A New Cancer On the Rise

Throat cancers are fast-growing and hard to diagnose. Here, lifesaving information you need to know

Throat cancer strikes tens of thousands of Americans annually, but chances are it only recently hit your radar (Michael Douglas' diagnosis spotlighted the disease earlier this year). Thanks to decreasing smoking rates, its incidence has been declining, except for one type: oropharynx cancer, which is increasingly affecting nonsmokers. That's due to a rise in human papillomavirus (HPV), the virus typically linked to cervical cancer. "HPV-related oropharynx cancer is an emerging epidemic," says Jochen Lorch, MD, a head and neck oncologist at the Dana-Farber Cancer Institute in Boston. "There are about 7,000 cases in America, and that is expected to double in 5 to 10 years."

Tip-offs such as hoarseness, swollen glands, and throat pain are so common during cold and flu season that it's easy to dismiss them, says Edward Kim, MD, chief of head and neck medical oncology at the University of Texas M D Anderson Cancer Center in Houston. A common scenario: A patient complains of a sore throat, gets treated for infection, and sees improvement. Then the "infection" returns and is treated with more medication. "This can go on for months, during which time a stage one throat cancer can progress to stage four because it's very aggressive," says Dr. Lorch. These essential steps help keep you and your family safe.

1. Pay Close Attention to Recurring Symptoms
Doctors don't routinely screen for throat cancer, so flag any symptoms that last longer than 2 weeks or that clear up but soon return. Your primary care doctor will refer you to an ear, nose, and throat doctor for more thorough testing. "When [HPV-related] cancer is caught early, patients have greater than a 90% survival rate," says Anna Giuliano, PhD, chair of the department of cancer epidemiology and genetics at Moffitt Cancer Center in Tampa. Most patients are younger and healthier than those with cancers triggered by smoking and drinking. Research shows that HPV-positive cancers also respond better to radiation and chemotherapy.

2. Know Your Risk
A 2007 New England Journal of Medicine study found that people with six or more oral-sex partners in their lifetime were at 3.4 times greater risk of this kind of throat cancer. The HPV virus may remain dormant for years or even decades, so your past partners can affect your current vulnerability even if you've long been married. If you've had abnormal Pap tests or a history of cervical HPV infections, then you may be at higher risk of oropharynx cancer.

But before you start fretting over your sexual history, know that "although the HPV virus is common, throat cancer is still relatively rare," says Dr. Giuliano. About 4 to 10% of people have oral HPV infections, but only a tiny fraction of those will be diagnosed with cancer. Your body usually just fights off the virus. Also, keep in mind that smoking is still the predominant cause of oropharynx cancer.

3. Vaccinate Your Children
Currently approved to prevent cervical cancer and genital warts in people ages 9 to 26, the HPV vaccine can likely thwart throat cancer too. One of the strains it protects against (HPV 16) is linked to more than 90% of HPV-related throat cancers. Experts advise getting your tween, teen, or young adult vaccinated.