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If You Had One HPV Cancer, You’re More Likely to Get Others

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It’s scary enough that HPV—the very common human papillomavirus—can cause cervical, vaginal, vulvar, throat, anal and penile cancers. Now a study done at leading cancer centers across the US has found that having one of these HPV-related cancers puts patients at a higher risk for a second one. These are not instances of metastatic cancer (when the original cancer spreads to another area). They are new cancers in a different part of the body.

Why does this happen? The most likely answer is that the virus infects multiple places in the body at once…but it takes different lengths of time for each cancer to develop. Research has also found that some people have variations in their immune genes that make them more susceptible to HPV-associated cancers.

The study, which looked at the records of about 73,000 female and 40,000 male patients with an HPV-related cancer, showed that the risk for getting a second cancer has grown over the past four decades…and that the risk varies depending on where the first cancer was located. The risk of a second HPV-related cancer was greatest in people who initially had HPV-related throat (oropharyngeal) cancer. And if the original cancer was not throat cancer, the most likely second cancer was throat cancer. But risk for any of the HPV-related cancers was elevated.

Here’s how you can protect yourself if you’ve already had one HPV-related cancer…

Be vigilant about getting all recommended cancer screenings. A colonoscopy can find signs of HPV-related rectal or anal cancer. Cervical cancer screenings for women uncover suspicious lesions, often before they have the chance to turn into cancer. Because the area susceptible to this type of throat cancer includes the base of the tongue, tonsils and soft palate, your dentist can visually check for signs of cancer in these areas—ask for this if it’s not already part of every visit. And see an otolaryngologist if you experience any of the possible symptoms of throat cancer such as a persistent sore throat, trouble swallowing or a lump in your throat, neck or the back of your mouth.

Talk to your doctor about the HPV vaccine. In October 2018, the FDA extended its approval of Gardasil 9 for people up to age 45. Scientists are also investigating whether it makes sense for people with a history of an HPV-related cancer to be vaccinated against HPV. The prevailing theory has long been that people are exposed to HPV when they are young and then develop cancer later in life. But it could be that later infection as well as infection with a different strain of the virus is occurring more frequently than previously thought and that vaccination could prevent cancer in these situations.

On the horizon: Clinical trials are currently looking at whether HPV vaccination can prevent existing precancerous lesions from developing into cancer and whether certain versions of the vaccine can decrease both the recurrence of an HPV-related cancer and the development of a second one when given as part of cancer treatment.

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Source: Andrew Sikora, MD, PhD, associate professor of otolaryngology, and codirector of the Head and Neck Cancer Program at Baylor College of Medicine in Houston, Texas, and coauthor of the study titled “Trends in Risks for Second Primary Cancers Associated With Index Human Papillomavirus-Associated Cancers,” published in JAMA Network Open. Date: November 7, 2018 Publication: Bottom Line Health
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