Focusing on Head and Neck Cancers
- “Iron Maiden” frontman Bruce Dickinson, 65, is still performing nearly 50 years after joining the heavy metal band. One noticeable difference over the years is his singing voice, which changed after he was diagnosed and treated for tongue cancer.
- Dickinson attributed his cancer to the human papillomavirus, or HPV, which is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex, according to the National Cancer Institute. It can cause a handful of cancers, including cervical and throat cancers.
- HPV-related throat cancers are generally very responsive to a combination of radiation and chemotherapy treatments.
- The HPV vaccine, like Gardasil 9, offers protection against “nine HPV types” and creates an immune response to HPV 16, the primary cause of 92% of head and neck cancers.
“Iron Maiden” frontman Bruce Dickinson, 65, is still rocking and rolling with a string of concerts nearly 50 years since the band formed and having his voice impacted by throat cancer.
“It’s a little bit different,” Dickinson noted, adding that the shape of his tongue is different, making his singing voice different than before.
“For me, the whole essence of this is letting the music do the talking, let the music do the storytelling,” Dickinson told heavy metal news outlet Blabbermouth.
Dickinson added that the latest tour will be scaled down from years past without the pyro effects and will focus mainly on the music. Longtime fans may also notice his singing voice slightly differs from the ’70s, ’80s, and ’90s.
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Dickinson puts the onus of his changed voice on throat cancer he was diagnosed with in late 2014.
“The shape of possibly the back of my tongue, which forms vowel sounds and things like that, might have changed shape slightly because, obviously, it had a big lump in it, and the lump’s gone. So maybe the surface has changed shape. So, I notice a few differences. Funny enough, the top end of my voice is maybe even a little bit better than it was before,” Dickinson explained.
Back in 2014, Dickinson noticed his voice was changing during live performances. A visit to see his doctor helped reveal he had two tumors on the back of his tongue.
“I had a three-and-a-half centimeter [tumor] – basically a golf ball – living down at the base of my tongue right at the base…So, that was sitting there for, I really don’t know how long by the time it got big enough to notice,” Dickinson told Yahoo News.
Fortunately, Dickinson’s cancerous tumor was caught in its early stages and was treated. He underwent seven weeks of treatment to rid himself of the tumor. He underwent radiation therapy, which uses high-energy beams aimed at cancer cells to kill them.
“You can imagine to get rid of that with radiation – the inside of my head has been cooked pretty effectively,” he told BBC, according to U.K.-based news outlet Express.
He said he was declared “cancer-free” in May 2015.
Dickinson’s throat cancer battle is highlighted as we recognize Head and Neck Cancer Awareness Month, which occurs in April. Typically, the added attention to different types of head and neck cancers helps with cancer awareness and prevention. The types of cancers that fall under the head and neck umbrella may impact the mouth, lips, tongue, throat, voice box, and salivary glands.
Expert Resources on HPV
HPV-Related Head and Neck Cancers
“From the 1980s to the 2010s, the rate of HPV-related head and neck cancers has gone up by 300 percent,” Dr. Ted Teknos, a head and neck cancer specialist and president and scientific director of University Hospitals Seidman Cancer Center in Cleveland, Ohio, told SurvivorNet during a previous interview.
Though not all oral cancer is caused by the human papillomavirus (HPV), the most common sexually transmitted infection in the United States, there is a link.
RELATED: Why the HPV Vaccine is so Important in Preventing Cancer
WATCH: Understanding the Human papillomavirus.
The vast majority of humans in the United States, both men and women, will eventually get infected with HPV, according to Dr. Allen Ho, a head and neck surgeon at Cedars-Sinai.
“The important thing to know about HPV is that there are many different strains, and only a couple of them tend to be more cancer-inducing,” Dr. Ho previously told SurvivorNet during an interview. “Probably less than 1 percent of the population who get infected happen to have the cancer-causing virus that somehow their immune system fails to clear, and over 15 to 20 years it develops from a viral infection into a tumor and cancer.”
While surgery is often required to remove the cancerous cells, other treatments include chemotherapy, radiation, and targeted drug therapies. If the cancer is advanced, some of these treatments can affect a patient’s ability to eat or speak, though it’s possible to regain those functions through rehabilitation therapy.
HPV’s Connection to Cancer
Dickinson claimed his throat cancer was caused by the human papillomavirus (HPV), “a group of more than 200 related viruses, some of which are spread through vaginal, anal or oral sex,” the National Cancer Institute says.
HPV infection is linked to multiple cancers, and many sexually active people will get it eventually.
Although nearly all cases of cervical cancer are indeed caused by HPV, people should also be aware that HPV puts both men and women at risk of developing several other cancers, such as oral cancer and cancers of the vagina, penis, anus, and throat.
Overall, HPV is believed to cause 90% of anal and cervical cancers, approximately 70% of vaginal and vulvar cancers, and 60% of penile cancers.
“There are no screening guidelines to screen for throat cancer, unlike cervical cancer with pap smears,” says Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic Cancer Center, previously told SurvivorNet. “There are no standard tests to determine if you harbor the virus.”
On the plus side, HPV-related throat cancers are generally very responsive to a combination of radiation and chemotherapy treatments, according to Dr. Geiger.
“The cure rates for people who have HPV-related disease are a lot higher than those who have tobacco-related throat cancer,” she said.
Protecting Against HPV
Nearly 80 million Americans have HPV today, according to the Centers for Disease Control and Prevention. It impacts men and women and won’t cause problems for most people.
However, it can lead to cancer in a small percentage of cases.
The HPV vaccine is recommended to protect against HPV and HPV-related cancers.
Gardasil 9 is an HPV vaccine that offers protection against “nine HPV types: the two low-risk HPV types that cause most genital warts, plus seven high-risk HPV types that cause most HPV-related cancer,” according to the National Cancer Institute.
The vaccine creates an immune response to HPV 16, the primary cause of 92% of head and neck cancers. Once children are vaccinated, they cannot be infected with that strain. For parents, the HPV vaccine enables them to protect their children from developing cancer in the future.
“The key with the vaccine is that you receive it before you have sexual encounters,” says Dr. Geiger. “So that’s why these vaccines are approved for young children ages 9, 10, 11 years old, up to age 26.”
According to the CDC, the HPV vaccine is recommended for all male and female preteens 11 to 12 years old, given in two doses between six and 12 months.
The series of shots can also start as young as 9.
The CDC also notes that teens and young adults through age 26 who didn’t start or finish the HPV vaccine series also need the vaccine.
Additionally, people with weakened immune systems or teens and young adults who started the series between 15 and 26 should get three doses instead of two.
Although adults over 45 can still receive the vaccine, it’s not recommended for everyone older than 26. Still, a person older than 26 could choose to get vaccinated after talking to their doctor about possible benefits, despite it being less effective in this age range, as more people have already been exposed to HPV by this point.
WATCH: Should children get the HPV Vaccine?
Vaccine hesitancy can impede people from getting the vaccine. The concern may come from parents who feel the vaccine paves the way for early sexual activity. For this reason, some health practitioners educate the public differently about the vaccine.
“I think rebranding the vaccine as a cancer vaccine, rather than an STD vaccine, is critically important,” says Dr. Ted Teknos, a head and neck cancer surgeon and scientific director of University Hospital’s Seidman Cancer Center.
Dr. Teknos believes concerted efforts to “change the mindset around the vaccine” can make a difference.
Questions for Your Doctor
Suppose you are concerned about your cancer risk related to the human papillomavirus or whether HPV caused the cancer you have. In that case, you can use one of the conversation starters below when talking with your doctor:
- I am unsure if I received the HPV vaccine when I was younger. What can I do to know for sure?
- If I experience symptoms that could be because of HPV, what tests can I undergo to know?
- How can I know if HPV caused the cancer I have?
Learn more about SurvivorNet's rigorous medical review process.