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Can a virus really cause throat cancer?

The answer is, most definitely, YES. Human papillomavirus (HPV) has emerged as the most common cause of oropharyngeal squamous cell carcinoma (OPSCC). OPSCC is a type of throat cancer that affects the back of throat including the tonsils and the back of the tongue. Most commonly, the only sign that this cancer is lurking in the tonsil or tongue base is a lump (enlarged lymph node) in the neck because the cancer has spread from the primary site (tonsil or tongue base) to a lymph node in the neck.

In the past, throat cancers usually occurred in older patients who were still smoking or used to smoke. Now, this type of cancer is affecting much younger patients, often people in their 40-60s and most of them have never smoked.

The reason for this is HPV. HPV is a common sexually transmitted infection that affects both men and women. Most sexually active people will get HPV at some point in their life but the immune system usually finds it and gets rid of it. Sometimes though the virus hides away in areas that immune system can’t get to and, over a period of 20 or more years it can cause a cancer to develop.

There are over 100 different types of HPV and most of them will not cause a cancer to develop. Some high-risk strains, particularly HPV-16 and HPV-18, have been linked to various cancers, including cervical, anal, and, more recently oropharyngeal cancers. For OPSCC the culprit is usually the HPV 16 strain. It is estimated that HPV infection now accounts for approximately 70% of all OPSCC cases. The good news though is that HPV associated OPSCC responds really well to treatment.

It’s important to make sure this cancer, as with any cancer, is picked up early. If detected early, the chances of successful treatment and survival are significantly higher. So, if you feel a lump in your neck, particularly one just under the corner of the jaw, and it doesn’t go away after six weeks or doesn’t get better after a course of antibiotics, make sure you see your family doctor for advice. It’s always better to check things out and an ultrasound of your neck is a simple and low risk way of making sure things are ok.

The other important thing to remember about this cancer is that it’s preventable. Vaccines such as Gardasil and Cervarix have been developed to protect against HPV infection, including the high-risk strains associated with OPSCC. It’s now part of the immunisation schedule for school children in Australia so, in 40 years time, hopefully this particular disease will be ancient history.