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New Study Links HPV To Head And Neck Cancers In Men

A new study finds that half of men in America are infected with the HPV virus. Dr. Jon LaPook reports on the growing concern that the virus in men could be responsible for an increase in head and neck cancers.

HPV Affects Half Of U.S. Men

A study out [yesterday] in The Lancet by Moffitt Cancer Center researcher Anna Giuliano, Ph.D., and her colleagues finds that 50 percent of men ages 18 to 70 in Brazil, Mexico, and the U.S. have genital infection with human papillomavirus (HPV).  HPV is the virus that causes cervical cancer in women. It also causes warts and cancer of the genitals and anus in both men and women. Over the past several years, researchers have realized that the virus can also cause cancer of the head and neck.

Aimee R. Kreimer, Ph.D., of the National Cancer Institute, estimates that about 65 percent of the approximately 8,000 cancers of the tonsils and base of the tongue (oropharynx) seen in the U.S. in 2010 were from HPV infection; eighty percent of these are in men. The rates for HPV-associated cancers like these are increasing; for sites like the mouth and larynx that are associated with tobacco and alcohol use, the rates are decreasing (though still too high since too many people still smoke and abuse alcohol).

An infection rate of 50 percent for a virus that can cause cancer sounds scary. But knowing a few more facts about HPV helps put the risk in perspective. About 90 percent of men and women infected with HPV virus get rid of it on their own within about two years. There are many different strains of HPV — some that cause cancer and some that don’t. Only about 6 percent of men have genital infection with HPV 16 — the strain linked to more than 90 percent of cancers of the head and neck. And only about 0.6 percent of men have HPV 16 in specimens taken from their mouths; what percentage of those men go on to develop head and neck cancer is unknown. Read more »

Whispering: Is It Bad For Your Vocal Cords?

Is whispering bad for your vocal cords? For most people, the answer is yes according to research publicized in a recent New York Times article.

In the mentioned study, out of a group of 100 patients, 69 percent exhibited increased supraglottic hyperfunction with whispered voice (i.e. it was bad for the voice.) Eighteen percent had no change and 13 percent had less severe hyperfunction.

As such, though whispering is not bad for everybody, it is for most people and as such, the safest thing to do if the vocal cords are damaged whether by infection or trauma is to rest your voice. If you have to talk, do not whisper, but rather talk in a soft voice.

The best way to think about injured vocal cords is to talk in an analogy. Laryngitis is like a badly sprained ankle. In this scenario, talking is like walking and screaming is like running. So just like you would rest the sprained ankle and not walk on it in order for it to recover as quickly as possible, you should refrain from talking in order for the laryngitis to recover as quickly as possible. Where does whispering fall in this analogy? Probably equivalent to running on a sprained ankle.

Read more about voice problems here.

REFERENCE: “Laryngeal hyperfunction during whispering: reality or myth?J Voice. 2006 Mar;20(1):121-7.

*This blog post was originally published at Fauquier ENT Blog*

The Link Between Oral Sex And Head And Neck Cancer

USA Today published a pretty accurate article regarding the rise of certain head and neck cancers with the increased popularity of oral sex and number of sexual partners.

The factor that creates this link is the human papillomavirus (HPV) which is associated with tonsil and tongue cancer. Alcohol and tobacco use is more highly linked with such oral cancers, but HPV does appear to be an independent risk factor.

A 2007 study in the New England Journal of Medicine found that younger people with head and neck cancers who tested positive for oral HPV infection were more likely to have had multiple vaginal and oral sex partners in their lifetime. Having six or more oral sex partners over a lifetime was associated with a 3.4 times higher risk for oropharyngeal cancer — cancers of the base of the tongue, back of the throat, or tonsils. Having 26 or more vaginal-sex partners tripled the risk. The association continued to increase as the number of partners in either category increased.

Of greater concern is that “French” kissing may also potentially be a mode of transmission.

The good news (if you’re a young non-smoker diagnosed with HPV-positive tumors) is that about 85 percent of non-smoking people with HPV-positive tumors survive. That number drops to 45 or 50 percent in people who smoke and are HPV-negative. Read more »

*This blog post was originally published at Fauquier ENT Blog*

The Musician’s Brain On MRI

Dr. Charles Limb is an otolaryngologist, and he’s also on the faculty at the Peabody Conservatory of Music. Wanting to study creativity on the neurological level, he used fMRI to scan the brains of musicians while improvising along with them. Here he describes the experiment, including the building of an MRI-compatible electronic keyboard:

Link @ TED…

*This blog post was originally published at Medgadget*

Post-Op Tips: A Preventive Strategy For Withdrawal Symptoms In Alcohol-Dependent Patients

It has been a while since I’ve had a patient with postoperative alcohol withdrawal.  I can still recall my first exposure to this problem as a 3rd year medical student at the Veteran’s Hospital.  It was my first clinical rotation – surgery service at the VA.

Browsing the CME articles on the JAMA website, I came across the article (full reference below):  Improved Outcomes in Patients With Head and Neck Cancer Using a Standardized Care Protocol for Postoperative Alcohol Withdrawal.  For me it was a nice review of the problem with updates on current drug use/protocol.

Their protocol is based on three distinct clusters of symptoms characterize alcohol withdrawal syndrome (AWS). Central nervous system excitation usually occurs within 12 to 48 hours after the last drink. Read more »

*This blog post was originally published at Suture for a Living*

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