Expert on the human papilloma virus shared the newest research for local doctors
The human papilloma virus (HPV) vaccine isn’t just for girls anymore, a visiting Johns Hopkins hospital expert told Bermuda’s medical community.
Sarah Pai, associate professor of otolaryngology-head and neck surgery at Johns Hopkins, told
The Royal Gazette that new recommendations were released in October about the HPV virus vaccine.
Medical experts were previously recommending the vaccine for 12-year-old girls to prevent HPV virus related cervical cancer. Now Centers for Disease Control and Prevention in the United States recommends that preventive HPV vaccines be given to both boys and girls ages 11 to 26 years old.
“Researchers at Johns Hopkins, about ten years ago, identified that the HPV virus can cause a subset of head and neck cancers,” said Dr Pai. “We are seeing that over the past several decades there have been increasing numbers of HPV-related head and neck cancers, generally in men. It is unclear why.”
Some people have theorised that these HPV-related cancers have always existed, and we were only now discovering them. However, Dr Pai said Johns Hopkins researchers have found evidence that this is not the case.
“When we go back to the 1980s we can see that it was there and that the numbers continue to increase,” said Dr Pai. “It is predicted in 2020, or at some time in the future, HPV-related head and neck cancers will outnumber cervical cancers. I don’t think people realise that HPV can cause cancers in men, as well as women.”
She said traditionally, people thought that smoking and excessive alcohol consumption was the number one risk factor for head and neck cancers in men. This is true, but the HPV virus is now thought to be the second most common cause of these cancers.
In fact, one out of four head and neck cancers are caused by an HPV infection. HPV is primarily seen in cancers in the tonsils and at the base of the tongue. “HPV in the United States causes over 33,000 cancers each year,” said Dr Pai. “There are about 12,000 head and neck cancers in the United States each year and it is about the same for cervical cancer. Then there are some less common ones.”
She said the medical community now has a unique opportunity to prevent cancers in men and women by administering the HPV vaccine to young teens. “It is unclear whether the vaccine will prevent head and neck cancer, but by vaccinating both boys and girls, you are decreasing the overall incidence of the virus,” she said. “We want to eradicate a virus that can cause cancers, just as we have done with other diseases such as Small Pox.”
Dr Pai said some parents are reluctant to get their teens immunised for fear that they are encouraging their child to be sexually active. But, she said, it is important to give the vaccine before the recipient becomes sexually active. “It is important to educate parents that by vaccinating, you are actually trying to protect your child from getting potential cancer from infection,” she said. “The most important thing is that we know the vaccine is most effective if given before the person has been exposed to the virus.
“Right now, they are still trying to determine if they would need a booster. Some vaccines you need a booster in subsequent years. Researchers are doing the studies now to see if that is the case.”
She said Johns Hopkins has recently developed a vaccine to treat patients who are already infected with the virus. In December 2011, they will be starting clinical trials, giving this vaccine to head and neck HPV-related cancer patients. “We are also trying to develop an oral Pap test to detect if a patient has oral HPV infection which might put them at risk for developing the cancer,” she said. “If you detect that that might warrant them getting a full head and neck exam.”
The good news is that if you have a head or neck tumour caused by the HPV virus it is more easily treated than those that are not caused by the virus. For this reason, Dr Pai would like to see more of these tumours tested for signs of the HPV virus. She felt it would give some patients hope to know that they had a better overall survival rate. While on the island earlier this month, Dr Pai talked with physicians, nurses, staff at the hospital and also cancer patients about the new recommendations.
“I think people were very interested,” she said. “They didn’t realise that HPV virus can affect men. They always think of it as a woman’s disease. That is why we are trying to educate people.”
For more information visit www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm.