However, there is one type of cancer that has risen significantly and that is oral cancer particularly as it relates to Human Papilloma Virus or HPV. Up until recently, oral cancer was primarily a disease found in people who smoked or drank alcohol or a combination thereof. However, with changing sexual mores, there has been a rapid increase in the incidence of cancer transmitted virally. This HPV-type driven cancer is now the most commonly transmitted cancer in the world with nearly 40,000 cases reported each year. For women in the U.S., virally-caused oral cancer is now approaching and will soon exceed the number of malignancies involving cervical cancer.
The virus has been found in approximately 70% of the adult population with a higher percentage in men. The incidence of the virus peaks between ages 52 and 60. The virus can lay dormant for years, often not leading directly to the development of oral cancer. But as mentioned, this type of cancer is dramatically increasing and increasing dramatically in a younger population of patients who wouldn’t traditionally develop oral cancer.
This type of malignancy usually occurs in the back of the tongue and in the throat, and can be detected in its early stages by a careful oral examination; something which every dental patient should undergo on a regular basis when they have their teeth cleaned or have any dental care.
Interestingly enough, not only can the disease be transmitted sexually but there’s evidence that it can be transmitted merely by kissing.
So the take-way from these findings is that a thorough oral examination to diagnosis early stages of oral cancer in general, especially virally-derived oral cancers, should be done regularly at your dental office.
The second take-away is that a test exists that can detect oral cancer in patients by collecting saliva and sending it to a laboratory where it can be analyzed for the virus.
Finally, there is a vaccine for this virus which at this point has been promoted in a number of states. The vaccine is recommended for children probably ages 11-13 in both boys and girls. In the United Kingdom, 70% of young women received the vaccine which costs about $400. The vaccine can be given up to 26 years of age for women and up to 21 years of age for men.
At this point, because the vaccine is rather new and although it’s known to target the particular types of viruses that cause oral cancer, we haven’t yet seen the results of the vaccination on the incidence of the disease; although officials knowledgeable in this particular problem are urging the vaccination for our young population.
The treatment of oral cancer remains standard, either laser removal or surgical removal; radiation and chemotherapy are not as commonly used. Chemotherapy is generally not the treatment of choice.
The good news is that the treatment of the viral origin type of cancer is reasonably successful but again I can’t stress enough the need for early detection.
If you have any questions or thoughts about this, please feel free to contact me.
Dr. Victor M. Sternberg, D.M.D.