Oral sex – cancer

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While Human Papilloma virus (HPV), a sexually transmitted virus, causesmajority of cervical cancer in women, it is also responsible for various cancers in men also. Between 2001 to 2017, “HPV led to a five-fold increase in head and neck cancers in young men,” data presented at the 2021 annual meeting of the American Clinical Oncology.

​There were 25,000 cases of HPV-associated cancers in women between 2013 to 2017 and 19,000 cases in men. Greater than 40 percent cases of HPV caused cancers are in men. These are all preventable with Gardasil vaccine, when boys and girls are vaccinated before they are sexually active, and for men up to age 45.

The rate of throat cancer in the United States has not declined, compared to most head and neck malignancies. I suspect that the statistics could also be true, when extrapolated, for other countries, like the Philippines, since most Filipinos are westernized in their lifestyle, habits, and behaviors, etc. 

​The most logical explanation why cancer of the throat has not diminished has been attributed to the Human Papilloma virus. HPV is popularly known to cause genital and most cancer of the cervix (mouth of the womb). It has only been recently when scientists discovered and identified HPV transmission through oral sex as an etiology of throat cancer.

​M.D. Anderson Cancer Center in Houston reported that its research team found “the incidence of throat cancer (in the United States) to be stagnant and even rising in some populations, defying a downward trend in other head and neck cancers linked more closely with smoking.”

​The American Cancer Society reports that the greatest risk factors in head and neck cancers are smoking and drinking alcoholic beverages, 90% of them either smokers or tobacco-chewers and about 80% of them also imbibed a lot of alcohol.

​The good news is that a trend analysis in head and neck cancers in the United States shows a decline the past twenty years, trailing a decrease in smoking prevalence, which started in the 1970s, by 10 to 15 years.

​The bad news is that oro-pharyngeal cancers (which include the tonsils, base of the tongue and soft palate, and side and back of the throat) have been up in some population in the United States, and probably among people in other parts of the world who practice oral sex, where HPV takes its toll. HPV could also cause cancer of the vagina, penis, and anus, besides cervical and throat cancers.

​Sample of the vaccine referred to is Gardasil, which is genetically engineered, and which blocks infection caused by two of the more than 100 types of Human Papilloma Virus (HPV), strains 16 and 18. These two sexually-transmitted viruses are responsible for about 70% of cervical cancers. HPV, in one form or the other, afflicts more than 20 million Americans. The other strains of the virus cause painful genital warts, and sometimes, cervical cancers too. 

​Let us momentarily discuss cervical cancer, since the HP virus is implicated in its causation in almost three quarters of this malignancy.

How prevalent is cervical cancer?

​In the Philippines, there are about 5000 new cases of cervical cancer each year. However, more alarming than that is the fact that there are between 10,000 to 25,000 women walking around (not seen by physician) who have undiagnosed pre-invasive lesions in their cervix. If diagnosed early, these women could be saved. For every four survivors of breasts cancer, there are less than 3 women who survive cervical cancer, which shows how virulent cervical cancer is.

What causes cervical cancer?

​Human Papilloma Virus (HPV, also known as genital herpes virus) accounts for most cervical cancers. At least 50% of sexually active men and women are infected with genital HPV, especially those with multiple partners. There are about 20 million American men and women infected with HPV, many linked with abnormal pap tests, genital warts and cervical cancer. It is estimated that at least 10,000 new cases of cervical cancers are discovered annually. Between half a million to a million Americans have genital warts, transmitted thru sexual contacts. It takes time for those infected with HPV to develop into cancer, so there are countless infected people out there who would potentially have cancers. The best for children (before turning 10) and adult up to age 45 is to get vaccinated to prevent HPV infection to begin with.

Is the cure for cervical cancer?

​Better than the cure! A vaccine (Gardasil) that prevents cervical cancer, vulvar and vaginal cancer that was approved by the US-FDA in 2006 was found to be “effective 100%, in the short term, at blocking the cancer and lesions likely to turn to cancer” (like the pre-invasive lesions), according to Gardasil manufacturer, Merck & Co. “To have 100 percent efficacy is something that you have very rarely,” Dr. Eliav Barr, Merck’s head of clinical development for Gardasil, told The Associated Press. The UK’s version of the vaccine is known as Cervarix.

How early should the vaccine be given?

​Students in grammar school, middle school and high school should be vaccinated before they become sexually active, as early as 9 years old for both boys and girls, and adults up to age 45, because once they catch HPV infection, there is no cure; herpes is for life. This was the recommendation of Dr. GloriaBachmann, director of The Women’s Health Institute at Robert Wood Johnson Medical School in Brunswick, NJ., who said this vaccine is a “phenomenal breakthrough.” Prophylaxis Gardasil vaccination comprehensively eliminates HPV 16 and 18 associated non-invasive and invasive cervical cancer. The vaccine also cuts down infection with HPV 6 and 11, the causes of 90% of genital warts. Gardasil is safe for both boys and girls and adults.

How about throat cancers?

​Of the 45,000 head and neck cancers in the US each year, about 10,000 of them are oro-pharyngeal cancers, and tongue cancers among young adults have also increased. The evident conclusion is that the cause is the HP virus.

​“Over the last five years, 35% of the throat cancer patients treated at the M.D. Anderson Cancer Center had no history of smoking, and that close to 90% of patients who had never smoked showed evidence of oral infection with HPV,” says Dr. Sturgis on Web MD.

​The researchers felt that “vaccinating only females against HPV could result in a missed opportunity to prevent throat cancers.” It is recommended forboth girls and boys to close that gap, preventing boys from spreading the HPV virus.

The use of cling plastic wrap used in the kitchen placed over the woman’s groin as a shield has been advocated by some to prevent HPV transmission.

Mouth, tongue, and other throat cancers could be as grave and deadly as most other forms of cancers. 

I do not know how to put this more seriously, more effectively, and more delicately, but medically speaking, a moratorium on oral sex might be in order.

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