The Epidemiology of the HPV/Head and Neck Cancer connection

longtermsurvivor said:

only the shadow knows.....
Because I sure don't. There are non-sexual ways to get genital HPV. That much is proven. The author correctly points out that we really don't know what cause and effect are operative here. That's basically a repitition of what infectious diseases have done throughout recorded history.

A great example of this is the plague. At one time in recorded history the plague wiped out a very significant fraction of humanity. Something has changed about the organism, and although the plague is still around, it isn't nearly as virulent a disease as before. It is not as infective, and not as lethal as it was centuries ago. Why? Only the shadow knows.

Pam M said:

Plague Fleas
Yep - the fleas were the culprits. That's where my Irish grandmother got the superstition (which she tried to foist on us with the others) that it was bad luck to kill a spider living in your house - spiders catch/kill fleas - flea can't bite/infect humans. It was YEARS later that I learned of the plague link.

Jennfer39 said:

Not into chicks
As a 40 yr old woman who has never had sex with another female, and was diagnosed with HPV tonsil cancer in October 2011, I too lean towards the concept of dormancy. I have been with my husband for 18 years, and although one can never be sure, I would say that neither of us have had any extra marital affairs......this would have to mean exposure happened prior to our meeting. I had chronic issues with my tonsils my whole life. Not sure why they were not removed, but the one I had issues with was the one who tested positive for cancer.

I am a rarity..a woman with tonsil cancer of this type. If I knew how I contracted it, I would gladly scream it from a mountain top, to spare anyone else from going throug the process of treating it! May researchers find the answers to this epidemic quickly, so that this disease can be irradicated.

Jen

Jennfer39 said:

Not offended
Just so you know SKIFF...I wasnt offended by your post. I have a quirky sense of humor, honed by yearsbof being raised with four brothers.

These two diseases offend me. HPV and cancer.

The fact that I have no idea how to keep my two teenage children safe from the possibility of contracting oral cancer from HPV exposure......One boy and one girl.

Praying that researchers figure this twisted mess out!

Jen

par said:

HPV
I was told by my doctor at M D Anderson that they know it is transmitted sexually but many think it could also be transmitted by as simply kissing or eating or drinking after someone who has HPV although this has never been documented.I was also told I could have had it for at least 15 yrs and it had gone undetected mainly because no one knew what it was and did not know to look for it.I was seen by my family doctor and an ENT for 3 years due to constant illness,(sore throat,ear aches,fatigue) before changing my ENT and the new one found it on my first visit.
There is much more information coming out about this now.

Daddisgrl said:

A few parts of the article
A few parts of the article for those that don't have time to read the whole thing. These were good parts. Note the last paragraph about the vaccine... They hope teens being vaccinated will not get oral cancer; it will be hard to prove & take a long time.

Is Oral Sex to Blame for the Surge in Cancer of the Mouth and Throat?

http://goo.gl/ChgO5
Like investigators elsewhere, we're seeing an increased incidence of oropharyngeal cancer," says Dr. John Deeken, a medical oncologist at Georgetown's Lombardi Cancer Center. Cancer-causing HPV strains tend to infect immune cells at the base of the tongue and tonsils, Deeken explains. "This may be why we're seeing the virus in tumors in those parts of the oropharynx, while the incidence of lip, larynx, and vocal cord cancers is not going up." If the cancer were simply caused by infection with HPV upon sexual transmission there would be more cases in women, he considers.

The epidemiology is perplexing," he says. "The assumption, when we noticed the trend eight or nine years ago, was that this was a sexually transmitted disease due to more oral sex," he says. "But at least at Georgetown, we have patients in their 80s with this kind of cancer," he notes. "That raises questions about the sexual habits of Americans who are older, or about HPV."

The latency period between initial HPV infection and cancer can last decades, confirms Dr. Maura L. Gillison, an oncologist and professor at Ohio State who has published seminal findings on HPV and cancer.

Human papillomavirus was one of the first viruses identified in human cancers. Approximately 40 subtypes spread sexually. Two types, HPV-16 and HPV-18, account for most cases of cervical cancer in the U.S. Most women with HPV are asymptomatic and don't get cervical cancer; when and if malignancy develops, it's usually 20, 30 years or longer after initial infection. Most often, oropharyngeal cancers are caused by the HPV-16 subtype.

"The mechanisms by which HPV causes cancer are pretty well-established," Gillison says. Two viral genes, called E6 and E7, are implicated. The virus itself contains only a few genes; it can't propagate apart from human cells. But once HPV has infected squamous cells like those lining the cervix, anus, or pharynx, E6 and E7 take over critical machinery that control processes like DNA repair, cell cycle, and maturation, she explains. Because the virus interferes with signals that normally regulate cell growth, HPV-infected cells tend to survive and replicate.

The E6 and E7 proteins, encoded by the genes, are necessary but not sufficient for cancer formation, Gillison considers. As is the case for HPV infection in the genitals, most individuals infected with HPV in the mouth don't develop tumors. The key question is what other factors -- like damage to the oral cavity from nicotine or other toxins, immune changes, or possibly a genetic disposition -- lead to oropharyngeal tumors in some people, typically years after the initial infection.

For patients with oropharyngeal cancer linked to HPV, the prognosis is relatively good. "We're seeing higher cure rates with HPV cancers than for other head and neck cancers," Deeken says. "The patients tend to respond more readily and completely to treatment no matter what we give them, whether it's chemo or radiation."

Deeken also supports a primary prevention, by vaccination of young people against HPV. "Hopefully in decades ahead, teenagers who are getting vaccinated now will not be developing oropharyngeal cancer," he says. "But that will be hard to prove, and it will take a long time."