HALIFAX — Facing a growing epidemic of throat and mouth cancer caused by HPV, Halifax doctors are refining a surgical technique that uses lasers to remove tumours - avoiding the standard practice of cracking open a patient's jaw.
"We are trying to remove it through the mouth using scopes, said Dr. Matt Rigby, a head and neck surgeon at the QE II Health Sciences Centre. "So that actually exposes the tumour at the back of the tongue which you can't see easily by direct line of sight."
Rigby said the advantage for the patient is that the surgery avoids the traditional method of splitting the jaw bone to operate in difficult-to-reach areas, while cutting recovery time down to three to five days, as opposed to 10 days to two weeks for conventional surgery.
"We not only want a cure, but the best standard of life after a cure," he said.
The Halifax hospital is the only one in Canada that uses trans-oral laser microsurgery, and is one of only a handful in North America. It was first brought to Halifax by Dr. Mark Taylor in 2002.
Rigby said surgical advances and more research will be key in dealing with a more than 200-per-cent increase in mouth and throat cancers caused by HPV over the last 20 years.
Dr. Rob Hart, also a head and neck surgeon in Halifax, has been researching specific cellular mechanisms that may be causing the throat and mouth cancers. His research team is looking for pathways to interrupt the development of the cancers.
"Why do some people who get an HPV infection develop a cancer and others don't? We don't know the answer to that."
Hart said what's known is that there has been a massive shift from traditional causes such as heavy smoking and drinking to HPV-related cancers. The ratio is now 80 per cent related to HPV and 20 per cent to other causes.
He said there are about 5,000 to 6,000 new oral cancer cases in Canada each year, with 150 to 200 of them in Nova Scotia.
Currently about seven per cent of sexually active adults have an oral HPV infection, while between 65 and 100 per cent of sexually active adults will have an oral exposure to the virus.
Most however, will clear the virus from their systems and will show few to no symptoms as long as they have it.
Hart said any link to oral sex in particular is a "supposition" at this point.
"We know that people who have more sexual partners have higher risk of HPV infection but, pretty much anybody who is sexually active will have had some exposure at some point in their life. Oral to oral contact is probably as important as oral to genital contact."
Both Hart and Rigby say it's hoped vaccine programs in young girls and boys will help curb the rapid rise in HPV-related cancers, projected to be half of all throat and mouth cancers by 2030.
Hart said the statistics haven't hit the "peak of the curve" yet.
"It will flatline and then as the vaccinated cohort moves forward we hope to see it tail off substantially," said Hart. "But I think we are probably 30 years before we know whether it makes a difference."
