Most of the time, patients who present to the office with throat problems can be managed with several straight-forward remedies. And we can evaluate nearly all of you without pain or discomfort right here in the office. However, there are times when we have to break bad news – that there is a suspicion of throat cancer.
Until around the turn of this century, most throat cancer was due to behaviors like using tobacco and / or alcohol. This has changed, with many throat cancer “lesions” coming from a virus known as the human papilloma virus (HPV). Like the “coronavirus”, there are many types but only a few being the cause of throat cancer. In other words, most who have HPV have a strain of HPV that does not cause cancer.
HPV is very common, whereas HPV throat cancer is not very common among all those with throat problems. Nearly every sexually active person will have HPV at some point, and as such, it is the most common sexually-transmitted infection in this country. However, one can get HPV by skin-to-skin contact, too.
Most types of HPV have no symptoms and cause no harm, and your body gets rid of them on its own. Some of them cause genital, mouth and/or throat warts. Still others can cause cancer of the cervix, penis, mouth, or throat. Three vaccines (Cevarix, Gardasil, Gardasil-9) are currently used for HPV.
One simple thing is to look at the back of your throat at times, say when brushing the teeth, and notice the uvula (the dangling part in the middle) and the areas to the front and sides of that. Do they look symmetrical? Is there something new there? See the schematic image attached to this post. If it is in the mouth (i.e. not that far back), there is a field of practice dedicated to this called “oral surgery”. ENT’s (aka ear nose and throat doctors, or otolaryngologists) manage the part further back.
Interestingly though, the first symptom is not at all something you see in the throat, but rather a lump in the neck! Another interesting thing: most did NOT have pain or sore throat, and only about one in ten have trouble swallowing. This means several things: usually it is not a throat problem that leads to the diagnosis of HPV-related cancer; that most (but not all) with symptoms of the throat due NOT have cancer; and that the disease can “go to the neck” via lymphatics early in the disease process.
The treatment for HPV throat cancer may include surgery, radiation and / or chemotherapy. This usually requires several doctors and medical care providers who form a team to care for the patient. There is good hope for many with HPV throat cancer: the “cure rates” are very good over the long term, although the treatments can have side effects.
We hope this blog post is useful. If you have a throat issue or lump in the neck, give us a call at 845-758-1456 and let us help you!