Human papillomavirus & Throat Cancer

Michael Douglas HPV Throat Cancer

Michael Douglas HPV Throat Cancer

We have already discussed Human papillomavirus (HPV) and it’s role in causing cervical cancer. However in recent days the role of Human papillomavirus in causing oral cancers has been in the media thanks to the assertion by Michael Douglas that oral sex gave him HPV which led to throat cancer.

Human papillomavirus (HPV) is a relatively common sexually transmitted virus that infects humans. HPV spreads via the keratinocytes of the skin or mucous membranes and can be transmitted that way during sex. One of the difficulties in avoiding HPV is that it often causes no symptoms in people affected with it. Some variants of the virus can cause warts and some can even lead to cancer of the vulva, vagina, penis, anus and more.

In the United States oral cancers are on the rise and medical professionals suggest that as many as 10’000 cases could be prevented with simple vaccines.

Michael Douglas said that he was diagnosed with throat cancer in 2010 and he believes that the cancer developed because of the HPV virus which he was infected with while performing oral sex. The 68 year old actor told the Guardian newspaper: “Because without wanting to get too specific, this particular cancer is caused by HPV [human papillomavirus], which actually comes about from cunnilingus,”

The actor’s publicist Allen Burry later clarified the statement, saying that Douglas “never said it was the cause of his particular cancer. They did discuss it. He did say oral sex is a suspected cause of certain oral cancers. He did not say it was his specifically.”

The statement by Douglas is backed up by recent trends in the United States which have seen the HPV virus partially responsible for the increasing number of throat cancers, according to some doctors.

In the United states over 60% of the 11’718 cases of oropharyngeal cancers diagnosed each year are a result of HPV infection according to the Center for Disease Control and Prevention. More than 3000 Americans are diagnosed with anal cancer each year, brought on by HPV and the rate of infection appears to be climbing.

There has been a recent push to vaccinate women against the virus to lower cervical cancer rates, but only 2% of boys are vaccinated against HPV in the United States. Statistically men are more likely to get HPV than women, due to sexual activity, so it is a deeply concerning figure.

Dr Kevin Cullen of the University of Maryland’s Marlene and Stewart Greenebaum Cancer Center says: “By the time they become adults, throat cancer from HPV in men is four times more likely than cervical cancer in women.”

It usually takes more than 20 years after exposure to the HPV virus for a cancer to develop. Medical professionals suggest that the younger generations changing sexual behavior, including more oral sex, is leading to a higher risk of HPV spreading throughout the community. Orpharyngeal squamous cell cancers, those of the throat, tonsils and base of the tongue are already on the increase.

Some studies have already reflected an increase in the prevalence of oral sex and the rise in oral cancers. In most developed countries more than 50% of all girls are vaccinated against HPV, and that figure is increasing every year. However with the small number of boys being vaccinated, there is a real risk of a throat cancer epidemic in coming years. Women can also get throat cancer from HPV, but the rate is much lower than men.

Two licensed vaccines, Gardasil and Cervarix are available in the United States and recommended by the CDC. Both of those vaccines will protect against cervical, anal, and oral cancers caused by HPV virus transmission.

The virus is still very common with nearly 80 million Americans infected with HPV and an estimated 14 million more getting the virus every year. The virus is so common that nearly every sexually active adult will get some strain of the virus in their lifetime.

In a socially conservative country like the United States, unfortunately many people are reluctant to get their daughters vaccinated because they don’t believe their daughter will be sexually promiscuous. However even if your daughter has only 1 sexual partner in their lifetime, it is still very likely they will be exposed to HPV and could potentially get cervical cancer from that infection. In addition other forms of sexual activity can spread the virus, so even if they aren’t having penetrative sex and remaining a virgin, they may be having oral sex and receive the virus.

Overall the rate of vaccination is increasing, so cervical cancer rates are falling, but it remains a significant problem amongst young men and the potential for a oral cancer epidemic in the coming years is very real.

Vinegar to Prevent Cervical Cancer Deaths

Vinegar Cervical Cancer Test

Vinegar Cervical Cancer Test

In developing countries, many people don’t have a great deal of money for expensive medical tests to check for cancer. This is true in India where many women cannot afford to have a pap smear to check for cervical cancer. However, in a medical breakthrough that took many years to achieve, doctor Surendra S. Shastri has decided to use a technique to check for cervical cancer using common household vinegar.

Cervical cancer is somewhat rare in developed countries because of testing procedures – for most people anomalies are found before becoming a serious life threatening cancer. Cervical cancer deaths in the United States amount to 4000 every year. In developing countries however, more than 200’000 women die every year from cervical cancer. Doctor Shastri considered it his lifetime goal to develop a simple testing procedure that could be used throughout the developing world to catch the illness early.

Cervical cancer first starts as a pre-cancerous lesion that grows into cancer. Spotting that lesion before it turns cancerous is why so many lives have been saved in the United States. The pap smear test was invented in the 1920s and has been used with great success to test for lesions in the cervix. The pap smear takes cells and sends them to the laboratory for testing – a simple procedure, but somewhat expensive for people living in the developing world.

Dr Shastri explains why widespread pap smear testing regimes would be difficult to achieve in India: “We don’t have the kind of laboratories or the kind of trained manpower needed for having a Pap smear. The Pap smear has succeeded in the countries where it has because of good quality control and frequency of screening”

So Dr Shastri decided to use a simple test that doctors perform after a suspicious pap smear result is returned – using a vinegar solution on the cervix and a magnifier to check the condition of cells. If a lesion is present the cells have a less “gooey” consistency and turn white. Healthy cells remain pink under the acetic acid solution.

The doctor didn’t stop there and decided to train health care workers in how to administer the test, so women across India didn’t even have to visit a doctor to have a test for cervical lesions performed.

Dr Shastri received funding from the National Cancer Institute to perform a clinical trial to check how effective the procedure could be. The results are nothing short of extraordinary, with cervical cancer reduced by 31% in the women screened every 2 years with the vinegar test. The results are to be presented at the annual meeting of the American Society for Clinical Oncology later today.

By conservative estimates, widespread use of the vinegar testing method could prevent more than 20’000 deaths from cervical cancer annually in India. If used in other developing countries that would be more than 70’000 lives saved every year.

Based on those results, the Indian government is rolling out the program to more parts of the country. Health workers are also using technology to further improve the results with digital cameras being used to train Health workers and to examine the results of the tests. The test itself is very low tech but with some simple and cheap technological tools it could be even more effective.

The developed world is even moving on to a more advanced method of testing for cervical cancer, with tests for the human papilloma virus DNA in women, the most common cause of the lesions that lead to the cervical cancer. Those viral DNA tests are very expensive however, and may be years off from widespread usage.

Human Papillomavirus and Cancer

Human papillomavirus

Human papillomavirus

Human papillomavirus (HPV) is a relatively common sexually transmitted virus that infects humans. HPV spreads via the keratinocytes of the skin or mucous membranes and can be transmitted that way during sex. One of the difficulties in avoiding HPV is that it often causes no symptoms in people affected with it. Some variants of the virus can cause warts and some can even lead to cancer of the vulva, vagina, penis, anus and more.

Additionally the HPV 16 and HPV 18 variants have been linked to throat cancer and other variants have even been linked with heart disease. Many carriers don’t know they have it and pass it along to different partners over many years, making it an extremely insidious and dangerous virus.

There are many types of HPV, an estimated 120 types have been found so far and they all are transmitted through sexual contact in the genital region. Some of the varieties that can create genital warts are less common because affected individuals generally seek treatment after noticing the warts. The high risk varieties of HPV can cause lesions and invasive cancer.

It is important to note that HPV is the leading cause of cervical cancer in women. While in most cases the virus is gone within a period of 1-2 years, up to 10% of women have the virus for a longer period in which precancerous lesions can develop in the cervix. The entire process usually takes over 10 years, giving affected individuals a lot of time to detect the lesions and seek treatment. Unfortunately the invasive surgeries that are sometimes required to remove the lesions can involve a loss of fertility.

A pap test can be used to detect cervical cancer, and is highly advisable for all women. If any abnormal cells are found in the papsmear, women will have to undertake a colposcopic inspection in which biopsies are taken and lesions removed.

Greater awareness of the virus and cervical cancer have reduced fatalities in developed countries in recent years, but cervical cancer is still responsible for up to 250’000 deaths worldwide. In most developed countries HPV vaccines (Cervarix and Gardasil) are now in use which should further decrease the spread of the virus and reduce the instances of cervical cancer.

Of the 120 HPV variants, it is estimated that as many as 16 are carcinogenic and a high risk of leading to cancers of the cervix, vulva, penis or anus. The highest risk are HPV variants 16, 18, 31 and 45.

The virus can also be transmitted from mother to child during childbirth, however the presence of HPV related illnesses in newborns is rare. Some HPV variants can lead to respiratory illnesses in children, but the incidence is very low (2 in 100’000).

HPV can also be contracted via a your or your partners hands or shared objects. Though usually it is from genital to genital contact, it can be passed on via hands to genitals or object to genitals.

It’s worth noting that HPV is the most frequent sexually transmitted disease in the world today.

The HPV vaccines Gardasil and Cervavix protect against HPV 11 and HPV 16 which cause 90% of genital warts. The vaccine is primarily for women who have not been exposed to the virus yet and will provide no benefit to women who have been infected with the dangerous HPV 16 and HPV 18.

The vaccines require 3 shots over six months and are now commonplace in many first world countries. Most countries just offer the shots to women, but some make the vaccine available to young men, to help lower the rate of transmission in the general population.

Condoms can also reduce the risk of contracting the HPV virus, however because it does not entirely remove the risk. Female condoms are more effective because they further reduce the skin to skin contact during sexual encounters.

There is some research indicating that topical microbicides may reduce the risk of contracting HPV virus if applied to the genitals before sexual contact. Some brands of lubricants containing chemicals like carrageenan have been shown to lower the risk of contracting HPV.

Getting tested and having your partner tested for the virus will also give you peace of mind. The virus can be very dangerous so it is worth taking precautions to avoid being infected.