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Life is one of the most extraordinary miracles that surround us and that is why we should protect it. However, serious health problems put it at risk or even cancel it out. These are mainly cardiovascular diseases, traffic accidents and cancers.

Cancer, in particular, is one of the most serious problems and the second most common cause of death after heart disease. It usually affects older people. Among other areas of our body, it also develops in the head and neck area (5% of all cancers). Men are affected 3-4 times more often than women. The event was previously associated mainly with smoking and alcohol.

These data have changed. Today, infections with the HPV virus, with its aggressive carcinogenic strains, are mainly responsible for the development of these carcinomas. Transmission occurs through sexual contact.

HPV is the main cause of cervical cancer and can spread beyond the genitals, through oral contact. This results in the appearance of its carcinogenic effect in the male population as well. These are mainly younger patients and non-smokers. It is responsible for 80%-90% of oral carcinomas (tongue, tonsil) and for 30% of carcinomas of the pharynx and larynx.

Therefore, the highly infectious HPV is not only female. 80% of the sexually active population will come into contact with the virus at some point in their lives.

Infection with HPV resolves in most cases with the help of the immune system, without causing harm. A small percentage, about 5%, results in persistent infection, which leads to cancer. The virus remains inactive for years.

To date, there is no treatment to eradicate it.

Infection with the now dangerous HPV is not enough in itself to lead to cancer. Of the 150 different types of HPV, about 40 are sexually transmitted. Mainly types HPV 16 and 18 are responsible for the development of these cancers. Types 6 and 11 are responsible for the development of papillomas.

The most important risk factor for HPV infection in the oropharynx is “the number of partners with whom a person has had oral sex”. These patients who are infected with the virus have a 30% greater chance of surviving cancer, compared to people whose disease had other causes, such as alcohol or tobacco abuse (where the virus is not detected). Therefore, this disease is characterized by a milder malignancy. The HPV virus also has a strong presence in our country. The therapeutic goal is to preserve the affected organ and its function (swallowing, speaking and breathing) as much as possible.

The treatment is based on three pillars:

• surgical treatment
• radio-chemotherapy
• biological therapy (targeted therapy drugs)

Often, the most effective treatment is with a combination of the above treatments.

For cancer prevention, in addition to avoiding excessive alcohol consumption and smoking, HPV prophylaxis during sexual intercourse is considered of major importance.

However, epidemiological surveillance is also required with the widespread use of vaccines in the fight against cancer, as treatment alone is not sufficient to treat the disease.

Half of the men in the general population are probably infected with the HPV virus. For this reason, the HPV vaccine should be widely administered to boys, as vaccination reduces the risk of cancer in this area. The existing vaccines against infection by these types of HPV are characterized by very high efficacy and safety.

The message that must therefore be conveyed through this column to the world is that: Cancer is a disease almost like any other and can often be cured. The patient, not only should not consider himself doomed, but also after treatment he should continue to enjoy his life.

Written by Elias Karapantzos, Professor of the School of Health Sciences, DIPAE,
Otorhinolaryngologist Surgeon
Director of the 2nd Clinic of ENT, Inter-Balkan Medical Center of Thessaloniki