Oral Cancer & HPV: A Doctor's Perspective

Oral Cancer Insights from Turville Bay physician Dr. Michelle Mackay

Thanks to Turville Bay physician Michelle Mackay for this guest blog post. Find more information here.

You've seen it in the news hopefully: the unfolding story of HPV, the Human Papilloma Virus, and its connection to oral cancer. Why am I blogging about this? Because as a wife, mother and millennial I'm smack in the middle of this issue and you probably are, too. I'm also Medical Director of Turville Bay MRI and Radiation Oncology Center and a practicing radiation oncologist treating patients with cancer. I hope you’ll stay with me here. I have information for you that could save your life.

Here are the facts about oral cancer & HPV
HPV has been around for a long time. There are more than 150 Human Papilloma-related viruses. They are transmitted sexually from one human to another and it’s so common than nearly all sexually active men and women get it at some point in their lives. In most cases the body fights off the virus and infected cells go back to being normal. But in some cases the body is unable to clear the virus and abnormal cells can multiply, often with no symptoms, eventually forming a cancer. We know that virtually all cervical cancers are caused by HPV-16, 18, and others, according to the National Cancer Institute. Wait, you say? We're talking about oral cancer here, not cervical cancer. Indeed. Though oral cancers have been associated with excessive tobacco and alcohol consumption the incidence of oral cancers began to rise, as the use of tobacco declined. So, researchers in epidemiological and molecular fields went to work and after 20 years found the connection with the thug of HPV’s, number 16. Research continues but this is what we know: HPV-16 causes oral cancer and there may be other HPV’s that do, too. The virus can lie latent in the body, sometimes for decades, but it can also develop earlier in young people. Men and women in their 20's, 30's and 40's, as well as those over the age of 50 are developing HPV-related oral cancer. My colleagues and I are treating patients in our center every day and we feel that it’s time to discuss the issue.

Who as at risk of HPV and therefore oral cancer?
We all are. Any person that is sexually active will probably have HPV at some point. Since there is no treatment for it, being aware of your risk factors makes sense.

1. Excessive alcohol and tobacco consumption puts you at a higher risk for oral cancer, and there is some evidence that they create a synergy with HPV. Bottom line, avoiding the excessive is smart.
2. The more sexual partners you have, the greater your risk of getting HPV and of passing it on unknowingly to others.
3. Men seem more likely to get oral cancer than women. We don’t completely understand why but are looking again at the alcohol-tobacco-HPV connection.
4. A weakened immune system makes the body less able to fight infection. If your body is unable to clear the HPV virus you are at a greater risk of developing oral cancer.
5. Those that do not protect themselves with condoms are at a greater risk. While not perfect, it is believed that the use of condoms reduces your risk of getting HPV.
6. Poor dental and oral hygiene and chronic irritation caused by rough teeth and dentures can cause oral cancer, too.

Preventing oral cancer is possible.
It involves taking care of yourself and that will lead to improved health in other ways, too.

1. Avoid excessive alcohol and tobacco.
2. Use condoms correctly and consistently.
3. Practice mutual monogamy with an uninfected partner.
4. Reduce the number of sexual partners.
5. Get vaccinated.
6. Have dental problems corrected.
7. Practice good oral hygiene.

There is a vaccine that helps ward off HPV. Who should get vaccinated?
In my opinion, all boys and girls aged 9-12 years should get vaccinated. Catch-up vaccines are recommended for males through age 21 and for females through age 26, if they did not get vaccinated when they were younger. The vaccine is also recommended for gay and bisexual men through the age of 26. It is also recommended for men and women with compromised immune systems (including people living with HIV/AIDS) through age 26, if they did not get fully vaccinated when they were younger.

We hope you’ll share your history with your physician and talk about any changes or concerns you have. If you have a sore throat that lasts for more than 3 weeks get it checked out. Lump in your neck? Difficulty swallowing? Don’t wait for your annual checkup, call your physician and be seen immediately.

Your dentist or hygienist may be your best ally.
Getting your teeth cleaned twice a year gives them a look at your overall health through your mouth. Ask them to perform a thorough screening every year using current technology. Share any concerns with your doctor immediately. Early detection could save your life. First Choice Dental offers free oral cancer screenings to new patients and annually for all regular patients. You can schedule your appointment for a free oral cancer screening at First Choice Dental.

As a community we can do better. Together we can improve our risk of HPV-related oral cancer. The entire staff of Turville Bay wishes to thank the people at First Choice Dental for inviting us to blog this month.

About Dr. Mackay   
Dr. Michelle Mackay is Medical Director of Turville Bay MRI & Radiation Oncology Center in Madison, Wisconsin.  A collaborative effort of Meriter Unity Point and St. Mary’s Hospital’s since 1986, Turville Bay’s mission is to provide healthcare technology in a comforting setting to benefit its patients. As a community healthcare technology center, Turville Bay treats cancer patients throughout south central Wisconsin.