Andrew Day, M.D. Answers Questions On: Head and Neck Cancer

Head and neck cancer refers to cancers of the mouth, throat, voice box, nasal cavity, and sinuses. These cancers develop in the mucosa, or surface tissue, that lines these locations.

Tobacco and heavy alcohol use are the most common causes of head and neck cancer. The human papillomavirus, or HPV, is another common cause. In the United States, HPV causes the majority of all throat cancers. Many people know about HPV because it also causes cervical cancer.

In the U.S., over 66,000 people will be diagnosed with head and neck cancer this year. About 15,000 of these will have throat cancers caused by HPV. Over the next 10-15 years, we expect the number of throat cancer cases caused by HPV to increase by 50%.

Smokers, people who use other forms of tobacco, and heavy alcohol users have the highest risk of developing head and neck cancer. People with many sexual partners throughout their lifetime, especially oral sexual partners, are at higher risk for throat cancer caused by HPV. Some researchers think that having performed oral sex on 6-10 or more people in your life puts you at higher risk. We don’t know why, but males are also 5-6 times more likely to develop a throat cancer caused by HPV compared to females.

Quitting smoking and other forms of tobacco is an important way to protect yourself from head and neck cancer. Drinking alcohol in moderation, if at all, is also important. Protecting you and your family against throat cancer caused by HPV takes a little more time to explain. There are hundreds of different types of HPV, and 14 are high-risk, meaning they can cause cancer. HPV is mainly spread through oral, vaginal, and anal sex. HPV infections are very common: About 80-90% of adults will get an HPV infection at some point in their lifetime. The vast majority of people clear the infection within two years, but some go on to develop a cancer.

The most effective way to protect your family is to make sure your kids get the HPV vaccine. The vaccine prevents most new high-risk HPV infections but doesn’t eliminate HPV infections that are already present. Therefore, it is important to vaccinate people before they get HPV. Currently, doctors recommend that people between the ages of 11 and 26 get vaccinated. If you’re between the ages of 27 and 45, you may want to talk to your doctor about whether the HPV vaccine is right for you.

Since most middle-aged and elderly individuals have already been exposed to HPV, we don’t know if the HPV vaccine would meaningfully help them. Regardless of whether or not you’ve been vaccinated, practicing safer sex may reduce your risk of developing new high-risk HPV infections. Adults who have been in longstanding monogamous relationships can still be at risk. We think many throat cancers are due to old, persistent HPV infections that started years, or even decades, ago.

Finally, identifying and treating the cancer early can help. Throat cancer often shows up as a non-tender lump in the neck. If you notice a lump in your neck, don’t ignore it. See your doctor right away.