Dear OncoLink "Ask The Experts,"
I was just diagnosed with cancer at the base of my tongue. I am a 37 year old woman. I looked it up on the Internet and it says the risk factors are smoking and drinking. I've never smoked and I only drink occasionally. My doctor says this may be a sexually transmitted disease. Is that true? How could that happen?
Christine Hill-Kayser, MD, Assistant Chief Resident in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania, responds:
Unfortunately, more and more young adults who are not smokers or drinkers are being diagnosed with head and neck cancer. In many cases, these cancers are due to human papilloma virus (HPV). You may have heard of HPV as the virus that causes genital warts. Some strains of HPV do indeed cause warts, but these are not the strains that most commonly cause cancer. Other strains do not cause warts, but can cause cancers of the anogenital tract (cervix, anus, and vagina), as well as oral cancers. The virus is generally transmitted through genital-genital contact and/or oral-genital contact. This is likely what your doctor meant when he said that your cancer could be a sexually transmitted disease. Unfortunately, HPV is extremely common in college-aged young adults. Barrier methods, such as latex condoms and dental dams, offer some protection (and protection from other sexually transmitted diseases) although HPV may cross these barriers in some cases. The Gardasil vaccine is now approved for males and females aged 9 - 26. Gardasil protects against infection with the strains of HPV that most commonly cause warts and cancer. At this time, the role of Gardasil for patients who have already been infected with HPV is not known.
Young adults who are diagnosed with head and neck cancer may feel sad, anxious, and angry about their diagnosis, as well as the complicated treatments that may be recommended. The good news is that some preliminary data has demonstrated that patients with HPV related oral cancers may have a better prognosis than those who have oral cancers related to smoking. Treatments appear to be very effective, and education may help others to protect themselves in the future.
This question and answer was part of the OncoLink Brown Bag Chat Series, Issues Facing Young Adults After Cancer. View the entire transcript.
A previous Brown Bag Chat addressed HPV and Cancer, view that transcript.