Human Papilloma Viruses (HPV) that cause cancers of the mouth and sexual organs are the most common sexually-transmitted diseases in the United States today, infecting 20 percent of people under age 60 (CDC’s National Center for Health Statistics, April 6, 2017). The Communicable Disease Center estimates that these cancer-causing viruses infect 80 million Americans, with more than 14 million of the new infections occuring among teenagers. They found that almost 31,000 new cases of cancer each year from 2008 to 2012 were attributable to HPV and that most could be prevented with immunization.
Types of HPV
There are more than 150 different types of HPV viruses.
- Most types go away after six to nine months
- Some types only cause common warts that go away after many months or years
- At least 14 of the HPV viruses can evade your immune system and stay in your body as long as you live, markedly increasing risk for cancers of the cervix, vagina, vulva, anus, penis, mouth, throat and tonsils. These 14 types cause 40 percent of the HPV infections in women and 45 percent in men.
It was only 34 years ago that Dr. Harald zur Hausen discovered the specific types of HPV that cause cervical cancer and in 2008 he was rewarded with the Nobel Prize. HPV-16, the most common type found in cervical cancers, is also found in more than half of all HPV-caused cancers in the mouth.
How Do You Get HPV?
You acquire HPV from an infected person through contact of skin-to-skin, mouth-to-genitals or from body fluids such as ejaculate, vaginal secretions and saliva. These viral infections occur at the site of contact, not through the bloodstream, so generally infections are on the skin or in body orifices. The more sexual partners a person has, the greater the risk of acquiring one or more of the cancer-causing types of HPV.
Four years ago, actor Michael Douglas made the world painfully aware of HPV when in an effort to save others, he told a reporter that his throat cancer was caused by HPV contracted through oral sex. The CDC says that each year, 12,638 men and 3,100 women in the United States develop HPV-related cancers in the middle of the throat including the back of the tongue, soft palate, sides of throat and tonsils.
Men who develop oral cancer are often young, healthy non-smokers who go to their doctors complaining of a sore throat, mouth ulcer or lump in their neck or mouth. They may be told that they have an infection and given antibiotics, which are totally ineffective. The patient needs a thorough check-up which often includes a biopsy of a non-healing ulcer, sore spot or lump. It usually takes from 10 to 30 years after the initial infection to develop cancer, so the exposure to HPV is likely to have occurred many years before the cancer is discovered.
Smoking and drinking increase risk for cancers of the mouth, but these cancers occur most commonly in healthy white, middle-aged men who do not smoke or drink heavily. They first notice a lump in their necks or lymph nodes and find out later that they have a lymph node cancer that started in the tonsils or base of the tongue.
Men at Higher Risk for Oral HPV
Men are more likely than women to become infected and develop cancer from the oral cancer-causing HPVs. When most women are infected with vaginal HPV, they develop high blood levels of antibodies to clear HPV, and these antibodies remain in the body so that a woman is somewhat protected from developing oral cancer in the future. On the other hand, men are far less likely to develop high levels of antibodies after genital exposure to HPV, making them five times more likely than women to suffer an oral infection.
No Drugs Cure HPV
There are no drugs to cure HPV after a person has been exposed. The only way to decrease the frighteningly-high incidence of HPV infections is to immunize people before their first exposure to the viruses. Unfortunately, at this time only 42 percent of girls and 28 percent of boys have received this immunization.
After HPV immunizations first became available in 2006, the risk for the cancer-causing HPVs (types 6, 11, 16 and 18) among girls and women between ages 14-19 decreased from 11.5 percent in 2003-2006 to 4.3 percent in the years 2009-2012. For the same years among women ages 20-24 the risk decreased from 18.5 percent to 12.1 percent (Pediatrics, February 2016).
Treatment for Oral Cancers Caused by HPV
Oral cancers caused by HPV have a much higher cure rate than those not caused by HPV. However, although radiation and chemotherapy are still mainstays of treatment, extensive radical surgery does not appear to improve survival by much, if at all. Treatment for HPV-induced cancers includes surgery, radiation and chemotherapy, but these treatments damage all tissue, not just the cancerous tissue.
What You Should Know about HPV
- Every sexual encounter with a new partner puts you at risk for HPV infection, which increases risk for cancer of the mouth and sexual organs.
- It can take 10 to 30 years for tumors to develop after infection with HPV.
- Condoms do not prevent infection. The virus spreads by direct skin-to-skin contact as well as in body fluids such as vaginal secretions, ejaculate and saliva. It appears that they are limited to the skin and body orifices as the viruses do not travel in the bloodstream.
- There are no effective drugs to kill HPV infections. The only means of prevention are abstinence and immunization.
- Once you are infected with HPV, it is too late for the vaccine to prevent infections. You must be immunized before you are infected with HPV. That is why the vaccine should be given to boys and girls by age 11 or earlier, before their first sexual contact. There is no evidence whatever that vaccination encourages youths to become promiscuous.
- Early detection and treatment of cancers and pre-cancers caused by HVP can reduce likelihood of recurrence, but do not guarantee a cure.
Gabe Mirkin, M.D., is a sports medicine doctor and fitness guru. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin has run more than 40 marathons and is now a serious tandem bike rider with his wife, Diana. His website is http://drmirkin.com/. Click to read Gabe’s full bio.