Guarding against the silent threat of oropharyngeal cancer
Mays Cancer Center Annual Report
“It’s going to sound cliché, but cancer treatment is a team sport. For head and neck cancers, a team approach is very much a prerequisite of care. These are challenging cancers to treat — no two tumors are created equal.”
– Jay Ferrell, MD, FACS, head and neck cancer surgeon at Mays Cancer Center
“Over 80% of sexually active people will be infected with human papillomavirus (HPV) at some point in their lives and be able to fight it off with no symptoms,” said Daniel Perez, DDS, MS, FACS, director of the Oral and Maxillofacial Surgery Clinic at UT Dentistry.
For years, health providers have issued warnings about cervical cancer as the most common cancer connected with the virus. However, a recent study published in the Delaware Journal of Public Health stated that oropharyngeal cancer rates have now surpassed cervical cancer as the most common cancer associated with HPV in the country.
Striking a new generation
“What makes people so susceptible to oropharyngeal cancer, which develops at the base of the tongue, in the tonsils and throat, is the concentration of lymphatic tissue there,” Perez said.
Perez explained that lymphatic tissue helps to fight infection. However, it contains deep pockets where HPV can hide and spread into the neck without causing pain or being seen, which is very different from oral cancer.
According to the study, this is due to oral sexual behaviors becoming more common over the past 50 years, particularly in younger generations. The paper states that the risk of individuals with more than 10 lifetime oral sex partners developing HPV-related oropharyngeal cancer increases fourfold.
Prevention and early detection
Early detection is key to managing any medical condition. However, the silent progression of oropharyngeal cancer poses a challenge for patients and health providers. Unlike cervical cancer, which can be detected early through a pap smear test, there is currently no equivalent testing available for other HPV-related cancers, making prevention a priority.
“The best preventative measure for HPV related cancers is going to be an early HPV vaccination before being exposed to the HPV virus,” said Jay Ferrell, MD, FACS, co-director of the Division of Head and Neck Surgery within the Mays Cancer Center.
A team-based approach
Ferrell and Perez represent two specialties that are part of a larger multidisciplinary cancer care approach at Mays Cancer Center. The collaboration is a patient’s line of defense in the face of a cancer diagnosis. Medical, dental, nursing and allied health professionals can easily connect patients directly with specialists at the Mays Cancer Center at the first sign of any concern.
Patients can then receive diagnostic services and cancer treatment at the only National Cancer Institute-designated Cancer Center in South Texas.
Ferrell chairs the cancer center’s Head and Neck Multidisciplinary Tumor Board, a body of specialists who meet weekly to review patient cases and decide their treatment plans. The membership of the board includes representatives from specialty surgical teams like Ferrell’s, radiation oncology, medical oncology, radiology, dietary and nutrition, speech-language pathology and plastic and reconstructive surgery.
The board stays invested in each patient by remaining in communication and reviewing a patient’s progress throughout their treatment and recovery.
And recover they do.
“Thankfully, with treatment, these patients have high cure rates. We observe overall cure rates of 80-90% in HPV-associated oropharyngeal cancer patients with radiation and chemotherapy,” Ferrell said.
