July 12, 2016 12:00 AM
By David Templeton / Pittsburgh Post-Gazette
As a diagnostic pathologist, Steven H. Wilson arranged for himself to be tested in his own laboratory at the Indiana Regional Medical Center in Pennsylvania after feeling a lump in his neck.
Soon thereafter he would be diagnosed with oropharyngeal cancer, a middle-throat cancer in the area of his tonsils. Such cancers traditionally involved tobacco use, but Dr. Wilson, 61, said he never smoked.
The fact is, Dr. Wilson’s cancer was caused by human papillomavirus or HPV, the same virus that causes cervical cancer in women.
It’s an example of the tide now turning on several fronts, with 80 percent of middle-throat head and neck cancers nowadays caused by HPV rather than smoking or alcohol, and more men getting HPV-associated head and neck cancers than women being diagnosed with HPV-associated cervical cancer.
HPV-associated head and neck cancers now are epidemic. Twenty years ago 80 percent of such cancers were linked to tobacco or alcohol use with HPV now responsible for that percentage.
“HPV long has been viewed as a women’s health issue, but now it’s a bona fide men’s health issue because they are on the front line of an epidemic, and this epidemic won’t peak for another generation,” Dr. Bauman said, noting the typical age of diagnosis being 40 to 60 years old.
HPV is associated with oropharyngeal, rectal, anal, penile, vaginal and vulval cancers.
About 3,000 women also were diagnosed with head and neck cancers, with significantly more women than men still being diagnosed with HPV-associated anal and rectal cancers, along with the strictly female cancers. From 2008 to 2012, about 39,000 HPV-associated cancers were diagnosed annually with about 23,000 involving women and 16,000 involving males.
But the turnabout in gender results with head and neck vs. cervical cancers could convince parents to get their children immunized with the HPV vaccine, regardless of gender, with boys often overlooked because of the now-errant perception that the vaccine predominantly protects against cervical cancer.
A vast majority of people are infected with HPV in their teens or 20s as a result of the person’s first sexually intimate experience, given that the virus commonly is present in the area of the anus and genitals, Dr. Bauman said. For that reason, adolescents must receive the vaccine before their “sexual debut.”
Once a person is exposed to the virus or infected, it’s too late for the vaccine. While the virus is eliminated by the immune system in most people without ever causing a symptom, persistent infection does occur in a small percentage of people, raising their risk of HPV-based cancers later in life.
Dr. Wilson said his treatments were successful, despite his being unable to taste food, a sensation he hopes will return in time. He’s resumed working full time. Despite successful treatments, such cancers and their treatments including surgery, radiation and chemotherapy often take their toll on important human functions, including speaking, chewing, swallowing, breathing and facial expression.
He said he and Dr. Bauman have discussed plans to advocate to parents the need to have their adolescent sons and daughters vaccinated to prevent HPV-based cancers later in life. The CDC says only 40 percent of girls and 22 percent of boys currently receive all three doses of the vaccine.
“I think the vaccine is essential,” he said. “Every boy and girl of appropriate age needs the vaccine, and we need to stop them from having these cancers.”
Dr. Bauman agreed that the vaccine is a necessity. “I think it’s very important to destigmatize it and understand that HPV also is a men’s health issue, with men now on the front line of the epidemic.”
