The leading cause of cancers in the oropharynx—an area that includes the back of the throat and base of the tongue—has shifted over the past generation or so.
Once, the average patient with this subtype of head and neck cancer was a man in his 60s or 70s with a long history of smoking and chronic alcohol use.
But even though smoking rates have dropped drastically (from roughly half of adults in 1965 to just one in 10 in 2020), the incidence of oropharyngeal cancers has actually increased over the past two decades.
What’s more, the typical person with oropharyngeal cancer is roughly 50 or so, and probably has healthier habits than their predecessors.
So what’s going on?
Today, the majority of oropharyngeal cancers—roughly 70 percent—are caused by the same family of viruses that are responsible for 99 percent of cervical cancers: human papillomavirus or HPV.
HPV is a sexually transmitted infection (STI)—the most common one worldwide, in fact.
But then why are we seeing more HPV-related oropharyngeal cancers than ever before? In short, because our society’s attitudes around sex have changed, today, people are more likely than before to engage in oral sex.
HPV infections often don’t cause symptoms, and in many cases, the infected person’s immune system can eventually rid the body of them.
However, in some cases, that doesn’t happen. And if the culprit is a high-risk strain of HPV, over time, the persistent infection can cause changes in cells that ultimately develop into cancer.
(Some subtypes of HPV only cause warts. While as many as 14 others can lead to cancer, most HPV-related oropharyngeal cancers are caused by just one: HPV16.)
The good news about oropharyngeal cancers caused by HPV is that they have a far better prognosis than those that are associated with smoking and alcohol use. Close to 90 percent of people with the former are still alive five years after treatment, compared to just 50 percent of those whose cancers are non-HPV-related.
But that good news has a darker side. Because these patients are also younger, and healthier overall, they can end up living with unwelcome side-effects from treatment for decades.
However a head and neck surgeon at one of Canada’s top hospitals is doing his best to reduce the number of patients who are left with these long-term problems.
You can read all about it in this piece I wrote for the latest issue of the Sprott Department of Surgery Magazine: ‘Mapping a Brighter Future Post Cancer.’
But don’t stop there. Every single story in the magazine will pull you in, and show you another example of world-leading advances in treatment that are taking place right here in Canada. You can find them all here.