Head & Neck Cancer
HPV Throat Cancer: A curable cancer that’s often misunderstood
When we talk about throat cancer today, we’re increasingly referring to a specific kind: HPV-related oropharyngeal cancer (aka HPV head and neck cancer), which primarily affects the tonsils and base of tongue. It’s one of the most common head and neck cancers I treat in my private practice—and the good news is, it’s also one of the most curable.
Let me walk you through what this cancer is, who it affects, how it presents, and what treatment and recovery actually look like.
Who gets HPV-related throat cancer?
There’s a very specific group of people who tend to present with this type of cancer. Typically, it’s white men aged between 45 and 60 who are non-smokers, generally well and don’t drink excessively.
How does it usually start?
Most patients notice a lump in the neck, which is almost always the first sign. They may go to their GP, and more often than not, they’re given two or three courses of antibiotics, as it’s assumed to be swollen gland due to an infection.
But when the lump doesn’t go away, patients start looking for answers. Many of them end up searching online for “lump in neck,” “tonsil cancer,” or “throat cancer”—rather than typing “HPV cancer” into Google. It’s only once a diagnosis is made that they begin to understand the connection.
The lump is typically a lymph node that’s arisen because of a cancerous tumour deep in the tonsil or base of the tongue. These tumours are small and often hard to spot without imaging and biopsy.
The diagnosis journey
The diagnostic process usually includes:
- Careful history taking
- Clinical examination
- Flexible endoscopy (a small camera through the nose to look at the throat in the outpatient setting)
- Scans (CT or MRI)
- Biopsy of the neck lump or suspicious area
- HPV testing on tumour tissue
What is HPV, and how did I catch it?
HPV (human papillomavirus) is extremely common—over 95% of adults have been exposed to it. It’s the same virus that causes cervical cancer in women and is transmitted through intimate contact, often during teenage or university years. Think of it like catching a verruca: highly contagious, incredibly common, and not anyone’s fault.
In almost all cases, the immune system clears the infection. But in a very small percentage, the virus remains dormant and causes changes in the cells over decades—sometimes leading to cancer 30 to 40 years later.
Understandably, this can lead to confusion and concern:
- “Did I catch it recently?”
- “Can I give it to my partner?”
- “Is it an STI?”
- “Have I done something wrong?”
These are incredibly common and sensitive questions. I spend time explaining that:
- It’s not a new infection—most people contracted HPV in their teens or 20s.
- It’s not contagious at the point of cancer diagnosis.
- It’s not a marker of recent behaviour or infidelity.
It’s a virus we all live with. For a tiny minority of us, unfortunately, it leads to cancer.
Why is HPV status important?
Because HPV-related cancers are dramatically more curable than other head and neck cancers. While smoking-related throat cancers have cure rates around 60%, HPV-positive cancers are curable in around 90–95% of cases.
So, while it’s shocking to be told you have cancer, I’m often able to tell my patients: “Yes, this is serious—but the outlook is excellent.”
Treatment for HPV throat cancer: What to expect
Most patients undergo chemoradiotherapy, a combination of chemotherapy and radiotherapy. Surgery is usually not required.
Chemotherapy
- Two doses of Cisplatin, given intravenously
- One dose at the start, and one in week five of a six-week radiotherapy course
- Overnight stay in hospital for each chemotherapy dose
- Intravenous anti-sickness medication and fluids to prevent side effects
- Oral anti-nausea medication for 3–4 days afterwards
- Alongside Radiotherapy daily for 6 weeks
Side effects may include:
- Tiredness and reduced appetite
- Mild nausea (vomiting is rare)
- Risk of infection (low, about 1 in 20)
- Temporary numbness in fingers or toes
- Occasional tinnitus or hearing changes
If side effects are troublesome after the first dose, we adjust the second chemo accordingly.
Radiotherapy
- Daily treatments, Monday to Friday, for six weeks
- Each session lasts around 20–30 minutes
- No need to stay in hospital
- Fatigue and sore throat build up toward the final two weeks
- Most patients start to recover 4–6 weeks after finishing
Can I work during treatment?
That depends on your job. Many patients do continue working, especially during the first half of treatment. Remote work or light duties are ideal.
I usually say:
- Avoid key meetings, presentations, or travel
- Be flexible with expectations
- You’ll probably feel well enough to work during the first 3–4 weeks
- Reserve the final two weeks for rest and recovery
Why consider private treatment?
Many patients begin their cancer journey in the NHS. The two-week wait system works well for urgent referrals—but once diagnosis is confirmed, the process can slow significantly.
In the NHS, delays creep in:
- Waiting for scans
- Waiting for MDT (multidisciplinary team) meetings
- Delays in radiotherapy start dates
Some hospitals now only meet the 62-day start-of-treatment target in 40% of cases.
In private practice, we can usually:
- Start treatment within four weeks of diagnosis
- Streamline everything: scans, chemo, radiotherapy
- Deliver care personally, not via large clinical teams
- Provide calm, hotel-standard facilities
- Maintain continuity with your consultant throughout
Private treatment is faster, more consistent, and far more patient-centric.
What happens after treatment for HPV throat cancer?
Follow-up is intensive—but that’s a good thing. We want to be sure you’re staying healthy, and that your treatment is working.
The follow-up plan includes:
- CT scan at 6 weeks
- PET scan at 3 months
- Monthly check-ups with flexible endoscopy in year one
- Then:
o Every 2 months in year two
o Every 3 months in years three and four
o Annually in year five
If you’ve had no recurrence by year five, you are considered to be complete in terms of your patient journey. That said, many private patients choose to continue with annual follow-ups for peace of mind or help with side effects.
What about HPV vaccination?
The HPV vaccine (Gardasil) is now part of the UK school immunisation programme for 12–13-year-olds. It’s incredibly effective at preventing the strains of HPV that cause cancer.
Most of my patients are vocal advocates for vaccinating their children—especially after experiencing treatment firsthand.
Vaccination won’t help current patients, but it will dramatically reduce HPV-related cancers in future generations. The cancers we’re treating today began with infections acquired 30–40 years ago. With widespread vaccination, we expect this type of cancer to become rare by 2040.
Don’t delay seeking help for a neck lump
If you’re a man aged 45–60 with a persistent lump in your neck—or you’ve just been diagnosed with tonsil or throat cancer—there’s a strong chance it’s HPV-related. And that’s good news, because it’s curable.
Private treatment offers speed, consistency, and peace of mind—especially if you’re insured. I’m here to guide you through this and offer world-class care at centres like The Royal Marsden, Harley Street Clinic, and Cromwell Hospital.
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