Experts warn that cases of head and neck tumors could increase by 13% due to HPV


Experts have warned on World Head and Neck Cancer Day that cases of the tumor could increase by 13% following infection with the human papillomavirus (HPV).

And, according to data from the Spanish Association of Head and Neck Cancer Patients, it is the sixth most common type of cancer in the world. Moreover, in Spain, between 13,000 and 15,000 new cases are diagnosed each year and the incidence is expected to increase to around 17,000 cases as a result of HPV. Its incidence is currently 10 times higher in men than in women and the average age of onset is over 50 years.

At least 75% of head and neck cancers are caused by tobacco and alcohol consumption. The most important prevention strategy to deal with it therefore lies in the prevention of these prolonged toxic habits.

However, research indicates that HPV infection is a risk factor for oropharyngeal cancer. From an epidemiological point of view, this may be a consequence of changes in sexual practices (oral sex) and sexually transmitted diseases. Therefore, limiting the number of sexual partners may also reduce the risk of contracting HPV.

Jose Granell Navarro.

Symptoms are related to painful swallowing or discomfort with persistent swallowing, as well as the sensation of a foreign body in the throat, the expulsion of traces of blood or the appearance of a “lump” in the throat. the neck. Yet most symptoms are nonspecific and extremely common.

Regarding the survival rate, experts report that it has improved considerably in recent years, reaching 5-year survival rates close to 80%, or even higher than 90% for certain population groups.

This is mainly due to two factors. The first of these responds to the increasing proportion of positive papilloma tumours, with a much better prognosis, while the second factor is linked to progress in treatments. On this last point, the introduction of minimally invasive surgical approaches has played a fundamental role.

Transoral robotic surgery is a minimally invasive alternative for benign and malignant pathologies, thanks to which lesions on the tongue, palate, pharynx, larynx and tonsil tumors are removed. “Originally, robotic surgery in this field was introduced with the idea of ​​improving the endoscopic management of laryngeal cancer, but in practice it has meant a real revolution in the treatment of this disease. itself and accumulating evidence is expected to solidify it as the technique of choice,” Dr. Granell argued.

Although many hospitals already have this type of technology, not all have a robotic head and neck surgery program. Although in 2017 the programs were scarce, these numbers are increasing to the benefit of the health system and by 2022 there are already more than 20 Spanish hospitals that have such programs.

In this sense, the “da Vinci” surgical system allows better dissection and manipulation of anatomical structures and tissues thanks to the “EndoWrist” instruments, which stagger the movements of the surgeon and filter the natural tremors of the human hand. Unlike other robotic surgeries, for neck cancers, the camera and arms are inserted through a natural opening, the mouth, and thus, in a minimally invasive way, the entire tumor can be removed.

The advantages of this technique include low blood loss, no visible scarring or disfigurement, and reduced need for adjunctive therapies such as chemotherapy and radiation therapy. In addition, tracheostomy is avoided, resulting in lower complication rates and shorter hospital stays, allowing for faster recovery, return to speech and swallowing, improving patient functional outcomes.

“The latter is very evident vis-à-vis the open transmandibular approach, which in addition to greater morbidity (and aesthetic consequences), involves higher costs, but also vis-à-vis treatment alternatives non-surgical (radiotherapy and radiochemotherapy)”, underlined the doctor. .

Regarding the benefit for the surgeon, this surgical system allows greater precision, an enlarged three-dimensional visualization; and moreover, it facilitates the realization of turns impossible with the human hand during the intervention.

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