Oropharyngeal human papilloma virus (HPV) is an infection of the throat that causes lesions that may become pre-cancerous or cancerous. Oropharyngeal HPV lesions may be found by a dentist or a doctor during a special type of exam, but the presence of the infection is discovered through a biopsy on people who have signs and symptoms of the disease. Oral HPV testing is an important diagnostic method that makes it possible for patients to get early treatment of the disease.
Oral HPV testing typically involves the use of small mirrors that are used to examine areas of the throat that are difficult to see. Lesions may appear in the throat, larynx, and at the base of the tongue. In some cases, a dentist may use a flexible laryngoscope or a pharyngoscope to see deeper into the patient’s throat and look directly at lesions.
Lesions that look suspicious may need to be biopsied. A biopsy is a diagnostic treatment wherein a small number of cells are removed from a tumor or lesion with a thin needle or a forceps. The cells can then be viewed under a microscope in a lab setting where the cells are examined to see if they are cancerous. Cell samples from an oral HPV test may be tested for cancer as well as the presence of HPV DNA. If a lesion is cancerous, or it tests positive for HPV DNA, it is likely to be more responsive to treatments than lesions containing cells that are HPV-negative.
Testing for oral HPV can be life-saving because if a patient tests positive for this infection, they’ll have the ability to be treated sooner than later for cancer. Typically, chemotherapy and radiation are used to treat the disease initially. Chemotherapy is a treatment that’s usually administered via IV and that involves the use of drugs that are known to kill cancer cells. This is followed by surgical removal of the lesion although sometimes surgery is performed first. Then, patients usually undergo another round of radiation with or without chemotherapy treatment.
Oral HPV testing is a screening method that can help doctors and dentists detect cancer early which means that the treatment methods and surgical reconstruction following removal of the lesions is likely to be much less involved. Patient outcomes are much higher with early detection of the HPV infection and cancerous or pre-cancerous lesions.
While it is possible to prevent HPV infections by abstaining from sex, vaccines have also helped diminish the incidence of certain subtypes of this disease, in particular, those subtypes that cause cervical cancer. Studies have not yet demonstrated whether the HPV vaccines help prevent oropharyngeal cancers that are linked to the same subtypes. Prophylactic vaccines can help prevent the HPV infection, but they won’t treat an existing infection, so the vaccine is generally administered before a person becomes sexually active. Doctors can administer the vaccine.
Patients who receive a diagnosis of oral HPV with active lesions in the throat have a good prognosis, especially if the disease is detected early. HPV-positive oropharyngeal cancers tend to have much better outcomes from treatment than other types of cancer. Patients with this disease tend to have fewer relapses after they’ve been treated than patients who are diagnosed with HPV-negative cancers. Patients who have developed oropharyngeal cancer that was treated using chemo and radiation had a higher survival rate than patients with HPV-negative tumors.
Early detection of this type of cancer is key, so the benefits of oral HPV testing are hard to quantify. Testing is relatively straightforward and can literally save the patient’s life. Give us a call at 206-546-1611 to for a dental exam and cancer screening.
© Eric Yao, DDS, MAGD, LLSR
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