Throat Cancer and the HPV Vaccine
- New research finds that oropharyngeal cancer – a type of head and neck cancer of the throat – has been on the rise in the United States, particularly among men and women living in the Midwest and Southeast regions.
- Throat cancer is a type of head and neck cancer where cancerous cells begin in the throat, voice box or tonsils. It is often an HPV-related cancer. One of the the easiest ways to reduce the risk of your children developing the disease is to make sure they get the HPV vaccine, particularly between ages 9 and 12.
- Nearly every sexually-active person will get the human papillomavirus (HPV) infection at some point in their lives. And this virus puts both men and women at risk of developing several cancers including cancers of the cervix, vagina, penis, anus and throat.
Oropharyngeal cancer develops when the cells that make up the oropharynx – the middle portion of the throat (pharynx) – grow and multiply abnormally. And a recent study of 260 ,182 patients with this disease published in JAMA Otolaryngology-Head & Neck Surgery suggested that cases of oropharyngeal cancer have been increasing by 2.7% per year between 2001 through 2017 among men and 0.5% per year among women with a notable annual increase greater than 2% in oropharyngeal cancer cases among women living in the Midwest and Southeast regions. The study also noted that the overall oropharyngeal cancer incidence-based mortality increased 2.1% per year among men.Read More
These findings are concerning, though it’s important to note that there are things we can do to turn the tide. But first, it’s important to understand the type of cancer we’re dealing with.
Understanding Throat Cancer
Throat cancer, generally speaking, is a type of head and neck cancer where cancerous cells begin in the throat, voice box or tonsils. Some of the main risk factors for this disease include smoking, drinking alcohol, a diet lacking in fruits or vegetables, acid reflux disease and the human papillomavirus (HPV). So, one of the easiest ways to decrease your chances of developing the disease is to get the HPV vaccine.
In a previous interview, Dr. Allen Ho, director of the head and neck cancer program at Cedars-Sinai Medical Center, talked about different kinds of throat cancers.
“[HPV-negative throat cancer] is the more familiar type of head and neck cancers that people know of, usually caused by decades of smoking and drinking,” he said. ” Those tend to be more aggressive. They tend to have a much poorer prognosis, and we tend to be a little bit more aggressive with our treatments when we come across these patients.”
Dr. Ho also explained HPV-positive throat cancer.
“It is driven by a virus called human papillomavirus, the same virus that causes cervical cancer, and what many women get Pap smears to test for,” he said. “Early stage disease is usually treated with one modality, which is either surgery, or radiation alone. As you get to the more advanced stages, the standard of care remains, two forms of treatment, either surgery with radiation, or a chemoradiation.”
What Is HPV?
Nearly every sexually-active person will get HPV at some point in their lives, but most people with the infection do not know they have it and never develop symptoms or health problems from it. The virus is spread via sexual activity and can manifest as warts on your genitals or mouth.
When people talk about HPV and cancer risk, they tend to focus on cervical cancer. And while it’s true that nearly all cases of cervical cancer are caused by HPV, people should also be aware that HPV puts both men and women at risk of developing several other cancers as well including cancers of the vagina, penis, anus and throat.
Oral and throat cancers, for example, are both on the rise in young, non-smoking adults, and Dr. Ho says HPV is the cause.
“The fastest-growing segment of the people developing oral cancers are young non-smokers,” Dr. Ho told SurvivorNet in a previous interview. “HPV, a very common virus, one responsible for the vast majority of cervical cancers, is now identified as a cause of this rapid rise of oral cancers.”
Which HPV Vaccines Are Available?
Thankfully, we have three types of HPV vaccines – Gardasil 9, Gardasil and Cervarix. All three went through years of extensive safety testing before being approved by the U.S. Food and Drug Administration (FDA), and the CDC reports that HPV vaccination has the potential to prevent more than 90 percent of HPV-attributable cancers.
The HPV vaccines, like other immunizations that guard against viral infection, stimulate the body to produce antibodies that attack if they encounter the HPV infection by binding to the virus and preventing it from infecting cells. HPV vaccines do not prevent other sexually transmitted diseases or treat existing HPV infections/HPV-caused disease, but their implementation can reduce the rates of certain cancers.
And while Dr. Susan Vadaparampil, the associate center director of community outreach, engagement and equity at Moffitt Cancer Center, previously told SurvivorNet there are few medical strategies that totally prevent against getting cancer in the first place, she emphasized that data from countries with high rates of vaccine coverage show decreases in HPV-related pre-cancer and cancer – particularly so in the case of cervical cancer.
“We have a safe and effective vaccine to prevent HPV-related cancer,” Dr. Vadaparampil told SurvivorNet. “It is widely available, and costs are typically covered by private or public insurance.”
Eileen Duffey-Lind, a pediatric nurse practitioner at Dana-Farber Cancer Institute/Boston Children’s Hospital, echoed Dr. Vadaparampil’s sentiment.
“No one should die of a preventable cancer like those tied to HPV, especially since we have a highly effective and safe vaccine available,” Duffey-Lind previously told SurvivorNet.
Who Should Get the HPV Vaccine?
According to the CDC, the HPV vaccine is recommended for all preteens (both girls and boys) 11 to 12 years old in two doses administered between six and 12 months apart. The series of shots can also be started as early as 9 years old.
That being said, the CDC also says that teens and young adults through age 26 who didn’t start or finish the HPV vaccine series also need the vaccine. And people with weakened immune systems or teens and young adults who start the series between the ages of 15 and 26 should get three doses instead of two.
Additionally, the HPV vaccine is sometimes administered in adults up to 45 years old, but it is not recommended for everyone older than 26. Still, a person older than 26 might decide to get vaccinated after talking to their doctor about possible benefits even though it is less effective in this age range since more people have already been exposed to HPV by this time.
What Are The Possible Side Effects?
With more than 120 million doses of HPV vaccines distributed in the United States, there is plenty of data showing the safety of HPV vaccines. But, like any vaccine, there are possible side effects.
According to the CDC, the most common side effects are pain, redness or swelling in the arm where the vaccine was given, dizziness, fainting (which is more common among adolescents after receiving any vaccine), nausea and headache. With the exception of fainting, there have been no confirmed adverse HPV vaccination side effects occurring at higher than expected rates.
Anaphylaxis, a serious allergic reaction, occurs very rarely after any vaccine – including HPV vaccines. The CDC says that anaphylaxis following vaccination in the U.S. has a reported rate of three cases per one million doses administered.
HPV Vaccine Hesitancy
Doctors say the benefit of having your child get the HPV vaccine outweighs any possible concerns, but timing is important. Duffey-Lind says the immune response is “significantly stronger” in those vaccinated before age 15.
“The greatest benefits for HPV vaccination occur when adolescents are vaccinated at younger ages,” Dr. Vadaparampil previously told SurvivorNet. “Their immune response is better, and they are less likely to have been exposed to the virus. Also, two doses are required if the vaccine series is started at age 14 or before, compared to three doses required after that age. Thus, waiting for a child to be older, may lead to missed opportunity to be maximally protected.”
So why are people hesitant to protect themselves and their children? One reason may be that there is a myth that that the HPV vaccine can cause autism.
“The HPV vaccines do not cause autism, there’s always a risk of some vaccine-related side effects … local site injection pain, some redness, some swelling,” says Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic Cancer Center. “There are no syndromes such as autism or other neurologic symptoms that have been linked to the HPV vaccines.”
Dr. Geiger also wants people to remember that, although you might not want to think about it, your children will likely participate in sexual activities at some point in their lives. Refusing to vaccinate your children denies them available protection from HPV-linked diseases, and that should be more important than not wanting to think about your kids ever having sex.
“The fact is that the majority of us are going to participate in sexual activity at some point in our lives,” Dr. Geiger said. “It’s unreasonable to think that just because your child isn’t engaging in sexual activity now that they won’t later in life.”