HPV and Throat Cancers: When Should You Seek Urgent Help?
Have you heard of the Human Papilloma Virus (HPV)? Human Papilloma Virus (HPV) infection causes many cancers. These include cervical cancer, anal cancer and also throat, tongue and tonsil cancers. In fact, HPV infection is the cause of up to TWO-THIRDS of throat, tonsil and tongue cancers!
At ENTcare specialist clinic in Singapore, we see many patients suffering from a sore throat and a feeling of something stuck in the throat. Some have strange lumps growing from the back of their throat. If the lumps look warty, this may be related to Human Papilloma Virus (HPV) infection.
What Are the Main Risk Factors for Throat Cancer?
In the past, the main risk factors for developing throat cancer were smoking and alcohol. With the discovery of HPV's presence in many throat, tonsil and tongue cancers, HPV is clearly another risk factor for throat cancers. HPV-16 is usually the main viral strain, transmitted through sexual contact, usually oral sex. Hence this can be a tricky and awkward topic to discuss with patients, especially if they are accompanied by their spouse or parents! "Where have I caught HPV from, Dr?!" Then I have to take a deep breath and explain how HPV is usually transmitted.
What Do I Do With an Abnormal HPV Test on My Cervical Smear?
Some female patients come to see me after having had an abnormal HPV test on their recent cervical smear. Therefore, they worry about HPV infection in their throat as this could potentially increase their risk of them developing HPV-related cancers of the throat, tonsil and oral cavity. Approximately 7% of people in the United States between the ages of 14 and 69 already have HPV infection present in their throats. So it is important to have an HPV vaccination in childhood ideally before you reach your teenage years.
When we see patients with persistent sore throat, feeling of throat irritation, difficulty swallowing, earache or blocked ears, we carefully check their throat and mouth. Then we use a special endoscope (tiny camera) passed into the nose to examine the rest of the throat and airway. Patients with throat cancers can present with neck lumps if their lymph glands already contain cancer cells from the original tumour.
If you have HPV infection in your oral cavity (mouth) or throat, it does not mean you will develop throat cancer. But the risks are higher if you have oral HPV. Indeed, the risks of throat cancer are even higher if you also happen to smoke or drink alcohol regularly.
Do I Need the Warty Lump in My Throat Removed?
Warty lumps (papillomas) should be removed and biopsied. This procedure is usually done as a day surgery case under local anaesthesia. The tissue removed is sent off for analysis and HPV-16 staining checks for the presence of HPV infection. The good news is that many HPV-related throat cancers have a good outcome if we diagnose and treat them early. About 85-90% of patients with HPV-related throat cancers are alive and free of disease five years after treatment.
Dr Anabelle’s 5 Tips to Minimise Risk of HPV infection and Throat Cancer
- Don't smoke.
- Don't drink large amounts of alcohol regularly.
- Practise safe sex, especially safe oral sex by using protection such as condoms or dental dams (plastic sheets spread over the mouth).
- Check your mouth regularly in the mirror for funny lumps or strange patches of different colours on your tongue or back of throat.
- Have the HPV vaccine, mainly Gardasil-9, which protects against 9 different cancer-causing HPV strains, and those which cause genital warts.
About Dr Annabelle Leong
Dr Annabelle Leong 梁翠娟
Senior Consultant ENT Surgeon
MBBS (Hons) (London), BSc (Hons);
DOHNS, MRCS (England), FRCS ORL-HNS (England)
Dr Annabelle Leong is a senior consultant ENT surgeon with more than 25 years of experience across the United Kingdom, Canada and Singapore. From childhood ENT concerns to hearing, balance and sleep problems in adults, she provides care across a broad range of ear, nose and throat conditions.
Known for being a patient and attentive listener, Dr Annabelle takes a sensible, holistic approach to care, considering the wider picture before recommending treatment. She favours conservative options where appropriate, with surgery considered when clinically indicated and appropriate for the patient’s overall care.