Awareness on safe sex, subsidized vaccines is crucial in reducing HPV-associated oral cancers, Health News, ET HealthWorld

By Nisha Kumari and Ritika Sakhuja

New Delhi: Cases of human papillomavirus (HPV) leading to oropharyngeal cancer are on the rise across the world. CDC’s report on ‘HPV and Oropharyngeal Cancer states that 10 percent of men and 3.6 percent of women have oral HPV globally. Most of the oral cancers developing in the throat, in the tonsils or at the back of the tongue, are caused by HPV, which infects the squamous cells that line the inner surfaces of these organs.

Experts inform that there are many factors that can be attributed to this rise in the incidence of HPV-related oral cancersthe most significant of which is the lack of awareness about HPV and its ability to lead to cancer, sex as a taboo concept leading to misinformation, and the preventive measures that one must follow to tackle or avoid HPV infection effectively.

To understand the sharp rise in cases of HPV and oropharyngeal cancer, ETHealthworld spoke to oncologists to gain insight into the modes of transmission of HPV, treatment of HPV-related oral cancer, and preventive measures that must be employed to stay safe and avoid this morbid condition. infection.

Oral cancer due to HPV on the rise

Highlighting the reasons for the rise in oral cancer cases owing to an infection of HPV, Dr Deepak Parikh, Head and Neck Onco Surgeon, ACI Cumbalall Hill Hospital, said “Earlier there were not many tests that were conducted to screen for HPV. The number of tests for screening oral cancer was always there but HPV as a cause remained unidentified. Testing is now done more frequently. So that might be the reason for the increasing incidence of such cases. Secondly, when we do the biopsy, the specimens are tested for HPV, so that is also a reason for the numbers picking up. Thirdly, the younger generation is more experimental with oral sex, which has also contributed to the increase in the number of oral cancer cases due to HPV.”

However, experts inform that the HPV vaccine might help prevent the spread of infection if the vaccine is delivered before a person becomes sexually active. This can even allow the prevention of transmission.

Informing about the same, Dr Yash Devkar, Consultant, Head and Neck Oncosurgeon, Fortis Hospital, Vashi said “The vaccine is a good way to protect from HPV. It will work better if it is taken earlier. After nine years of age, vaccines are approved for children. So the same vaccine which protects women from cervical cancer works the same for the oropharyngeal because it is coming from the genital.”

Merck Sharp & Dohme’s Gardasil 9 is a vaccine that has been available in India since 2009 and is indicated in females nine through 45 years of age for the prevention of cervical, vulvar, vaginal, anal, oropharyngeal and other head and neck cancers caused by human papillomavirus (HPV). Another vaccine that can prove effective against oral cancer-causing HPV infection, is India’s first indigenously developed vaccine to prevent cervical cancer, CERVAVAC, developed by the Serum Institute of India (SII).

The HPV vaccine should be included in the vaccination program itself, recommends Dr Devcker.

Resonating Dr Devcker’s suggestions, Dr Akshay K Susvirkar, Skin and Sexual Health Physician, The Humsafar Trust Clinic, Vakola, said “The government still hasn’t subsidized the vaccine for women let alone men, but in other countries, governments have already subsidized it for both men and women irrespective of their sexuality . So in this way, a uniform policy can be established and can be made part of a national immunization program because youth irrespective of their sexuality is going to face these threats and it would make sense to make it as common as something like the polio vaccine. “

Prognosis is better in HPV-positive than HPV-negative oral cancers.

An oral cancer diagnosis owing to an HPV infection might not be as debilitating as it sounds. Dr Sheetal Radia, Consultant, Otorhinolaryngology, Head & Neck Oncosurgery, Wockhardt Hospitals, Mira Road, informed that studies have shown that HPV-related cancer shows better treatment as compared to non-HPV-related tumors. “One reason behind it is that HPV is radiation sensitive, and smaller in size as compared to non-HPV,” said Dr Radia.

Adding to Dr Radia’s statement, Dr Vishal RaoGroup Director, Head Neck Surgical Oncology & Robotic Surgery, HCG Cancer Hospital, Bangalore said, “This is attributed to the p53 gene which is also called the tumor suppressor gene. This particular gene is known to suppress tumors from coming up. Now as we know that HPV in some way does not damage the p53 gene, and that is the reason why it is still amenable to a better outcome because the p53 mutation that we see in HPV is of a slightly less aggressive variety. Therefore they are more curable with better outcomes.”

Focussing on the treatment procedure, Dr Radia added “HPV virus cancers are not very dangerous so most of them can be treated by surgeries only. Few require radiation therapy and very few require both chemo and radiation therapy. If the prognosis is worse, then only patients are kept at three modalities- surgery plus chemo plus radiation therapy. But not for early-stage cancer. HPV is radiation sensitive, so as soon as radiation is given they die easily. The prognosis is better in HPV-positive rather than HPV-negative cancers.”

HPV awareness: Need of the hour

The topic of sex is still a taboo concept in India, which leads to misinformation that can prove extremely dangerous since it discourages people from employing safe sex practices increasing the risk of contracting an STD.

Commenting on the lack of awareness around HPV, Dr Susvirkar concluded, “The awareness among the community is low. They still think of HPV as just a STD, some not even aware that the growth is following sexual intercourse. However, HPV further leads to oral cancer that is not known to them and can occur after giving fellatio or analingus. To give a rough estimate only 1 in 20 of my patients would be aware of the oral cancer link.”

Experts agreed that the easily avoidable HPV infection can prove fatal due to delayed diagnosis and treatment, for which awareness about HPV leading to cancer, verified information on sexual health and safe sex practices, and subsidized vaccines that are included in the national vaccination program are essential. and must be employed immediately.