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Posts for tag: oral cancer

By Dr. Bill Kuttler, DDS
April 09, 2018
Tags: HPV   oral cancer   vaccination  

I remember when I was scheduled for my first colonoscopy, I was reluctant to proceed with it.  My doctor looked me in the eye and said “Colon cancer is the only cancer we can truly prevent, and we can do it by detecting polyps in your colon and removing them before they can develop into cancer.”  His comments had a huge impact on me, and my colonoscopy was performed the next day – and several polyps were removed.  Many years later I have colonoscopies scheduled when my doctors tell me to.  Yep, it’s a small hassle.  But based on the number of polyps I’ve had removed, it seems like a really small price to pay.

Having your children vaccinated against the human papillomavirus (HPV) is also a way to prevent cancers.  Research has shown that 2.5% of adolescents have HPV, and that 1 in 9 American men have oral HPV.  While HPV vaccinations are probably not quite as effective as colonoscopies, they are far easier.  The statistics I’ve read indicate the vaccinations are probably preventing 90% of related cancers.

HPV causes 70% of oralpharyngeal cancers.  While happily the numbers of oralpharyngeal cancer aren’t enormous, HPV causes about 31,500 cases of cancer in the US in both genders.  (While not all of those cancers are oralpharyngeal, I’m all about preventing ALL cancers.  So, if vaccinations can prevent 70% of those linked to HPV, that strikes me as huge!)

I suspect that there are people reading this who are against all vaccinations.  While I don’t agree with that perspective because I believe the safety of vaccinations is incredibly high, I’m not going to spend any ink arguing against that position.  I simply ask that they study the research and the options.

What I know is that when I first became a dentist, people who developed oral cancers were generally older adults, mostly males, who had smoked and consumed an above average amount of alcohol.  Today, the average age of people developing oral cancers is plummeting.  A significant percentage of those people don’t use tobacco and most of them don’t drink excessive amounts of alcohol either.  Further, most of them test positive for HPV.

For a large number of years the majority of HPV related cancers were cervical cancer in women.  Today, with HPV related cancers, oralpharyngeal cancer has overtaken cervical cancer.  Also for many years it seemed that most HPV related cancers were in women.  Today men are four times more likely than women to be diagnosed with oralpharyngeal cancer.  In less than 40 years, many of the statistics have been turned upside down – I find that both amazing and terrifying!

To make this even worse, many of the oralpharyngeal cancers related to HPV are found in and around the tonsils and are often far more difficult to detect than the more “traditional” types of oral cancer.  That translates to the reality that by the time those are detected, they are larger and are more likely to have spread – making treatment far more difficult and less likely to succeed.

In the beginning HPV vaccinations were encouraged more for girls than boys.  Today, I would want all of my children to be vaccinated.  The recommended age is 11-12, but the vaccinations can be given as early as age 9, and it is most effective if given before the age of 13.  Having said that, if your children have not been vaccinated or if you are a young adult, vaccinations can be given up to the age of 26, and they will still provide significant benefits.

I encourage you to have a discussion about HPV vaccinations with your medical doctor.  April is Oral Cancer Awareness Month – this seems like a GREAT time to take action!  Don’t just be aware of it, PREVENT IT!  (And tell your medical doctor that I sent you.)

By Bill Kuttler, DDS
June 02, 2013
Tags: HPV   oral cancer   throat cancer  

We all know that April showers bring May flowers. But what else does April bring? April is Cancer Control Month. It is also Facial Protection Month and STD Awareness Month. April 19-25 is Oral and Head and Neck Cancer Awareness Week. And, to top it all off, April is Humor Month.

Believe it or not, there is a common topic that ties these threads together (but it is NOT a laughing matter)! Perhaps it is one that you would not think of right away. It’s the Human papillomavirus (HPV).  

When I was a dental student, I learned that over 75% of the people who had oral cancer were heavy smokers and/or drinkers and most of them were males–roughly 2 or 3 times more males had oral cancer than females. Most commonly, the people with oral cancer were over the age of 50. Today there is a new and rapidly growing sub population of people developing oral cancer: They are between 20 and 50 years old, are predominantly non smoking and white, and males only slightly outnumber females. What’s the cause of their oral cancer? HPV.

It may seem strange to read about sexually transmitted diseases (STDs) in a column by a dentist, but a dental office is likely to be where you get your most complete oral cancer examination.

HPV is the most common STD in the United States according to the Centers for Disease Control and Prevention (CDC). It is currently affecting over 20 million people in the United States with new cases occurring in about 5 ½ million people each year!

Oral and throat cancer is diagnosed in about 40,000 people each year according to The National Cancer Institute estimate – thankfully a much smaller number, but this number has also been steadily growing.

To me, these are relatively huge numbers! They mean that more than 1 in 20 people in the U.S. are likely to have a current HPV infection, and most of them are under the age of thirty. While the infection is potentially more serious in women, due to its connection with cervical cancer, the incidence of HPV appears to actually be slightly higher in males. Indeed the incidence of oral HPV infection is currently 4 or 5 times greater in males than females, and those overall numbers also appear to be rising.

While the incidence of oral cancer is still comparatively low, the risk of it occurring is currently estimated to be 53 times greater in someone who has had an oral HPV infection versus someone who has not.

While I trust that all dentists are performing oral cancer screenings as part of their examination process, the lesions associated with HPV are often particularly hard to detect. They often begin in areas that are difficult, if not impossible, to see, and that means that the detection is often delayed until the lesion has grown — which of course is not good news.

That is why prevention is so very important! There are vaccinations available that protect against the most dangerous strains of HPV – especially the ones most often associated with cervical and oral cancers. While the vaccinations have been largely promoted for young girls, the research supports the vaccination of young males as well. And while the recommendation is for the vaccination to be given between the ages of 11 and 14, there is also evidence that there are significant benefits to it being given later if the person is already past that ideal age. That later vaccination is probably still valuable even if the person has already been diagnosed with HPV. The rationale for that is that since it is unknown which strain of HPV was responsible for the initial infection, the vaccination will still prevent infection from the other strains, and they may be the ones most often responsible for causing cancers.

I know this vaccination has been controversial for some people. The research, however, strongly supports the benefits and has demonstrated few risks. That research also supports that the benefits are NOT tied to a specific gender – both males and females will benefit from the protection of the vaccine.  So please consider talking with your medical doctor about the HPV vaccine. It’s no laughing matter.

This article originally appeared in Dubuque 365ink magazine. It is republished with permission from the publication.