancerous changes.

Is there a treatment for HPV?
There’s no treatment for the infection but there are for the serious cancers that may result from it, such as surgery, chemotherapy and radiation.

What’s the prognosis for someone who gets HPV oral cancer?
Even those who get advanced HPV-caused throat cancers, such as actor Michael Douglas, have a fiveyear survival rate of at least 80 per cent, whereas advanced non-HPV linked oral cancers – those caused by smoking and alcohol – have a survival rate about half that. Non-HPV cancers usually affect the front of the tongue, floor of the mouth, cheeks and gums, while HPV cancers tend to affect the back regions of the mouth: the base of the tongue and tonsil area.

Is there a screening program for HPV-related oral cancers?
There’s no way to screen for HPV-related throat cancers, but a B.C.-developed device called the VELscope is used by some dentists to detect abnormalities in the front parts of the oral cavity. The device utilizes special light to detect suspicious cells, but it has not yet been shown to find HPVtype cancers in the furthest reaches of the throat. The tonsil area has folds and crevices where HPV tumours can hide out. BC Cancer Agency scientists are trying to improve the imaging system for the hardto-reach sites at the back of the throat and tonsil area.

Does it take a long time for an HPV infection to arise or should you blame the last person you had sex with?
If you do get HPV, you can’t necessarily point the finger at the last individual you had sex with. HPV infections wax and wane over lifetimes so getting an HPV-linked cancer may be more likely caused by the “sum total of your life experiences,” according to Rosin. A 2010 study in the British Medical Journal found that in those who developed throat cancers, a third had HPV antibodies (meaning they had been exposed to the virus) up to 12 years before the onset of disease.

How can one prevent or lower the chances of getting HPV-related cancers?
Talk to your doctor about getting vaccinated against the high-risk strains of HPV, reduce intake of alcohol and tobacco, limit your number of sexual partners, get tested for HPV if you have any symptoms or concerns. Women should get Pap smear tests of their cervix, which can show abnormal cellular changes that point to a possible HPV infection.

How prevalent is the oral HPV virus in the general population?
A recent snapshot-in-time U.S. study published in the Journal of the American Medical Association found that about seven per cent of Americans aged 14 to 69 are infected by HPV. But only one per cent of the 5,500 people in the study had HPV-16, the most strongly linked strain to oral and cervical cancers. If the figure is extrapolated to the whole population, it would mean that millions have HPV, but fewer than 15,000 Americans develop HPV-linked throat cancers each year. Lead author Dr. Maura Gillison, of Ohio State University, said that should be seen as reassuring; most people with oral HPV don’t get throat cancer.

The same study found that oral HPV infection was more common in men (10 per cent) than women (four per cent). HPV infection was most common in people aged 55 to 59.

How common is oral sex?
The Canadian Youth, Sexual Health and HIV/AIDS study, along with other studies and surveys in the U.S. and Canada, have shown that oral sex is enjoyed by two-thirds of adults. Results have shown it’s increasingly popular among Canadian teenagers. In 1994, nearly half of Grade 11 students (47.5 per cent) reported having oral sex at least once. When the survey was repeated in the same age group in 2002, more than half (52.5 per cent) indicated they had done so.

Should you swear off oral sex?
Since there is a long latency period for HPV infections to inflict serious damage, it’s unlikely there’s any benefit for adults to change sexual practices and preferences, especially if they are in monogamous relationships. But Rosin and Hay agree it may be prudent for individuals to be discriminating when it comes to sexual partners. They can consider asking partners about whether they’ve had HPV, if they’ve been vaccinated against HPV, or about their health and sexual histories.

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