Throat cancer- the Michael Douglas effect

  • Niall Hunter, Editor

The reported experience of actor Michael Douglas with human papilloma virus-related cancer has raised public awareness of this type of cancer, according to Irish experts.

Michael Douglas was initially reported to have linked his contracting throat cancer to HPV caused by oral sex, but subsequently denied that he was talking about the specific cause of his own cancer.

Experts from NUI Galway say the Hollywood star had however, unintentionally raised awareness of head and neck cancer that can be caused by HPV infection.

In an editorial in the current Irish Medical Journal, the experts point out that HPV viral infection, which is also linked to cervical cancer, is the commonest sexually-transmitted infection in the US.

The vast majority of HPV infections are cleared in most people who contract them without any problems. A small proportion, however, will develop genital warts and a smaller proportion will develop HPV-related cancer.

According to the editorial, a new Irish research project is to embark on an investigation of HPV in cancers of the mouth and throat diagnosed since 1994. This will provide the first population-based data on HPV infection in in head and neck cancer in ireland.

According to the editorial, various international studies have shown that an increasing incidence of HPV-related oropharyngeal cancer has been seen in younger white males, without a significant history of tobacco or alcohol use usually associated with this type of cancer and from a higher socio-economic background.

In the US, the risk factors for HPV-related head and neck cancer have been linked to the sexual revolution of the 1960s and 1970s which changed sexual behaviours and led to higher number of lifetime partners, an increase in oral sex practices, same sex-contact and earlier age of sexual experience.

"Ireland’s sexual revolution began a lot later so it’s likely that the dramatic rise in these cancers will be
seen here in the next five to 10 years if patterns are similar to other countries," the editorial states.

"Now that Michael Douglas has single-handily enlightened the general public about aspects of this cancer, attention must now focus on assisting primary care healthcare professionals in recognising the signs and symptoms of HPV-related head and neck cancer. Also, GPs and dentists are likely to be the first point-of contact for Irish patients’ who will have a myriad of sensitive questions."

Throat and neck cancer often presents with persistent difficulty swallowing or sore throat, and in many cases may indeed present with a metastatic node in the neck.

The authors say that as the incidence of HPV-related head and neck cancers is on the increase, the argument for also vaccinating boys against HPV infection continues to gain momentum.

"For now, every HPV-positive head and neck cancer patient presents an opportunity to learn more about the disease. Given the suspected numbers involved, medical professionals and policy-makers in Ireland must continue to closely observe the national and international research into these increasingly common, but highly treatable subgroup of cancers."

The editorial is written by ENT surgeons Prof Ivan Keogh and Mr Tony O'Connor, and Diarmuid Coughlan of the School of Business and Economics at NUI Galway.

Find out more about throat cancer here.




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