ABOUT THE CONDITION
What is HPV?
Some cancers of the very back of the throat (tonsil, back of the tongue and soft palate) may be caused by the human papillomavirus, known as HPV.
There are about 200 types of HPV virus that can infect the human body. For example, certain types of HPV virus cause common skin warts. These have no association with cancerous change.
Most of us have been infected with a few types of HPV virus at some point since childhood. Most of us will have no symptoms when we have caught an HPV virus as our body’s immune system can usually get rid of the viruses.
Some types of HPV can infect a woman’s cervix, and some women then develop cervical cancer as a result. One of the types of HPV virus associated with cervical cancer (HPV 16) can also cause throat cancer of the tonsil, back of the tongue and soft palate.
For general information about HPV, visit www.nhs.uk/conditions/human-papilloma-virus-hpv
A small piece of tissue, called a biopsy, can be taken from the back of your throat to find out whether your cancer has been caused by the HPV virus.
Throat cancers caused by HPV and the chance of cure.
The most important feature of throat cancers caused by HPV is that they respond differently to treatment, compared to other throat cancers. The chances of successful treatment and cure are higher than with throat cancers not caused by HPV. This tends to be the case no matter how the cancer is treated – by surgery, radiotherapy, chemotherapy, or a combination of treatments.
How does HPV infect the throat?
HPV infection of the mouth and throat area is extremely common. Most of us will have an HPV infection of the mouth or throat area at some point in our lives, usually as young adults. Most people will overcome an oral or throat HPV infection within a year. However, a very small proportion of the population will not get rid of the infection and it will remain. It is in this very small group of people that cancerous changes may develop, sometimes up to 30 years later, as a result of this infection.
HPV is transmitted by normal sexual activity. Getting an HPV infection in no way implies any abnormal sexual practice or promiscuity. The virus can be transmitted through simple intimate mouth-to-mouth kissing, oral sex or through other types of transmission.
It is important to note that there is often a very long gap, sometimes decades, between the initial infection and the development of cancer in those who do not overcome the infection. This means there is no suggestion that a patient who develops this type of throat cancer has been recently unfaithful. The same applies to their partner.
Are partners of patients with HPV cancer at risk of HPV infection and HPV-related cancer?
Long-term partners of patients with HPV cancer of the throat are usually not at an increased risk of acquiring HPV-associated throat infection. Some HPV 16 subtypes can occur within a small area, but this is very rare. It is thought there is a slightly increased risk of cervical cancer in the female partners of patients with HPV throat cancer, but this has not been proven. Female partners of patients with HPV-related cancer are advised to attend routine cervical screening and have regular smears, as recommended by the National Cervical Screening Programme. No other action is needed.
Commercial vaccines (such as Gardasil and Cervarix) are available and protect against HPV 16. These vaccines do not work in people who have already been exposed to the virus. They have no benefit for a patient who has already had a cancer caused by the HPV virus and are unlikely to be effective in their partners.
Since September 2008, the NHS has provided free vaccination against HPV viruses that can cause cervical cancer for girls from the age of 12-13 years old. From September 2019, boys at the age of 12-13 years old have been offered the HPV vaccine in the United Kingdom. If you are eligible but missed your vaccine (or it was not yet offered to you as part of the vaccination schedule e.g. boys born after 1 September 2006) it is available for free on the NHS up until your 25th birthday.
Men who have sex with men (MSM) are also eligible to have the vaccine on the NHS in the United Kingdom if they are aged 45 or under.
Trans-women who were assigned male gender at birth can have the vaccine on the NHS in England and on a case-by-case basis in Scotland.
Trans-men who were assigned female gender at birth, who have sex with other men and are aged 45 or under, can have the vaccine on the NHS in England and on a case-by-case basis in Scotland.
Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice