Well, according to Dr. Gillison at Johns Hopkins (who is doing current research on human papilloma virus-16 and oral cancer and is on the OCF Board) -- Hopkins tests all the HNC patients for HPV and Dr. G. told us that 70% of their tumors test positive for HPV-16. Tha blew us away. An ENT surgeon at same institution said that his current patients are "over 50%" never-smokers and the percentage has been increasing in the last decade. It appears that smoking is not the primary cause of many new cases, perhaps not even a majority of them. The rate of never-smokers with oral cancer is far above the 8% that someone's doctor told them. I can't believe that Baltimore is a "hotbed" of HPV and the rest of the country is not!

Dr. Gillison has a paper in press on this changing demographic of oral cancer, she presented some of these data at a conference in May -- Brian has summarized these above. Our ENT (in private practice) says most of her new HNC patients are young (some in 20s) and non-smokers, and are presenting in the tonsil and base of tongue.

Hopkins will test tumor samples (even the path slides) from other institutions for HPV-16 -- however at this point it should be emphasized that it will not change one's treatment protocol (although response to treatment appears better and risk for recurrence less).

There is a new therapeutic vaccine for HPV-16 in clinical trial at Hopkins -- the trial for cervical cancer has been ongoing for over a year and the one for head and neck cancer has been ongoing for some months. My husband Barry is one of the participants. The vaccine is designed to stimulate the immune system to recognize and "clear" the virus, something which most people infected with the (ubiquitous) virus do, but for some reason some individuals do not. They may have perfectly adequate immune response to, say, influenza but not HPV. It is hoped that this increased immune response will, in turn, attack the HPV-containing cancer cells. Animal trials have been very encouraging but right now the human trial is only at the "what dose of vaccine will stimulate an immune response?" stage. It is far from being ready for clinical application. I have been posting occasional updates on the trial in the General Forum.

The current FDA-approved vaccine is a prophylactic vaccine designed to prevent infection. It would be a very good idea for boys and girls to be inoculated, perhaps more appreciation of the growing role of HPV in oral cancer will lead to this.

Gail