Medical Minute 4-14: The Rise of a Cancer

By: Ramin Khalili Email
By: Ramin Khalili Email

Paul Wyett's been through a rough couple months.

"I was fine. Healthy. Then all of a sudden I was in a surgery room for the first time in my life," said Paul Wyett.

Last August, he was diagnosed with oro-pharynx cancer. It's a type of throat cancer experts say may double in 10 years. Doctor Ron Karni knows what to look for.

"You can actually grow quite a large tumor, even the size of a golf ball or bigger in the back of your tongue or in your tonsil and not know it," said Ron Karni, M.D., UT Health/Memorial Hermann.

And now - it's popping up in patients without warning.

"We see them in people who don't have any risk factors in regards to smoking or alcohol."

Experts are now blaming part of the cancer's rise on human papilloma virus - or HPV.

"We're certainly seeing the evidence of some of the changes that that virus causes to the cell in patients who have HPV-related cancers."

As a result, experts hope the Gardasil vaccine - which protects younger people against HPV - may prevent oro-pharynx cancer, too. In 2009, about 70 percent of oro-pharynx cancers were HPV positive. In 2003, it was just 35 percent.

"We'll probably have to wait almost a whole generation before we can look back and say that we've seen a marked reduction in head and neck tumors because of the vaccines we're giving today."

Paul had robotic surgery, chemo and radiation for his tumor.

"This was just a little speed bump in the road that you just deal with and you go on."

Hopefully science will keep his child from fighting the same battles.

For more information on other series produced by Ivanhoe Broadcast News contact John Cherry at (407) 691-1500,


BACKGROUND: The oropharynx is the middle part of the throat, and includes the base of the tongue, tonsils, the back of the mouth, and the walls of the throat. When cancers form in these areas, they are usually squamous cell carcinomas. When left untreated, oropharynx cancer is usually fatal.

Symptoms of oropharynx, or oropharyngeal, cancer can be difficult to detect, but they include a chronic sore throat, unexplained weight loss, voice changes, difficulty swallowing, ear pain, and lumps in the neck, mouth, or the back of the throat. However, lumps in the neck, mouth, or back of the throat usually mean that the cancer has already started to spread to the lymph nodes. (SOURCE:

RISK FACTORS: The risk factors for oropharyngeal cancer include excessive drinking and tobacco use. Doctors have also found links between oropharyngeal cancer and the human papilloma virus, or HPV, which is usually associated with cervical cancer. Increasing numbers of oropharynx cancer patients also test positive for HPV. (SOURCE:

TREATMENT: Treatment for oropharyngeal cancer usually includes radiation, chemotheraphy, or surgery. Due to the nature of the symptoms, oropharynx cancer is often detected late, and therefore it's important to get started on treatment as soon as possible. In the past, surgery for oropharynx cancer was extremely invasive and had significant negative impact on a patient's ability to speak and swallow: the procedure involved splitting the jawbone in order to gain access to the tumors and lymph nodes.
However, newer treatments are far less invasive and have shorter recovery times. They include laser therapy, which uses beams of light to shrink tumors, and robot assisted surgery, in which the surgeon remotely operates hand controls that hold surgical instruments. This procedure allows the surgeon to operate on areas that are usually harder to reach.
Though the newer treatments for oropharyngeal cancer are vast improvements over older procedures, the link between the HPV virus and oropharynx cancer suggests that the cancer might actually be preventable-- if the relationship between HPV and oropharyngeal cancer is causal, the HPV vaccine, Guardasil, would be an effective tool in curbing the rise of oropharynx cancer.
 For More Information, Contact:

Ron J. Karni, M.D.
UT-Houston/Memorial Hermann – Texas Medical Center
(713) 965-3097

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