Have you ever heard of the virus called HPV? Probably yes. When most people hear the word HPV, they think it's something that only affects women, like cervical cancer. But the truth is, it's a lot different. Did you know that this virus called HPV can also cause infections in our mouth and throat? That's why we call it Oral HPV. Although there's not much talk about it in society, it's very important to be properly informed about it. So, let's talk about everything in a very simple way today.
What exactly is oral HPV?
Simply put, Oral HPV is an infection of our mouth and throat caused by the Human Papillomavirus (HPV), one of the most common sexually transmitted infections (STIs).
Think about it, HPV is not just one virus. Just like there are different siblings in the same family, there are more than 200 strains of HPV. Of these, only about 40 strains can cause infections in our mouth, throat, and genital areas.
Now here's the important thing. Out of these 40 types, there are about 12 types that have some chance of turning into cancer . Of these, the most dangerous type that has the highest risk of causing throat cancer (`Oropharyngeal Cancer`) is HPV-16 . But don't worry. This HPV-16 type is not very common in the general population. However, 8 out of 10 throat cancers diagnosed have been found to be related to this HPV virus.
But remember this: Not everyone who gets HPV in the mouth will develop cancer. In fact, the vast majority of people who get infected will not develop cancer.
Most of the time, our immune system is very good at fighting off HPV before it becomes an infection. But sometimes, in about 7% of people, the virus can persist and develop into an infection.
What are the symptoms of this? How do we know?
Here's the scary part about this infection. Many people with oral HPV infection don't have any symptoms . That means they don't even know they have the infection. This makes it more likely that someone else, including their partner, will be infected.
However, a very small number of people may experience some symptoms.
- Small growths, warts or lesions on the lips, inside the mouth, or throat.
- These warts usually start to appear between 3 and 6 months after the virus is transmitted.
Are there any specific symptoms of HPV-related throat cancer?
Yes. If an HPV infection leads to the development of throat cancer (HPV-positive oropharyngeal cancer), the symptoms may be slightly different. These usually start in the tonsils on either side of our throat or on the inside of our tongue. So they are difficult to see at first. But as the disease progresses, the following symptoms may appear.
| Symptom | Description |
|---|---|
| A lump on the neck or cheek | A sudden, painless lump. |
| White or red spots on the tonsils | Unusual spots visible when the mouth is opened. |
| Bleeding when coughing | A small amount of blood may be present, either with or without mucus. |
| Earache | Persistent ear pain, especially on one side. |
| Voice change (hoarseness) | Voice hoarseness or change for no reason. |
| Pain or swelling in the jaw | Unusual pain or swelling in the jaw area. |
| Sore throat and difficulty swallowing | Feeling of choking or pain when swallowing food or drink. |
| Weight loss without any reason | Weight loss without dieting or exercise. |
Having these symptoms doesn't mean you have cancer 100% of the time. However, if one or more of these symptoms persist for more than two weeks, it's definitely best to see your doctor and get checked out.
How does this spread from person to person?
Oral HPV is mainly spread through oral sex . It can also be spread through deep kissing (or French kissing) .
Think of it this way: A person with HPV has the virus in their saliva and mucus (fluids like mucus). So, if that saliva or mucus comes into contact with a small cut or scratch in their partner's mouth, the virus can be passed on to the other person.
Who is most likely to develop this? (Risk factors)
The main risk factor for this is oral sex. But there are several other factors in addition. Over the past three decades, the incidence of oral HPV infections has increased worldwide. In particular, it has been found that the condition is about four times more common in men than in women.
Let's see what the other risk factors are.
| Risk factor | Simple explanation |
|---|---|
| Having multiple oral sex partners | The more partners you have in your lifetime, the greater your risk of exposure to the virus. |
| Being HIV positive | Because HIV weakens the body's immune system, it is less able to fight viruses like HPV. |
| Having an HPV infection in the genital area | A person with an HPV infection in the genital area is more likely to develop an oral infection as well. |
| Excessive drinking | Excessive alcohol consumption can weaken the immune system and cause other health problems. |
| Smoking | Smoking damages the tissues of the mouth and throat, allowing the virus to easily enter and cause an infection. |
Why is this more common among men?
Even doctors don't know the exact cause of this, but there have been various theories.
- Perhaps one reason is that men engage in oral sex with more partners than women.
- Another theory is that the virus is more likely to be transmitted when having oral sex with a woman's genitals.
- Another theory is that when women are exposed to HPV, their bodies develop a strong immune system against it, protecting them from future oral HPV infections.
Further research is needed on this.
How does a doctor diagnose and treat this?
Currently, there is no specific screening test that can detect oral HPV in someone who has no symptoms. Usually, when a doctor examines your mouth, they find these warts or growths by chance. This means that most of the time, they only test people who already have symptoms.
If your doctor sees something suspicious inside your mouth, he or she may take a small piece of tissue from the area and send it for a biopsy . The tissue sample is examined to see if it is cancerous cells, precancerous cells, or a normal infection.
What are the treatments?
If you have an oral HPV infection, your body's immune system will usually clear the virus on its own. However, if you have growths like warts in your mouth, your doctor can remove them. There are several methods used to do this.
- Surgery: Removal of warts through minor surgery.
- Cryotherapy: The use of extreme cold to destroy warts.
- An interferon injection (`Interferon alfa-2B`): An injection of a drug that helps fight the virus.
The important thing is that these treatments only remove the visible warts on the surface. This does not mean that the virus inside the body is completely eliminated. Therefore, if the infection is active, you can still pass it on to someone else.
Most importantly: Can the HPV vaccine prevent this?
Yes! It definitely is. This is the best and most important message in this article.
Research has clearly shown that the HPV vaccine can prevent oral HPV infections . This vaccine protects not only against oral HPV, but also against many other types of HPV-related cancers, such as cervical cancer, vaginal cancer, anal cancer, and penile cancer.
Based on this evidence, the US Food and Drug Administration (FDA) has recommended the HPV vaccine for the prevention of throat cancer in 2021. In our country, the government also provides the HPV vaccine to young girls. Also, boys can get this vaccine. If you want to know more about this, talk to your family doctor.
What should I do if I have Oral HPV?
First of all, don't panic. As we mentioned earlier, most oral HPV infections clear up without any treatment within two years. If you develop warts in your mouth, your doctor can remove them.
However, in some people, the virus can remain in the body for decades. In such cases, the risk of developing serious health problems such as throat cancer arises.
Therefore, if you develop any symptoms, be sure to see a doctor. Also, don't forget to keep your follow-up appointments after the warts are removed.
Take-Home Message
- Oral HPV is a very common sexually transmitted viral infection, but many people don't know about it.
- Many people do not experience any symptoms, so they can spread the infection to others without even knowing they have it.
- Most of the time, our body's immune system clears this virus within 2 years.
- Infections with high-risk strains, such as HPV-16, can sometimes lead to throat cancer, but this only happens to a very small number of people.
- The best and most effective way to protect yourself from this infection is to get the HPV vaccine . Ask your doctor about this.
- If you notice an unusual lump, spot, or lump in your mouth, lips, or throat, or if you have a sore throat or difficulty swallowing that lasts for more than two weeks, see a doctor immediately.
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