Throat Cancer: The HPV-related Cancer That Affects More Men Than Women

Look for these signs of throat cancer, and three tips to reduce your risk

Author: Jasmine Brown

Man with Throat Issue

“Most of the oropharyngeal cancer cases are caused by the HPV virus, rather than smoking and drinking.”

Though we hear about the human papillomavirus (HPV) causing cervical cancer in women, this sexually transmitted infection can also cause cancer growth in other areas of the body. The HPV virus is linked to the majority of vulva and vaginal cancer cases in women, over half of penile cancer diagnoses in men, and most anal and oropharyngeal cancer in both men and women. Oropharyngeal cancer, also known as throat cancer, is nearly twice as common in men than in women, according to the American Cancer Society (ACS).

“Most of the oropharyngeal cancer cases are caused by the HPV virus, rather than smoking and drinking,” explained Jonathan Waxman, MD, a board-certified otolaryngologist who specializes in head and neck cancers at Karmanos Cancer Institute at McLaren Flint. “When it’s [oropharyngeal cancer] related to the HPV virus, it’s very treatable. We see very good outcomes.”

Oropharyngeal cancers begin on the base of the tongue, tonsil, or the back of the mouth (soft palate). Tobacco and alcohol are traditional causes of oropharyngeal cancer, but the HPV virus is linked to around 60% to 70% of cases, according to the Centers for Disease Control and Prevention (CDC).

HPV is a virus that our body is normally able to fight off within two years. Most people are not aware that they have HPV. According to the CDC, almost everyone will be infected with HPV in their lifetime, and there are over 42 million people in the U.S. that have HPV, particularly subtypes that can lead to disease.  If the virus has been in your system for years and your body is not able to fight it off, the risk of cancer increases. In the U.S., HPV has been related to around 36,000 cancer cases each year.

One of the common subtypes that causes oropharyngeal cancer is HPV type 16. This same subtype also causes most cervical cancer cases.

Signs and symptoms of oropharyngeal cancer may not be noticeable until the cancer has spread.

“The actual cancer, which may begin in the base of the tongue or tonsil, is usually very tiny – like millimeters in size. Often these cancers will spread to the neck. Having a neck mass is usually the first thing someone will notice,” Dr. Waxman said.

“If someone comes in with a persistent neck mass, I’m going to order a CAT scan and biopsy in hopes of ruling out cancer. If the biopsy comes back as P16+, that means the cancer is HPV-related.”

Additional signs and symptoms of oropharyngeal cancer are:

  • Pain or difficulty when swallowing
  • Ear pain
  • Changes to the voice
  • Unintended weight loss
  • Difficulty breathing

Chances are, you may already have been infected by HPV, and the hope is that your body has fought off the virus. However, the National Cancer Institute (NCI) lists some measures you can take to reduce your risk of oropharyngeal cancer and other head and neck cancers:

  • Quit smoking: Speak with your primary care provider about ways to quit smoking cigarettes or chewing tobacco. You may also visit karmanos.org/quitsmoking for resources.
  • Avoid HPV infection: The HPV vaccine, Gardasil 9, protects against subtypes that are linked to many HPV-related cancers, including oropharyngeal cancer. The vaccine is FDA approved through age 45, though it is only recommended for children and adults, ages 9 through 26. Past the age of 26, most people may have already been exposed to HPV, so there may not be much benefit. Patients 27 to 45 years old are recommended to speak with their doctor to see if they should be vaccinated.
  • Receive routine dental checkups: Speak to your dentist about performing a check of not only your teeth but also your gums, tongue, and throat. Though they may not be able to see your entire throat, they are able to look in your oral cavity for possible signs that could lead to a head and neck cancer.

For more information on head and neck cancers, visit karmanos.org/flint_headandneck.