Human Papillomavirus and Head and Neck Cancers

[Dr. Gopi Shah]
When we say “HPV-positive,” I always also think of cervical cancer, anal cancer, penile cancer. Is it the same HPV strains? Are these all sort of similar in terms of the relation with HPV?

[Dr. Andrew Day]
Yeah. So these 13 high-risk types are responsible for all the cancers of these different anatomic sites: cervical, anal, penile, vaginal, vulva and oropharynx cancers. The thing that's different about them is that the distribution of which type causes cancer at which location varies. So for instance, HPV 16 is actually the dominant cause of cancer in the oropharynx and anus, whereas the other types are responsible for a greater proportion of cervical cancers.

[Dr. Ashley Agan]
For patients who present to our practices with new cancers, can you talk about how a patient with an HPV-positive squamous cell carcinoma might present differently? Is it different? Is it the same? Do they look just like your patients who come in, or is the clue that maybe they don't have that history of smoking and drinking?

[Dr. Andrew Day]
Yeah, they have a very unique presentation, which immediately clues you in to the fact that they likely have HPV-mediated disease. I would say at least 50%, if not more, patients will present with neck mass and oftentimes they'll be totally asymptomatic otherwise. They might not even have pain. Some other patients will present with issues with swallowing, maybe voice changes, maybe a sensation of their lump in their throat or minor discomfort. That's in pretty stark contrast to our HPV-negative patients whose dominant symptom is fairly severe pain associated with weight loss and everything else.