Rowegie Abanto

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<p>For many years, head and neck cancer in the Philippines has been strongly linked to smoking, alcohol consumption, and betel nut chewing. These lifestyle factors have been the main causes of cancers in the mouth, throat, and voice box, mostly affecting older adults. </p><p>However, doctors are now seeing a new trend—younger patients and non-smokers are being diagnosed with head and neck cancer. This raises an important question: Are we seeing more cases caused by viruses instead of smoking and alcohol?</p><div><strong>A New Cause? The Role of Viruses in Cancer</strong></div><p>Numerous research has shown that some head and neck cancers are linked to viruses, particularly:</p><ul><li><p><strong>Epstein-Barr Virus (EBV)</strong> – Associated with nasopharyngeal cancer, a type of cancer behind the nose that is common in Asia, including the Philippines.</p></li><li><p><strong>Human Papillomavirus (HPV)</strong> – Linked to oropharyngeal cancer, which affects the back of the throat or “lalamunan”, tonsils, and base of the tongue.</p></li><li><div><a href="https://www.abs-cbn.com/news/health-science/2025/3/27/colon-cancer-sa-pilipinas-sobrang-taas-na-paano-ito-agapan-at-gamutin-1446">Colon cancer sa Pilipinas &#x27;sobrang taas na&#x27;: Paano ito agapan at gamutin?</a></div></li></ul><p>HPV-related cancers are different from smoking-related cancers. Research shows that patients with HPV-related oropharyngeal cancer have a better response to treatment and higher survival rates (Cohen et al., 2019). Because of this, doctors believe that these cancers may require different treatment approaches in the future.</p><div><strong>Why This Matters for Filipinos</strong></div><p>While HPV-related head and neck cancers are increasing in other countries, the situation in the Philippines remains unclear. A previous study by Albano et al. (2017) found a low prevalence of HPV in head and neck squamous cell carcinoma (HNSCC) in Northwestern Philippines, which contrasts with global data showing an increasing link between HPV and oropharyngeal cancer. </p><p>However, one major limitation of this study was the inclusion of various head and neck cancer sub-sites, rather than focusing solely on oropharyngeal cancer, where HPV is most consistently found (Chaturvedi et al., 2010).</p><div><a href="https://www.abs-cbn.com/news/health-science/2025/2/12/alamin-bakit-nagkakaroon-ng-cancer-ang-isang-tao-1842">ALAMIN: Bakit nagkakaroon ng cancer ang isang tao</a></div><p>This again highlights the need for well-designed, site-specific research to accurately determine the true burden of HPV-driven head and neck cancer in the Philippines. This lack of clear data is concerning because virus-driven diseases affect our genetic makeup differently across races, genes, and individuals. Because of this, the real impact of HPV-related head and neck cancer in the Philippines remains unknown, and this absence of precise data could already be a cause for concern.</p><p>Understanding the causes of cancer is essential for improving treatment, prevention, and early detection strategies. Without accurate epidemiological data, Filipino patients may not receive the most appropriate diagnostic and treatment approaches tailored to the biological behavior of their cancer, potentially impacting their prognosis and response to therapy.</p><div><strong>Could an HPV vaccine help prevent head and neck cancer?</strong></div><p>HPV vaccines have already been proven to prevent cervical cancer in women. Now, researchers are studying whether these vaccines can also help prevent HPV-related oropharyngeal cancer. If successful, HPV vaccination could become an important tool in reducing head and neck cancer cases in the future.</p><div><strong>What can be done?</strong></div><ul><li><p><strong></strong>More research funding should be allocated to study head and neck cancer in the Filipino population. Understanding the prevalence of HPV-related cases and other risk factors will help in improving treatment and prevention efforts.</p></li><li><p><strong></strong>Raising awareness is essential to educate Filipinos about the changing risk factors of head and neck cancer. Public information campaigns should focus on both traditional causes like smoking and alcohol, and newer risks like viral infections.</p></li><li><p>Early detection remains key. People with a family history of head and neck cancer or known risk factors (such as smoking, alcohol use, previous radiation exposure, or hazardous work environments) should seek regular screening.</p><p>Symptoms to watch out for include but are not limited to: difficulty swallowing, tinnitus (ringing in the ears) or ear fullness, voice changes or persistent hoarseness, lumps in the oral cavity, head, or neck, non-healing ulcers in the mouth or throat, and nosebleeds or chronic nasal congestion.</p><p>“That’s why if you experience any of these symptoms, see a doctor for a complete head and neck examination, including endoscopy to check for abnormalities.”</p></li><li><p>Public health programs should study the potential role of HPV vaccination in reducing oropharyngeal cancer cases, especially among younger individuals.</p></li></ul><div><strong>A step towards Universal Health Care</strong></div><p>The Philippine government’s Universal Health Care (UHC) agenda aims to provide accessible and affordable medical care for all Filipinos. Integrating head and neck cancer screening, early detection, and HPV vaccination into UHC programs could help save lives and reduce the burden of cancer in the country. Stronger partnerships between medical organizations, government agencies, and researchers are needed to develop better cancer prevention and treatment strategies for Filipinos.</p><div><strong>Looking ahead</strong></div><p>Head and neck cancer in the Philippines is evolving, with a growing number of younger patients who have no traditional risk factors, suggesting a shift toward other cancer etiologies. While smoking-related cancers remain a major concern, this changing landscape calls for a multidisciplinary approach to ensure accurate diagnosis, effective treatment, and stronger prevention strategies.</p><p>As we navigate this challenge, the Philippine Academy of Head and Neck Surgery, Inc. (PAHNSI) and the Academy of Head and Neck Oncology of the Philippines (AHNOP), together with our core specialty societies, the Philippine College of Surgeons (PCS) and the Philippine Society of Otolaryngology - Head and Neck Surgery (PSO-HNS), stand with the DOH in pushing for research, early detection programs, and public awareness initiatives to improve head and neck cancer care.</p><p>Through national and multidisciplinary collaborations, we can strengthen prevention, enhance early diagnosis, and achieve better treatment outcomes. Let’s take action, spread awareness, and outsmart cancer together.</p><p>References:</p><ol><li><p>Albano, P. M., et al. (2017). Low prevalence of human papillomavirus in head and neck squamous cell carcinoma in the northwest region of the Philippines. PLOS ONE, 12(2), e0170438. https://doi.org/10.1371/journal.pone.0170438</p></li><li><p>Cohen, E. E. W., et al. (2019). The immune microenvironment of head and neck cancer. Immunity, 51(5), 801-811. https://doi.org/10.1016/j.immuni.2019.11.014</p></li><li><p>Tang, K. D., et al. (2021). The role of HPV in head and neck cancer. Advances in Cancer Research, 151, 69-98. https://doi.org/10.1016/bs.acr.2021.05.002</p></li><li><p>Yang, J., et al. (2023). Viral etiology of head and neck cancers. Frontiers in Oncology, 13, 10650136. https://pmc.ncbi.nlm.nih.gov/articles/PMC10650136/</p></li><li><p>Chaturvedi, A. K., et al. (2010). HPV and rising oropharyngeal cancer. The Lancet Oncology, 11(8), 781-789. https://doi.org/10.1016/S1470-2045(10)70017-6</p></li><li><p>National Cancer Institute. (n.d.). Head and neck cancer fact sheet. Retrieved from https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet</p></li><li><p>Mehanna, H., et al. (2020). Oropharyngeal cancer—New insights. Annals of Oncology, 31(9), 1092-1102. https://www.annalsofoncology.org/article/S0923-7534(20)42767-X/pdf</p></li></ol><div><em>Dr. Adrian Fernando is an Otolaryngologist, sub-specialized in Head and Neck Reconstructive Microsurgery. He is the current President of the Philippine Academy of Head and Neck Surgery, Inc. (PAHNSI) and the Head of the Head and Neck Oncology Unit at the Benavides Cancer Institute, UST Hospital, and an active consultant at Cardinal Santos Medical Center. He serves as an Assistant Professor at the University of the East Ramon Magsaysay Memorial Medical Center (UERM) and is a former Board of Trustee of the Philippine Society of Otolaryngology - Head and Neck Surgery (PSO-HNS).</em></div>

<p>For many years, head and neck cancer in the Philippines has been strongly linked to smoking, alcohol consumption, and betel nut chewing. However, doctors are now seeing a new trend: younger patients and non-smokers are being diagnosed with head and neck cancer.</p>

For many years, head and neck cancer in the Philippines has been strongly linked to smoking, alcohol consumption, and betel nut chewing. However, doctors are now seeing a new trend: younger patients and non-smokers are being diagnosed with head and neck cancer.

A new face of head and neck cancer in the Philippines: What we need to know

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A new face of head and neck cancer in the Philippines: What we need to know

ABS-CBN News,

Adrian F. Fernando,

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FPAHNSI

Published April 13, 2025 10:20 AM PHT

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