Counseling the patient with potentially HPV-related newly diagnosed head and neck cancer.
The recent emergence of a clinically distinct subset of head and neck cancers (HNC) caused by infection with the human papillomavirus (HPV) necessitates critical reevaluation of the existing counseling paradigm for patients with newly diagnosed HNC. Herein we propose a structural framework for patient counseling in which HPV testing is incorporated and the impact of HPV-status is discussed in the context of multiple medical and psychosocial domains. We strive to maintain a balance between making recommendations based on the best available scientific evidence and acknowledgment of uncertainty for both patients and providers. We anticipate that both the standard-of-care diagnostic workup and treatment, and counseling guidelines for these patients will change rapidly in the years ahead, as data from ongoing and planned prospective clinical trials become available.
Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, USA, john.finnigan@mssm.edu.
John P
JP
Finnigan
Andrew G
AG
Sikora
D002294:Carcinoma, Squamous Cell / Q000821:virology*; D003376:Counseling / Q000379:methods*; D019317:Evidence-Based Medicine; D006258:Head and Neck Neoplasms / Q000821:virology*; D006801:Humans; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D000077195:Squamous Cell Carcinoma of Head and Neck