{"id":69819,"date":"2023-05-18T09:12:02","date_gmt":"2023-05-18T15:12:02","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=69819"},"modified":"2024-07-18T14:30:28","modified_gmt":"2024-07-18T20:30:28","slug":"house-mom-spotlights-hpv-amid-throat-cancer-fight","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/house-mom-spotlights-hpv-amid-throat-cancer-fight\/","title":{"rendered":"Ending up in \u2018cancer land.\u2019 HPV-related cancers are now 90% preventable with vaccine"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><figure id=\"attachment_69824\" aria-describedby=\"caption-attachment-69824\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-69824\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/05\/01133710\/Marilyn-HPV-sororitygirls1-Courtesy-CSU-Athletics-web.webp\" alt=\"Members of Colorado State University\u2019s Kappa Kappa Gamma sorority house, where Marilyn Votaw is house director, have been Votaw\u2019s biggest supporters during her fight against a HPV throat cancer. Photo courtesy of CSU Athletics.\" width=\"640\" height=\"426\" \/><figcaption id=\"caption-attachment-69824\" class=\"wp-caption-text\">Members of Colorado State University\u2019s Kappa Kappa Gamma sorority support their house director, Marilyn Votaw, in her fight against a HPV-related throat cancer. Photo courtesy of CSU Athletics.<\/figcaption><\/figure>\n<p>Marilyn Votaw, 59, has spent the past decade supporting the nourishment and growth of young women. So when she found out she had cancer \u2014 one that is now preventable thanks to a vaccine \u2014 she put aside embarrassment to discuss prevention, the importance of knowing your body and getting the HPV vaccine.<\/p>\n<h2><strong>A lump in her neck that wouldn\u2019t go away<\/strong><\/h2>\n<p>Votaw was one of three children born into a very \u201cacademic\u201d family. Her father was a University of Connecticut School of Medicine microbiologist, and her mother is now a retired psychotherapist.<\/p>\n<figure id=\"attachment_69882\" aria-describedby=\"caption-attachment-69882\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-69882 size-full\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/05\/04091254\/Marilyn-HPV-portrait-web.webp\" alt=\"Marilyn Votaw, who is battling HPV throat cancer. Photo courtesy of Marilyn Votaw.\" width=\"300\" height=\"324\" \/><figcaption id=\"caption-attachment-69882\" class=\"wp-caption-text\">Marilyn Votaw. Photo courtesy of Marilyn Votaw.<\/figcaption><\/figure>\n<p>\u201cI\u2019m a medical snob \u2014 well-informed in medicine and how my body works,\u201d Votaw said.<\/p>\n<p>Votaw sees her primary care physician and her dentist as recommended. In May 2022, she saw her dentist. Everything was well. Her primary care physician had retired earlier that year, and she had scheduled a new patient visit for November with a new doctor.<\/p>\n<p>As the house director of <a id=\"\" href=\"https:\/\/colostate.kappa.org\/our-house\" target=\"_blank\" rel=\"noopener\">Kappa Kappa Gamma at Colorado State University<\/a>, Votaw lives almost year-round at the sorority house. She gets the same holiday breaks as CSU students and two additional weekends off a semester.<\/p>\n<p>In June 2022, the girls had all moved out of the house for the summer, and Votaw was planning her usual July beach vacation. That is when she noticed the lump on her neck and thought it might be a swollen lymph gland.<\/p>\n<p>\u201cI thought maybe I was getting sick, or it was a flu thing,\u201d she said. \u201cBut I never got sick.\u201d<\/p>\n<p>Votaw went ahead with her July vacation. The lump was still there when she returned a few weeks later. Concerned, she went to urgent care, where she saw a nurse practitioner who ordered a sonogram of her neck.<\/p>\n<p>\u201cShe told me I needed to see an ENT (ear, nose, throat doctor) immediately. She wrote me a referral and told me to establish a primary care doctor on Monday.\u201d<\/p>\n<p>The sonogram confirmed a mass.<\/p>\n<figure id=\"attachment_69829\" aria-describedby=\"caption-attachment-69829\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-69829\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/05\/01133724\/Marilyn-HPV-teamshot-web.webp\" alt=\"Kappa Kappa Gamma members with Marilyn Votaw and the CSU senior guard Meghan Boyd, who wore Votaw\u2019s name on the back her jersey, pose for a picture during a special \u201cFight Like A Ram\u201d event at Moby Arena. Photo by Kelly Tracer, UCHealth.\" width=\"640\" height=\"354\" \/><figcaption id=\"caption-attachment-69829\" class=\"wp-caption-text\">Kappa Kappa Gamma members with Marilyn Votaw and CSU senior Meghan Boyd, a guard on the women&#8217;s basketball team. Boyd wore Votaw\u2019s name on the back of her jersey and posed for a picture during a special \u201cFight Like A Ram\u201d event at Moby Arena in January 2023. Photo by Kelly Tracer, UCHealth.<\/figcaption><\/figure>\n<h2><strong>\u2018How did we end up in cancer land?\u2019<\/strong><\/h2>\n<p>Votaw saw an ENT the following week. \u201cHe said, \u2018While it\u2019s possible that this is an infection, I think we need to assume this is cancer,\u2019\u201d Votaw said.<\/p>\n<p>\u201cI went to my car, called my mom and cried,\u201d she said. \u201cHow did we end up in cancer land? How did that happen?\u201d<\/p>\n<p>The biopsy confirmed throat cancer, but there was good news, the cancer was found in an early stage.<\/p>\n<p>Her heart sank as she dealt with a cancer caused by a sexually transmitted infection. Mortified, she thought, &#8220;How can I talk about this?&#8221;<\/p>\n<h2><strong>What is HPV?<\/strong><\/h2>\n<p>There are more than 200 types of HPV (human papillomavirus), about 40 of which can be <a id=\"\" href=\"https:\/\/www.oncolink.org\/risk-and-prevention\/sexual-history-human-papillomavirus-hpv\/all-about-hpv#:~:text=Human%20papillomaviruses%20(HPV)%20are%20common,HPV%20do%20not%20cause%20problems\" target=\"_blank\" rel=\"noopener\">spread through sexual contact<\/a>, making it the most common sexually transmitted infection in the United States.<\/p>\n<p>\u201cTo be human is to get HPV. Assume all people have it \u2014 you and your future partners,\u201d said <a href=\"https:\/\/www.uchealth.org\/provider\/christine-conageski-md-obstetrics-and-gynecology\/\">Dr. Christine Conageski<\/a>, a physician at the UCHealth Women\u2019s Care Clinic on the Anschutz Medical Campus and associate professor of obstetrics and gynecology at CU School of Medicine.<\/p>\n<p>In <a id=\"\" href=\"https:\/\/www.cdc.gov\/sti\/about\/about-genital-hpv-infection.html\" target=\"_blank\" rel=\"noopener\">nine out of 10 cases<\/a>, HPV goes away on its own within two years without health problems. Often, the person never even knows they had it. HPV can remain in the body for years without detection or abnormalities.<\/p>\n<figure id=\"attachment_69825\" aria-describedby=\"caption-attachment-69825\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-69825\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/05\/01133714\/Marilyn-HPV-sororitygirls2-Courtesy-CSU-Athletics-web.webp\" alt=\"Girls from Colorado State University\u2019s Kappa Kappa Gamma sorority house show their support for their house director, Marilyn Votaw, during a special \u201cFight Like A Ram\u201d event at Moby Arena. CSU partners with UCHealth to put on the event at both the men\u2019s and women\u2019s basketball game to honor cancer patients. Photo courtesy of CSU Athletics.\" width=\"640\" height=\"426\" \/><figcaption id=\"caption-attachment-69825\" class=\"wp-caption-text\">Young women from Colorado State University\u2019s Kappa Kappa Gamma sorority show their support for their house director, Marilyn Votaw, during a special \u201cFight Like A Ram\u201d event at Moby Arena. In January, CSU partnered with UCHealth to honor cancer patients during a men\u2019s and women\u2019s basketball game. Photo courtesy of CSU Athletics.<\/figcaption><\/figure>\n<h2><strong>So why is HPV such a concern that there is a recommended vaccine?\u00a0 <\/strong><\/h2>\n<p>For unknown reasons, some people can\u2019t fight off the virus. The infection causes cells to change and, if not treated, those cells may become cancerous over time \u2014 sometimes taking decades.<\/p>\n<p>Multiple cancers are attributed to HPV in the U.S. According to the <a id=\"\" href=\"https:\/\/www.ajmc.com\/view\/13-years-after-the-hpv-vaccine-was-introduced-us-uptake-remains-low\" target=\"_blank\" rel=\"noopener\">American Society of Clinical Oncology<\/a>, HPV is responsible for 91% of cervical and <a id=\"\" href=\"https:\/\/www.cdc.gov\/cancer\/hpv\/cases.html\" target=\"_blank\" rel=\"noopener\">anal cancers<\/a>, 75% of vaginal cancers, and 69% of vulva cancers. According to the <a id=\"\" href=\"https:\/\/www.cancer.gov\/about-cancer\/causes-prevention\/risk\/infectious-agents\/hpv-and-cancer#:~:text=HPV-related%20cancers%20include%3A%201%20Cervical%20cancer%20%3A%20Virtually,60%25%29%20are%20caused%20by%20HPV.%20...%20More%20items\" target=\"_blank\" rel=\"noopener\">National Cancer Institute<\/a>, 70% of oropharyngeal cancers (ones that develop in the mouth and throat) and over 60% of penile cancers are caused by HPV.<\/p>\n<p>At first, Votaw struggled to come to terms with the cause of her cancer.<\/p>\n<p>\u201cNow, I\u2019m at a place where I understand to have it (HPV) is human. Everyone has it; I just lost the lottery,\u201d she said. \u201cI am a human that collided with bad odds. It is no one\u2019s fault. \u2026 That took the guilt and shame out of it.\u201d<\/p>\n<p>HPV accounts for about 37,000 new cases of cancer each year.<\/p>\n<h2><strong>Few screenings for HPV-caused cancer, so cancer prevention is key<\/strong><\/h2>\n<p>There is only one FDA-approved screening for HPV-related cancers: the Papanicolaou (Pap) test. Although experts proved the pap test efficacy in 1941, the HPV test to screen for cervical cancer (often happening during the same exam) didn\u2019t come along until decades later, and there is no FDA-approved HPV test to detect throat or anal cancers, though test are under development, said <a id=\"\" href=\"https:\/\/www.uchealth.org\/provider\/hillary-dunlevy\/\">Dr. Hillary Dunlevy<\/a>, infectious disease expert at UCHealth on the Anschutz Medical Campus and assistant professor at CU School of Medicine.<\/p>\n<p>\u201cScreening is secondary prevention, but primary prevention is the vaccine. If you get the vaccine, you will prevent most of these cancers. There is no medicine to treat HPV,\u201d said Dunlevy.<\/p>\n<p>The vaccine became available in the U.S. in 2006. The Centers for Disease Control and Prevention recommended the vaccine for males and females aged 11 to 26 but as young as 9. It prevents 90% of all HPV-related cancers.<\/p>\n<p>U.S. health officials recently expanded the recommended age range to 45, with a health care provider\u2019s recommendation. However, the vaccine&#8217;s effectiveness lowers in older age groups because of possible previous exposure.<\/p>\n<figure id=\"attachment_69835\" aria-describedby=\"caption-attachment-69835\" style=\"width: 642px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-69835\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/05\/01140006\/Marilyn-big-check-web.webp\" alt=\"Kappa Kappa Gamma sorority women raised money for the UCHealth Foundation of Northern Colorado in honor Votaw, who is their house director and who spent the past year battling a HPV-related cancer. Votaw is using her experience as a way to bring awareness to HPV and the vaccine, which now prevents 90% of HPV-related cancers. Photo by Kelly Tracer, UCHealth.\" width=\"642\" height=\"414\" \/><figcaption id=\"caption-attachment-69835\" class=\"wp-caption-text\">Kappa Kappa Gamma sorority women raised money for the UCHealth Foundation of Northern Colorado in honor of Votaw, who has spent the past year battling HPV-related throat cancer. Votaw has vowed to raise awareness about HPV and a vaccine that prevents 90% of HPV-related cancers. Photo by Kelly Tracer, UCHealth.<\/figcaption><\/figure>\n<h2><strong>Treating her HPV-related throat cancer<\/strong><\/h2>\n<p>After Votaw\u2019s diagnosis, things moved \u201cquickly and very seriously.\u201d<\/p>\n<p>\u201cFor me, it was about finding the right team,\u201d she said.<\/p>\n<p>Her family ties with the medical community led her to <a href=\"https:\/\/www.uchealth.org\/provider\/john-campana-md\/\">Dr. John Campana<\/a>, a head and neck surgeon at <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-highlands-ranch-hospital\/\">UCHealth Highlands Ranch Hospital<\/a> and <a id=\"\" href=\"https:\/\/som.cuanschutz.edu\/Profiles\/Faculty\/Profile\/9876\" target=\"_blank\" rel=\"noopener\">associate professor<\/a> of Clinical Practice, Otolaryngology-Head and Neck Surgery for <a id=\"\" href=\"https:\/\/medschool.cuanschutz.edu\/\" target=\"_blank\" rel=\"noopener\">CU School of Medicine<\/a> on the <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-at-university-of-colorado-anschutz-medical-campus\/\">Anschutz Medical Campus<\/a>.<\/p>\n<p>\u201cI met him, and right away, I knew that was the guy,\u201d Votaw said.<\/p>\n<p>She was impressed by his willingness to explain her cancer and the surgery plan in detail. She said he reviewed with her photographs of the primary infection site on the base of her tongue. He took notes during the appointment and even printed them off for her before she left.<\/p>\n<p>The surgery took four hours. Along with cancer, surgeons removed Votaw&#8217;s right tonsil and the lymph nodes on the right side of her neck. She spent five days in the hospital before returning home.<\/p>\n<p>Then it was time for radiation: five days a week for six weeks and chemotherapy once a week for six weeks. Votaw worked with UCHealth radiation oncologist <a href=\"https:\/\/www.uchealth.org\/provider\/joshua-h-petit-md-radiation-oncology\/\">Dr. Joshua Petit<\/a> and hematology oncologist <a href=\"https:\/\/www.uchealth.org\/provider\/ross-w-mcfarland-md-cancer-oncology\/\">Dr. Ross McFarland<\/a>.<\/p>\n<p>Treatment was grueling, she said, but she was determined to get the upper hand on her cancer.<\/p>\n<p>\u201cThey did give me a choice on whether or not to do chemo,\u201d Votaw said. \u201cBut this wasn\u2019t about the fight anymore. It was more about control. \u2018This is my body, and you (cancer) need to get out.\u2019 I wanted to toss everything at it. I didn\u2019t want to get down the road and see I could have done more.\u201d<\/p>\n<p>Votaw did physical therapy and worked with a nutritionist after surgery. She admits that recovery has been a rollercoaster. Some days she\u2019s great and other days, \u201care the pits.\u201d She continues to go to acupuncture to calm her nervous system. She sees a mental health therapist to process her experience. On the outside, \u201cI look fine,\u201d she said. But inside, she feels she still has some ways to go.<\/p>\n<p>She&#8217;s continued her work as a house director, caring for about 50 young women at a time. She shares her knowledge of HPV and the vaccine when appropriate. Still, cancer made her realize that sometimes you should ask for help and leave behind the &#8220;I can do it all by myself&#8221; mentality.<\/p>\n<p>\u201cCancer has forced me \u2014 and given me the opportunity \u2014 to really rely on many people in a way I\u2019ve never had to do before,\u201d she said.<\/p>\n<figure id=\"attachment_69826\" aria-describedby=\"caption-attachment-69826\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-69826\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/05\/01133716\/Marilyn-HPV-sororitygirls3-Courtesy-CSU-Athletics-web.webp\" alt=\"Members of Kappa Kappa Gamma showed up in force during a January 2023 CSU basketball game at Moby Arena that honored cancer patients. The sorority women were there to support their house director, Marilyn Votaw, who spent the past year battling a HPV-related cancer. Photo courtesy of CSU Athletics.\" width=\"640\" height=\"426\" \/><figcaption id=\"caption-attachment-69826\" class=\"wp-caption-text\">Kappa Kappa Gamma members show support for cancer patients at a January 2023 CSU basketball game at Moby Arena. Photo courtesy of CSU Athletics.<\/figcaption><\/figure>\n<h2><strong>Before and after the HPV vaccine<\/strong><\/h2>\n<p>Those connections also helped her build awareness about HPV.<\/p>\n<p>\u201cEveryone should be aware of the ubiquitous presence of HPV in adult human bodies and the possibility that certain HPV strains will cause multiple types of cancer,\u201d she said.<\/p>\n<p>Because of her age, Votaw never had the option to get vaccinated against HPV.<\/p>\n<p>\u201cI don\u2019t know if people my age know how vulnerable they are (to HPV-related cancers) because we aren\u2019t eligible for the vaccine,\u201d she said. \u201cThere is no way to prevent (HPV) so you must catch (cancer signs) early.<\/p>\n<p>\u201cDon\u2019t mess around with these things. Know your body and speak up when you think something is wrong.\u201d<\/p>\n<p>And <a href=\"https:\/\/www.uchealth.org\/today\/benefits-of-the-hpv-vaccine\/\">for those eligible for the vaccine<\/a>, Votaw hopes they take the opportunity to protect themselves against a similar fate as hers.<\/p>\n<p>\u201cHPV cancers are preventable. So many cancers are not,\u201d she said.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Marilyn Votaw, 59, has spent the past decade supporting the nourishment and growth of young women. So when she found out she had cancer \u2014 one that is now preventable thanks to a vaccine \u2014 she put aside embarrassment to discuss prevention, the importance of knowing your body and getting the HPV vaccine. A lump [&hellip;]<\/p>\n","protected":false},"author":2164,"featured_media":69825,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[7],"tags":[28,49,9081,162,257,212],"class_list":["post-69819","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-cancer-care-oncology","tag-cancer-treatment","tag-head-and-neck-cancer-treatment","tag-infectious-diseases","tag-virus-prevention","tag-womens-care"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - 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