Management of human papillomavirus-related head and neck cancer

Human papillomavirus (HPV)-related head and neck malignancies (HNMs) have become a serious health risk over the past 20 years. Despite decreases in non-HPV-related HNMs, the incidence of HPV-related HNMs has skyrocketed, and a new form of tumorigenesis is developing. HPV type 16 is the primary offender, and the majority of these tumors present in the oropharynx, with a smaller proportion in the larynx and oral cavity. While traditionally treated with surgery, the paradigm has shifted to more of a nonoperative chemoradiation therapy approach, with the hope of improving vital functions after therapy. Unfortunately, we continue to see significant dysphagia in these patients after treatment, and work is being done to improve outcomes. With the advent of transoral robotic surgery, we have again been able to reconsider treatment options for these patients, although it has been met with some skepticism and resistance. Here we discuss the scope of HPV-related HNMs, the treatment options and prognosis for the disease, and finally touch upon psychosocial issues related to HPV-related HNMs.