My parents were life-long smokers and died in their mid-70s of lung cancer and emphysema -- Although less was known back then, I still find myself sometimes angry at both of them for 'cheating' me, and extended family, out of the extra years they could have lived had they stopped smoking before smoking stopped them....

Two years ago when I was told I had SCC, HPV was harder to find than a Snipe at a Boy Scout overnight. Tobacco was assumed to be the culprit. I was lucky to have found my connection to HPV. Last year when I testified before the Fl House NO ONE in Tallahassee had heard about HPV and the Head and Neck Cancer connection and not many H & N doctors readily acknowledged it either. Now jumping 2 years forward to today and HPV is pretty well known at the CCC's but not as well known the farther you get away from them. HPV is now credited with being the cause of appx 70% of new OC in the Oropharnyx region but I believe tobacco is still, percentage wise, the leading cause of all Head and Neck Cancers. Brian, correct me if I have misposted.

It is annoying to be asked about smoking as though you deserved the cancer. I wasn't content with just a no but went on to explain that my mom smoked a pack a day from the time she was 14 until she quit at 70. Not a trace of lung cancer or oral cancer even though she also drank "high balls" daily. Oh and her diet was terrible and when she quit eating out of grief when my dad died of a heart attach - it was the beginning of the end. Her father drank and smoked really heavily right up until he died of liver problems - again zero cancer.
I agree that it seems to be a way for people to reassure themselves that they won't get cancer because somehow I had to be at fault. Although recent studies on HPV and its interaction with gum disease may very well prove (apologies to Jimmy Buffet) "Some people say that there's a (insert cancer cause here)to blame, now I think, hell it could be my fault"

Perhaps we should broaden our horizons a bit beyond just Smoking and HPV.

During my search to know, I found this on www.canceranswers.com and have often notice similar info elsewhere.

Like any cancer, the exact reason why one person gets oropharynx cancer and another does not
remains unknown. However, several"risk factors" have been shown to be be much more likely to be
present in mouth cancer patients:

1. Tobacco Usage--
This is the single strongest risk factor for developing cancers of the head and
neck, and especially mouth, esophagus, and oropharynx. Any form of tobacco taken through the
mouth, whether smoked or chewed, increases the risk over time. It often takes several decades
of use to get cancer but children who use chewing tobacco (often to emulate famous baseball
players) have gotten mouth cancer. The more tobacco that is used, for a longer period of time,
the higher the chance to get mouth cancer. Likewise, when use is stopped, the risk declines
almost to normal over a 5 to 10 year period.

2. Alcohol Usage--
Is the next strongest risk factor after tobacco. Occasional wine or beer may
raise risk very slightly, if at all, but frequent use of strong drinks like whiskey will increase cancer
risk to the mouth, throat, esophagus (food pipe), stomach and pancreas.
Furthermore,combining alcohol with tobacco will have a "super additive" effect to greatly
increase cancer risk for all of these areas. This means that the risk is much more than twice as
high as for using either tobacco or alcohol alone. Like tobacco, people who stop frequent drinking
will gradually lower their cancer risk to nearly that of non-drinkers.

3. Poor Oral Hygiene--
The more unclean the mouth and throat are, the more it is subject to
constant irritation from grime. Each teaspoon of saliva contains about one billion bacteria, which
are making waste products which cling to teeth and tonsils ("plaque"). This allows gum disease
(pyorrhea) to lead to subsequent tooth loss. Although plaque itself is not show to cause cancer, it
helps other chemicals (like in smoke) to stick in the mouth and throat, irritate it, and stimulate the
cells to divide. The more cells divide, the more chance one of them will become cancerous. That
is why the common thread of many risk factors is irritation, leading to lots of cell division.

4. Ill-Fitting Dentures
irritate the gum lining ("gingiva") and trap debris. This can lead to tongue
cancers over time.

5. Betel-Nut Chewing
in Indian populations is strongly associated with tooth loss, mouth and throat
cancer, again the common factor is prolonged irritation.

6. Infections
such as syphilis and some viruses can lead to cancer over time, these cause throat
sores which heal poorly. The constant attempt to heal leads to chronic cell division and thus
more chance for cancer. Viruses can also get into the mouth cells themselves and change the
genes in them to form a cancer cell. This elaborate process is called "oncogene activation".

7. Lowered Immunity
such as from AIDS or transplant anti-rejection drugs will increase the risk for
many cancers, including those of the "aero-digestive tract" (i.e. the area from the nose and
mouth to the lungs and stomach). This will be especially important in combination with the other
risk factors noted above.

8. Precancerous "Plaques"
can develop in the mouth and throat, from chronic irritation. These
may be white in color ("leukoplakia") or red ("erythroplasia") and may or may not become
cancerous. They must be monitored closely.

9. History
of Cancer of the aero-digestive tract can mean as much as 5% chance of a separate
simultaneous cancer, and a 25% chance of developing another cancer in this area over time
(especially if risks like smoking are continued).

A cancer must grow to 1 billion cells to be just 1 cm. (about 1/2) across, so a very early cancer will
have no symptoms and likely go undetected.

And lets not forget endogenous causes!

A) the genotype.
DNA damage will happen regardless of any precautions, this is a fact of life.
Some people have a very efficient DNA repair system, others do not.

B) even if people have efficient repair systems (there are many) that does not guarantee that a damaged DNA in a critical location gets caught in time before it is harmful. It is a chance event and in many ways like russian roulette. All you can do is lower the chances for damage and increase the efficiency of repair systems but the risk will not be zero.

To get an idea for just one type of mutagenic damage. 8-oxoG is a damaged G base that we do not have normally in our DNA. If memory serves my right it was shown that we make and exise gram amounts of this stuff each day. Assume it is just one gram and that each 8-oxoG comes from a damaged DNA segment that means that there were about 10^21 damage events per day. That is 10'000'000 events for each (average) cell/day. These very rough estimate are nevertheless staggering.... and this is just one type of damage!


M

Sorry Don but the fact that your source left HPV out of the equation renders it outdated at best as one can not ignore HPV as a cancer causing agent in as many as 11 different cancers, including H & N and I might be outdated with that number.

David,
HPV is a virus
See item 6
The source lists viruses

Went right past it. I guess I was looking for the letters HPV. My bad.

Don - some of this is not right, and you have to consider what is a KNOWN and proven direct cause, and what is suspected, and what is just urban myth or an old wives tale. You would be surprised at the incorrect information that is on pretty good and reputable web sites. As soon as a site starts making unsubstantiated claims (" Dr. Jonathan Stillwell ( this is the world authority?) and (their site) remains the world's premiere provider of cancer information.") I have a problem with it. Who say cancer answers is the world's premiere provider of information? Typical jargon for someone that has something to sell.

Also this paragraph cut from their site has numbers that are at least 10 years old : Each year in the United States there are about 20,000 new cases of mouth cancer leading to 4,000 deaths annually from this disease. Men are affected twice as often as women. Overall, mouth cancer represents about 3% of all new cancers each year, and it is more common in blacks than whites, and in those of "lower socioeconomic status" (poor people). The average patient is 60 years old.

There is no definitive proof that irritation or trauma causes oral cancer, though it is often cited (poorly fitted dentures which I wrote a really long post on how this is misinterpreted a couple years ago), ditto poor hygiene. Truth be told, the data that exists on that has so much bias in it you wonder how it got published. People with poor hygiene have numerous other issues related to their lifestyle which were not eliminated from the equation. Pre-cancers like leukoplakia are not a CAUSE of oral cancer, they re an intermediate cellular change that is visible in the mouth. Only about 25% of cells in white lesions like these ever progress to dysplasia and cancer. For that matter only 25% of all dysplasias ever progress treated or not. Infections in oral cancers are not tied to each other except in viral infections that being HPV. We don't speak to quid, betel nut, etc. since in the US their use is unknown - though they are known causes of oral cancer in third world countries. So you really have to distinguish what is a cause and what is a facilitator, and what is conjecture without strong documentation.

Lastly related to your link. That is a site that is in the business of selling information and more. I would stick to sites that are non commercial like the NCI, CDC, NIH etc. if I wanted to be sure that the information was current and correct.

David - oncogenic HPV is a known and proven cause of what cancers besides oral and cervical?

Brian,

According to what I have read and been told, HPV can cause cancer of the cervix, esophagus, mouth, throat, larynx, tongue, tonsils, rectum, penis and skin.