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HPV virus leads to increase in oral, throat cancers

About 49,670 people will get oral cavity or oropharyngeal cancer in the US in 2017. An estimated 9,700 people will die of those cancers, according to the American Cancer Society. The cancers are more than twice as common in men as in women. They are about equally common in blacks and in whites.

Dr. J. Michael Kerley, board-certified in radiation oncology at the Cancer Centers of Southwest Oklahoma in Duncan, offered some insight from his perspective recently. He usually works at the cancer center in Duncan on Monday and Wednesday and the cancer center in Lawton Tuesday, Thursday and Friday.

"We've known for a long time that alcohol and tobacco products of all kinds are associated with a significant increased risk," Kerley said. "Then recently, the HPV (human papillomavirus)  the wart virus, particularly No. 16, seems to be particularly carcinogenic. There is a vaccination for young people. I strongly encourage that because that particular virus is now associated with oral cancers in general, particularly the back of the mouth, which we call the oropharynx; also cancers of the cervix in women in the long term, the vulva; and penis for men, particularly in uncircumcised men in a lot of other countries; and anal cancers. Recently, larynx cancers and maybe a few lung cancers are associated with that virus."

HPV tends to turn on squamous cell cancers and there is a whole host of cancers the virus can cause once a patient has been exposed to it, according to Kerley. 

"The best protection is to get vaccinated early in life," Kerley said. "I strongly encourage young men and young women to get vaccinated  not just for the warts  but to protect against oral and genital cancers."

People who smoke or chew tobacco significantly increase their risk for developing cancer. 

"We consider the head and neck, anything from the lips to the thyroid and vocal chords," Kerley said. "They used to call it a 'field effect.' If you smoke, those areas get coated with carcinogens, including the vocal chords, but all the way down to the lungs, too. That whole area has been exposed, like it's a field effect. Chewing tobacco can cause that, especially the gingival where the teeth sit and the side of the mouth where they tend to keep the tobacco, or in the old days they used to keep snuff inside the lower lip; a lot of cancers are associated with those things. Then if you drink, drinking kind of dissolves the mucous membrane covering. It kind of dissolves it and actually doubles the risk of cancer from tobacco."

Folks who drink and smoke are more than doubling their risk for cancer because they work together to cause cancer.

"In Asians, there's also a risk of cancer behind the nose called nasal pharynx cancer ... There's a real high risk of cancers of the nasal pharynx in Asian people, particularly if they've been infected with Epstein-Barr virus, which causes mono ... " Kerley said. "In Asian people, the DNA from the virus can get in their DNA and cause a nasal pharynx cancer. If you were in a clinic like this in southern China, half the patients have nasal pharynx cancer. Here it's pretty rare. Here, half our patients are either breast or prostate cancer. There, breast and prostate cancer are not common. Nasal pharynx cancer is common."

Head and neck cancers in general, from the lips all the way down to the larynx, are increasing. 

"Right now it's about 3 percent of the cancers in the world, but it's rising rapidly," Kerley said. "In the U.S. it's about twice the population of Duncan each year. That's about 45,000 people get oral or oropharynx or nasal pharynx or hypopharynx or larynx cancers. It's about one city's population every year here in this country and the risk is going up, particularly because of that HPV virus."

Particularly in younger people, physicians are seeing a rapid rise in cancer due to the HPV virus, according to Kerley. 

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