Human Papillomavirus and Head and Neck Cancers

In this episode, head & neck surgical oncologist Dr. Andrew Day joins Dr. Gopi Shah and Dr. Ashley Agan in discussing the screening, treatments, prevention, and current research over HPV-positive oropharyngeal cancers.

We begin by discussing the ubiquitous Human Papillomavirus (HPV) and identifying high-risk strains. While there is still a lot of research to be done over this virus, Dr. Day describes the estimated prevalence of HPV in the adult population and available screening methods. He brings up the possibility of latent infections and differences in individuals’ immunogenic responses.

Moving into HPV-mediated cancers, Dr. Day distinguishes HPV-positive from HPV-negative head & neck cancers and discusses the differences in presentation and treatment for each type. HPV-positive oropharyngeal cancers usually present as neck masses with no other clear risk factors, and they can be confirmed through ultrasound-guided fine needle aspiration biopsy. Treatment options include various combinations of transoral robotic surgery, transoral laser microsurgery, chemotherapy, and radiation.

Finally, we discuss patient education over HPV and its associated cancers. We address patient inquiries about tonsillectomy as a preventative measure, advice for partners/spouses of HPV-positive cancer patients, and otolaryngologists’ role in raising awareness of the HPV vaccine (Gardasil 9).