Cancer diagnosis linked to HPV

According to the Centers for Disease Control and Prevention, each year in the United States, more than 46,700 new cases of cancer are found in parts of the body where human papillomavirus is often found. HPV causes about 37,000 of these cancers.

Research has found that it can take 5 to 10 years for HPV-infected cells to develop into precancers and about 20 years to develop into cancer.

When U.S. military veteran Scott Anglin was diagnosed with Invasive Anorectal Squamous Cell Carcinoma in January 2022, at the age of 62, he had no idea his cancer was linked to HPV.

“Although my wife and I had been and she continues to be in the medical field, neither of us had knowledge about the association of cancer and HPV,” Anglin said.

HPV is a group of more than 200 related viruses, some of which are spread through sexual activity and skin-to-skin contact. Sexually transmitted HPV types fall into two groups: low-risk and high-risk. High-risk HPV types can cause several types of cancer. These include anal cancer, cervical cancer, oropharyngeal (throat) cancer, penile cancer, vaginal cancer, and vulvar cancer. More than 90% of anal cancer is caused by HPV.

According to the National Cancer Institute, nearly all sexually active people, regardless of their sex, gender identity, or sexual orientation, are infected with HPV within months to a few years of becoming sexually active. Around half of these infections are with a high-risk HPV type.

Anglin said before he was diagnosed, he had been experiencing constipation for about 2 years which was relieved using a short-term laxative. He also noticed some light rectal bleeding which he attributed to a history of hemorrhoids and some mild sacral area pain.

“I was admitted to Landstuhl Regional Medical Center after experiencing profuse rectal bleeding, followed by low blood pressure and fainting,” Anglin explained. “An MRI of the rectum revealed a large mass involving the anterior rectal wall and other areas near the rectum.”

At that time, his wife, Army Lt. Col. Marielos Vega, was the chief of Quality and Safety at LRMC. The couple was quickly flown back to San Antonio so Anglin could receive his care at Brooke Army Medical Center.

“I feel blessed to have been transported to BAMC for treatment,” Anglin said. “From the moment we arrived in San Antonio, doctors and nurses from multiple disciplines started to plan the complex but best treatment for my type of cancer.”

The BAMC Tumor Board composed of multiple disciplines came together to develop a treatment plan to reduce Anglin’s tumor with possible follow-up surgery. He underwent daily radiation and chemotherapy for approximately three months.

“We both were so scared but a community of other cancer survivors and staff at BAMC who remembered me from my prior time here rallied up and gave me strength and hope,” Vega said. “Soon after completing his cancer treatment, Scott got more diagnostic testing and these tests revealed that his cancer was under total remission.”

“HPV-associated cancers tend to grow very quickly, whether it’s anal cancer or cervical cancer or throat cancer,” explained Army Maj. (Dr.) Avinash Chaurasia, radiation oncology service chief. “They can also shrink very quickly in response to chemotherapy and radiation and can have relatively high rates of control and cure if caught early and treated appropriately.”

“For prevention or screening anal cancers which are linked to the HPV virus, the most important thing we tell patients is to get vaccinated for HPV and get their children vaccinated because that’s really the best way to prevent it from occurring,” Chaurasia said. “The earlier you get the HPV vaccine the more effective it’s going to be.”

HPV vaccines can prevent infection with disease-causing HPV types, preventing many HPV-related cancers.

The HPV vaccine series is recommended for girls and boys at the age of 11 or 12, and the series can be started at age 9. In the United States, those who start the vaccine series before age 15 should receive two vaccine doses, and those who receive their first dose at age 15 or older should receive three doses. For young people who weren’t vaccinated within the age recommendations, HPV vaccination is recommended up to age 26.

Although the vaccine has FDA approval to be given through age 45, it is not routinely recommended for most people ages 27 to 45. People in this age group are unlikely to benefit from the vaccine because they have likely been exposed to HPV already.

“If you are concerned that you are at risk for a new HPV infection, talk with your health care provider about whether HPV vaccination may be right for you,” Chaurasia said.

Anglin and Vega are grateful for the care he continues to receive at BAMC.

“The professionalism and empathy demonstrated by all medical and non-medical providers that we have come across and continue to come across had enabled me to live as a cancer survivor for an additional two more years,” Anglin said. “Thanks to their diligent care and concern for surveillance, I was diagnosed with liver cancer in November 2023. Once again, the BAMC team of medical professionals rallied around me and my family to start a different type of cancer treatment that has enabled me to once again go into remission and continue to live a fulfilled life alongside my wife, family, and friends.”

“Today my husband continues to be both in remission from his rectal and liver cancers and I get to continue using all the knowledge that I started to acquire here at BAMC as chief of Clinical Quality Management knowing that I not only have a job that I love, but most importantly I feel that I have a family here at BAMC,” Vega said. “As I walk through the hallways, I continue to feel so blessed to have such a privilege and duty to work in the place that gave me hope and strength when I and my husband had none.”