ONS Connect - September 2008 - (Page 25)

NEwTrEaTmENTS,NEwhOpE Oropharyngeal Cancer in Men Associated With HPV [By Deborah McBride, RN, MSN, CPON ®, Contributing Editor] The researchers suggest, given the high risk of HPV-associated cancers in men, that vaccinating all adolescents should be considered. H uman papillomavirus (HPV) is a virus known to lead to cervical cancer in women. Because of this, the U.S. government recommends that all girls be vaccinated for HPV at age 11 or 12, before they become sexually active. Now a new study has found that many oral cancers in men also are associated with the virus. The study found that more than 40% of advanced tongue and tonsil cancers in men are infected with HPV. In addition, the study found that people with tumors with high HPV levels were significantly more likely to respond to treatment. Researchers conducted a hospitalbased clinical study in patients with newly diagnosed oropharyngeal cancer (OPC) to look at the association between HPV and OPC. The study included 51 men and 15 women with stage II and IV squamous cell carcinoma of the oropharynx who were treated with one cycle of cisplatin or carboplatin and with fluorouracil to select candidates for concurrent chemoradiotherapy or surgery/ radiotherapy (Worden et al., 2008). The researchers examined pretreatment biopsies of 42 of the subjects. After testing for HPV, the researchers found that 27 tumors, close to two-thirds, were positive for the virus. Twenty-two of the 51 men had HPV. All of the patients in the study were treated with induction chemotherapy to shrink the tumors. Those whose tumors did not shrink by at least 50% were then treated with surgery. Of the remaining group, 49 of the 54 responded to combined chemotherapy and radiation. Seventy percent of those treated survived more than four years. Twenty-four of the 49 patients were positive for HPV, and all but three of them were men. Of the estimated 28,900 cases of oral cancers a year, 18,550 are in men. The researchers suggest, given the high risk of HPV-associated cancers in men, that vaccinating all adolescents should be considered. The study provides evidence that the vaccine that was approved for women and cervical cancer could have broader implications for other cancers. In the future, more clinical trials will be designed for either HPVpositive or HPV-negative patients. More research needs to be done to identify the best treatment regimen. Although the number of patients in the study was small, the researchers concluded that in patients with HPV-positive tumors, chemotherapy followed by combined chemotherapy and radiation appears to be an effective treatment. ✱ Worden, F.P., Kumar, B., Lee, J.S., Wolf, G.T., Cordell, K.G., Taylor, J.M.G., et al. (2008). Chemoselection as a strategy for organ preservation in advanced oropharynx cancer: Response and survival positively associated with HPV16 copy number. Journal of Clinical Oncology, 26(19), 3138–3146. Contributing Editor Deborah McBride, RN, MSN, CPON ®, is a nurse at the Kaiser Permanente Oakland Medical Center and a faculty member at Samuel Merritt College in Oakland, CA. September 2008 ONS CONNECT 25

Table of Contents Feed for the Digital Edition of ONS Connect - September 2008

ONS Connect - September 2008 Contents Editor's Note Just In Advances in Prostate Cancer Treatment A Year in the Life - Month Nine Web Connect Capitol Connection Manage Infusion Reactions From Cetuximab Notice Nursing Now Caregiver Care Oropharyngeal Cancer in Men Associated with HPV Working for You Calendar of Events Staying on Top

ONS Connect - September 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.