Human Papilloma Virus
Thursday December 6,
Dear Dr. Mady: I am now 47 years old and was recently examined by my dentist who found several of these small wart-like bumps on the back of my tongue. He has referred me to see an oral surgeon to have them removed for biopsy, but believes they represent the Human Papilloma Virus that can some times lead to cancer. Is it possible that something that looks like a wart can cause cancer and isn't this virus one that women get?—Glen in Toronto
Dear Glen: We hear a lot lately in the news and see abundant information on our physician’s office wall and brochures about the Human Papilloma Virus or more commonly known as HPV. When we hear about HPV it is almost always related to women and its potential to lead to cervical cancer. They are even now offering a vaccine at schools that the government is paying for, to help protect young individuals (mostly girls) from this virus in the future.
The fact is that the human papilloma virus has been brought more to the attention of the public because it is one of the most common virus groups (there are many types) in existence today that affects the skin and mucosal areas of the body, including the oral mucosal tissues. There are well in excess of one hundred types that have been identified and different types can affect different parts of the body. The exact areas infected are the epithelial cells of the tissue in question. The epithelium is a membranous cellular tissue that covers the surfaces of our body to protect. Epithelial cells make up the layers of the tissues including the skin and mucosa of the mouth, tongue, throat, tonsils and the list goes on. The infection commences when these areas come into contact with the virus enabling it to transfer between epithelial cells of already infected tissue and healthy tissue. So if the results of your biopsy show you have HPV then you must have come into contact with it at some point.
The most common forms of HPV result in papillomas (warts) on different parts of the skin like hands, arms and legs. Most of the cauliflower-looking bumps are harmless and treatable. Some of the sexually transmitted types can be a serious problem and represent the most dangerous types (HPV16 and HPV 18). These cancer causing types can look flat and sometimes nearly not visible. New studies have shown that these are linked to many oral cancers as well. If these cancer causing ones are found in the mouth, they are usually located at the back of the tongue, at the back of the throat or on the tonsils.
From my experience, I have found that oral cancer most commonly finds its way into the mouth and oral areas by two ways. This is through a combination of alcohol and tobacco use and the other is via the human papilloma virus. I would guess that the HPV tumors are found more often in younger individuals than the alcohol/tobacco related cases. Literature related to research states that oral HPV occurs more often in white males and non-smokers. So, males are just as susceptible to HPV as females and the number of cases is growing rapidly. This is not a female virus. It is a fact that the HPV group is one of the, if not the fastest growing portion of the oral cancer cases diagnosed today and alcohol and tobacco use may even promote HPV invasion.
It is mandatory to remember that the most dangerous thing about the human papilloma virus is its potential to cause cancer. Anyone old enough to engage in behaviors which are capable of transferring this virus should consider routine screening for oral cancer by their dentist. Catching this disease, like any, in the earliest possible stage, makes it most vulnerable to treatment and increases chances of survival. Early detection and diagnosis is key.
For any questions or more info, visit www.askthedentist.ca or e-mail Dr. Mady directly at firstname.lastname@example.org
This column is reprinted with the permission of the author and The
Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS
member), Dr. David Mady Jr.. The column appears the first Thursday of
each month in the Windsor Star. Readers with questions can write to "Ask
The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A