Last night (July 1st), Jamie Dimon, the chief executive of banking giant JPMorgan, told employees that he is being treated for throat cancer. In a memo, he said that he would begin eight weeks of chemotherapy and radiation treatment at Memorial Sloan Kettering Cancer Center.
He wrote:
The good news is that the prognosis from my doctors is excellent, the cancer was caught quickly, and my condition is curable. Following thorough tests that included a CAT scan, PET scan and a biopsy, the cancer is confined to the original site and the adjacent lymph nodes on the right side of my neck. Importantly, there is no evidence of cancer elsewhere in my body.
It’s impossible to speculate on Dimon’s cancer beyond what he put in his memo. I contacted JPMorgan and the company could not confirm any other details about his conditions. But it’s very possible that Dimon has been swept up, along with thousands of other men, by an increasingly common disease: throat cancer caused by infection with the human papilloma virus, or HPV.
“It wouldn’t be unusual,” says Eric Genden, chief of head and neck oncology at the Mount Sinai Hospital in New York. “This is an epidemic.”
In 2008, the last year for which data are available, the Centers for Disease Control & Prevention estimate that 2,370 women and 9,356 men developed HPV-caused head and neck cancer, about a third of the cases of head and neck cancer that year.
HPV surpassed other causes of throat cancer in 2004. Source: Journal of Clinical Oncology
But Genden says that 70% to 90% of head and neck cancer cases worldwide are now caused by HPV; the American Cancer Society estimates that this year, there will be 42,440 cases of head and neck cancer in the U.S.
Traditionally, head and neck cancer patients were older men who smoke and drank heavily. The alcohol and tobacco damaged the cells in the throat, eventually leading to cancer.
HPV-caused cancer is different. The men (and it’s still mostly men) who get it are younger. In a series of cases at Mount Sinai, they were between 35 and 65.
Five years ago, I profiled Maura Gillison, the Ohio State University researcher who helped establish that this was a big problem. She told me how when enrolling a study several years ago, she’d recruited, in sequence, a malpractice lawyer, doctor, a scientist and a rear admiral. The first patient I spoke to about his HPV throat cancer was a consultant and economist who later died from his disease. Two years ago, I wrote about a 50-year-old biotech CEO who also had HPV throat cancer. Last year, the actor Michael Douglas said that his throat cancer was caused by HPV.
The point is that these are men much like Dimon: CEOs and consultants, men at the peak of their lives and professional power. And their numbers are increasing.
The chart above shows the total number of throat cancer cases, and also the amount caused by HPV and the amount that weren’t, among patients in Hawaii, Iowa, and Los Angeles. As you can see, in 2004 the HPV cancers began to outnumber the type caused by smoking and drinking.
How do you get HPV cancer? HPV is sexually transmitted. It’s mainly known as a cause of cervical cancer, which is what happens when it infects women. But men can get it by performing cunnilingus. It’s also possible, though less likely, that it can be transmitted by kissing. Eighty percent of sexually active people between the ages of 14 and 44 have had oral sex with an opposite sex partner. Researchers estimate that HPV throat cancer in men will be more common than cervical cancer in women in the U.S.
Most strains of HPV do not cause cancer, either in the throat or the cervix. And most HPV infections are cleared by the body. But in a minority of cases, perhaps 10%, they persist. If the strain is of the right variety – for instance, the HPV 16 strain of the virus – this infection can eventually lead to cancer. When it comes to throat cancer, this process takes decades.
The good news is that throat cancer caused by HPV is far less deadly than the old type that resulted from chronic tobacco use and drinking. Some researchers have cited data that it is 80% curable. In a series of 500 patients who were early in their disease conducting at Sinai, more than 90% were still cancer free five years after surgery. And in that study Sinai was deliberately using less invasive surgery and skipping chemotherapy and radiation in the interest of sparing men side effects.
One hope is that the vaccines developed to prevent HPV infection in women – Gardasil, from Merck , and Cervarix, from GlaxoSmithKline – could prevent HPV infection in the throat and, therefore, cancer later on. But there’s no way to prove this. Drug companies funded studies showing the vaccines prevented the formation of precancerous lesions in the cervix, but there’s no way to do something similar in the throat.
“I think the downside of having the HPV vaccine in young boys is so low and the potential upside is so high that I advocate it,” says Genden. “Do we have evidence that it prevents oropharangeal cancer in boys? No.”
As I said before, there’s no way to know right now whether Dimon’s illness is caused by HPV – although given what that would mean for his prognosis, I hope it is. But what we do know is that this virus is likely to give cancer to a lot of men who look a lot like him in the years to come.
Written by Matthew Herper and published by Forbes, July 2, 2014.
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