Introduction
The link between cancers and various underlying conditions is often studied in research. In the article “HPV-Associated Oropharyngeal Cancers,” Timbrell (2011) looks at the connection between human papillomavirus (HPV) and cancers that arise in the head and neck, particularly in the oropharynx. According to the author, substantial evidence exists that HPV is a significant causative factor for cancer to develop, the most common type being oropharyngeal squamous cell carcinoma (OPSCC) (Timbrell, 2011).
For instance, some statistics show that approximately 60% of people with cancers of the oropharynx are also HPV-positive (Timbrell, 2011). Simultaneously, studies show that HPV-positive individuals with OPSCC are at a lower risk of health complications and have better prognoses for treatment (Timbrell, 2011). Knowing the connection between these two conditions can improve further investigations and treatment options.
Description of Oropharynx
The oropharynx is located between the base of the skull and the sixth cervical vertebra in the pharynx. It is connected to the nasopharynx and laryngopharynx above and below and includes the tonsils, the base of the tongue, and the soft palate (Timbrell, 2011). It is a part of the digestive and respiratory systems and is partly responsible for speech.
Oropharyngeal Cancer
Outcomes
Most cancers in this region are squamous cell carcinomas – about 95% (Timbrell, 2011). It is usually easy to distinguish and grade cancers of the oral cavity. However, those that arise in tonsillar crypts, at the base of the tongue, and in the hypopharynx are differentiated poorly.
Risk Factors
Risk factors for oropharyngeal cancers include age between 40 and 65, male sex, location in Western countries, chewing of the betel nut, smoking, poor oral hygiene, alcohol consumption, and sexual HPV infection. The clinical features of the tumors are often difficult to notice because the early stages are asymptomatic (Timbrell, 2011). Some signs include pain and difficulty swallowing, white or red lesions, referred pain, lymphatic spread to the neck nodes, and a sore throat.
Stages
The four stages of oropharyngeal cancer follow the standards set by the American Joint Committee on Cancer and the International Union Against Cancer. The diagnosis usually occurs in stages III and IV, where further classification is possible. For instance, the size and spread of lesions are ranked from T0 to T4a-T4b, and the metastasis is graded between N0 and N3 (Timbrell, 2011). Furthermore, the carcinomas are also staged anatomically from 0 to IVC to note the spread to other areas.
Causes
HPV is a major factor in the development of oropharyngeal cancers. The viruses are double-stranded deoxyribonucleic acids (DNAs), and half of the 200 types are often linked to genital tract infections (Timbrell, 2011). Most HPV infections are asymptomatic, although some may lead to the development of benign warts and papillomas.
The risk of HPV-related cancers is high – 14 types of this virus have been found in the mucosa with cervical cancer (Timbrell, 2011). The most common type of HPV is HPV-16, which is also a significant cause of oropharyngeal cancers, cervical cancer, and several types of cancers in the penis and anus (Timbrell, 2011). Thus, oral-genital contact during sexual activity is a major risk for HPV-positive people to develop and increase the risk of cancer in sexual partners.
Treatment
Treating oropharyngeal cancers may involve a combination of radiation therapy, surgery, and chemotherapy. Treatment cannot be harsh to preserve organ function and the patient’s ability to speak; thus, a preference for radiation therapy exists (Timbrell, 2011). Surgery was usually not the primary option due to poor patient outcome history and low survival rates. However, modern transoral laser microsurgery has yielded better results for patients, thereby increasing its use (Timbrell, 2011).
Conclusion
Overall, HPV infection, especially the HPV-16 type, is strongly connected to the development of oropharyngeal cancers. HPV-positive patients with OPSCC respond to treatment well and have high survival rates. Further research should investigate epidermal growth factor receptor therapy and HPV vaccination to reduce the risk of cancer.
Reference
Timbrell, R. (2011). HPV-associated oropharyngeal cancers. Radiation Therapist, 20(2), 1-11.
