Provide names of other journalists involved.
Charlotte Huff
List date(s) this work was published or aired.
2012 Summer Issue, June 2012
Provide a brief synopsis of the story or stories, including any significant findings.
A lot has been written about human papillomavirus (HPV) status in the context of cervical cancer, but less about its impact for head and neck malignancies. A flurry of recent data, though, has highlighted two key trends. On the one hand, these malignancies are proliferating, as HPV infection becomes more common in the U.S. population. More positively, the survival rates appear better for this category of malignancies, and early findings indicate that treatment might not need to be as toxic. Consider the following: a) HPV-positive oropharyngeal malignancies increased 225 percent from 1988 to 2004. If trends continue, they are on track to surpass cervical cancer diagnoses, according to a 2011 Journal of Clinical Oncology study. b) Knowing your HPV-status matters, as a window into long-term survival. The three-year survival rate was 82.4 percent in patients with HPV-positive tumors, compared with 57.1 percent among patients who tested negative, according to a New England Journal of Medicine study. c) Research studies are looking at whether less aggressive approaches might be feasible for this HPV-positive group, potentially sparing the mouth and throat from the sometimes debilitating side effects of chemotherapy and radiation. Patients can suffer from difficulties in swallowing, tasting, saliva production and some of these effects can be permanent. Researchers are trying to determine: Is this toxic approach necessary for HPV-positive as well as HPV-negative patients? d) The cancer involved is one that doesn’t get as much media coverage as more common malignancies, and the diagnosis can result in sometimes disfiguring consequences, particularly when surgery is needed. By interviewing current and former patients, such as Kevin Pruyne and David Hastings, I was able to put a face on this seldom-discussed malignancy. e) The article was packaged with several graphics, showing the location of various head and neck cancers, the DNA mutations linked to tobacco use, as well as a chart detailing ongoing clinical trials. A sidebar describes the two available HPV vaccines.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
I spent some time not only sifting through the most recent and relevant studies, but interviewing doctors about the best clinical trials to feature. With limited space, I couldn’t include every one, and wanted to focus on those that are attempting to pinpoint to what degree treatment can be dialed back for HPV-positive patients. I also worked through support groups and contacts to identify a couple of patients to profile as part of the article.
Explain types of human sources used.
Since the HPV/oral cancer connection is relatively new, and particularly the effort to test for it, I preferred to include both a recently diagnosed patient and a long-term survivor. The long-time survivor, David Hastings, not only showed that some people can live many years cancer free, but also society’s perception of oropharyngeal patients when the malignancies were only linked to smoking and alcohol.
Results:
None, except for a few readers expressing gratitude. For example, one reader wrote, “Thank you for the article on squamous cell tongue cancer. Few people know it is the sixth most common cancer world wide. It is becoming more prevalent among young adults[…] Articles like the one in the most recent Cure help raise awareness and provide hope.”
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
None.
Advice to other journalists planning a similar story or project.
A lot of cancer stories about so-called breakthroughs overstate the underlying science, and can mislead the patients involved. In this piece, I provided an overview of the intriguing data about better survival for HPV-positive patients, and how that might change treatment approaches in the years ahead. But I didn’t want today’s patients to think they could ease up on aggressive treatment. For that reason, as I wrote and reworked the story, I kept Dr. Stephen Liu’s perspective high up that outside of a clinical trial, he “would really discourage anyone from receiving less treatment because their tumor is HPV-positive.”