Human Papillomavirus (HPV)
The Sydney Head and Neck Cancer Institute’s research program is in its infancy. To date work has focussed on the role of certain human papillomavirus (HPV) in oropharyngeal carcinogenesis. The Institute has participated in a large international study coordinated by the International Agency for Research into Cancer (IARC) in Lyon, France. This study has found strong evidence for a causative role for HPV in a proportion of head and neck cancers, especially tonsil cancer. Findings will soon be published in the prestigious Journal of the National Cancer Institute. Work performed locally has shown that approximately half of Australian tonsil cancers are positive for HPV DNA but that HPV does not appear to play a major role in tonsil cancer in China; this lack of HPV may help explain the lower incidence of tonsil cancer in China compared with western countries such as Australia.
Further investigations of tonsil cancers have shown that HPV affects the expression of certain proteins that control the cell cycle. Importantly, we have found that HPV positive cancers represent a distinct biological group with less aggressive characteristics than HPV negative cancers. The involvement of HPV in a subset of head and neck cancers has important implications clinically. In the first instance, screening of tonsil cancers for HPV DNA may help optimise treatment and provide more accurate prognostic information. Secondly, preventative HPV vaccines (expected to be available in the next five years) may eventually help reduce the incidence of head and neck cancers.
HPV is acknowledged as the major risk factor for cervical cancer. Investigations are underway to establish whether the pathways by which HPV causes cervical cancer are the same as those leading to head and neck cancer.
Quality of Life Study
The Institute has been conducting a prospective study on the Quality of Life and Nutritional research project over the past 2 years. This project involves evaluating patients’ quality of life and nutritional status before and after treatment for head and neck cancer. All information is gathered and recorded on a database for statistical analysis. Besides providing measures of outcome this program provides an extra layer of clinical care, identifying problems which may be important to the patient and allowing for interventions to be implemented earlier than otherwise might occur (eg. Nutritional, psychosocial and pain management). It also provides an opportunity for our patients to discuss and document their experiences, which is sometimes not available with medical follow-up. Preliminary results were presented at the Australian & New Zealand Head & Neck Society Annual Scientific Meeting in November 2003. This study has provided new insights into how people cope with their cancer therapy.
Staging of Cancer Involving the Parotid Gland
An important international multi-centre study was initiated by the Institute. The study involves patient outcomes following treatment for aggressive head and neck skin cancer that has spread to the lymph glands in the parotid gland and neck. Over 400 patients have been entered into this study from the 12 participating institutions. Results were presented a the 6th World Head and Neck Cancer Congress in Washington, USA in August 2004.
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