Oral HPV and Throat Cancer -- What You Need to Know

Remember, there's a high probability that if you have been sexually active, you have or have had HPV. Get screened, prevent transmission of the virus with barrier protection, support your immune system and consider vaccinations for your kids or if you are in the appropriate age range.
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You probably have the same sexually transmitted disease as Michael Douglas. As a matter of fact, me, too.

There's been a lot of Michael Douglas news lately with his estrangement from his wife, Catherine Zeta-Jones and now with him winning his well-deserved Emmy award for his role as Liberace, but the news I think that's most important to focus on is about his health. Douglas has been battling a form of throat cancer that has been linked to HPV (human papilloma virus), a sexually transmitted disease.

There's a high probability that you have or have had HPV, the same type of sexually transmitted disease that Michael Douglas has. According to the Centers for Disease Control and Prevention, "HPV is so common that most people get it at some time in their lives." As an ob/gyn turned preventive-medicine doctor and hormone specialist, these are the questions I hear when pap smears turn up HPV positive: "How did I get this?" and "Does this mean my partner is cheating on me?"

Diagnosis with an HPV infection does NOT mean that your partner is cheating on you. And it doesn't mean that you've been promiscuous. The majority of sexually active people have had the infection at one point or another in their lives. It's known that HPV is not transmitted by sharing drinks and food, or kissing on the cheek, but it's not known if deeper kissing can transmit HPV.

I tell this story not only as an ob/gyn, but also as a patient. In my 20s, I was diagnosed with HPV and a precancerous lesion on my cervix. I can tell you first first hand that the diagnosis of cervical HPV is no fun. An uncomfortable stigma is attached to the diagnosis, and the medical evaluation can be downright scary. I suffered lots of unwanted but necessary poking and prodding of my private parts by medical professionals. And I was lucky enough to be treated quickly with no recurrence. Still, I am always a little nervous when I'm waiting for those pap smear results.

Most people who are infected by HPV live it with for many years without any symptoms. Infections can come and go completely undetected, frequently disappearing without any treatment. In the case of Douglas and Zeta-Jones, one or both of them may have come into their 13-year marriage with the virus that was related to his throat cancer. The fact is, we don't know how long it takes from the time of infection with HPV until one gets cancer, but we do know that it takes years. It has been documented to take as long as 15 years from infection to cancer in some people.

There are many different types of HPV. One of the basic HPV classifications is the risk of cancer. HPV can be classified as low-risk or high-risk. HPV can cause many different types of cancer, including cervical and other genital cancers like vulvar, vaginal and penile cancer; oral cancers (including throat, mouth and tonsillar cancer); colorectal and anal cancers; even bladder cancer.

The September 2013 issue of the journal Oral Oncology came out last month, and authors Fakhry and D'Souza have noted some interesting statistics about HPV in mouth and throat cancers. The percentage of mouth and throat cancers caused by HPV is rising sharply, from only 16 percent in the 1980s to approximately 73 percent of the mouth and throat cancers in the year 2000. The incidence of mouth and throat cancers is rising as well. From 1988 to 2004, there was a 28 percent increase in the risk of mouth and throat cancers, primarily in men ages 50 to 59. Some good news here is that HPV-positive cancers tend to be more responsive to treatment.

Prevent HPV-related cancers with regular screenings, proper protection, and immune-system support.

A pap smear can help to screen for the presence of cervical cancer and for the presence of cervical HPV. If you don't know if you're currently being screened for HPV with your pap smear, be sure to ask your practitioner. When you get your HPV test, make sure it screens for high-risk types. Some of the HPV types that put you at the highest risk of cancer are types 16, 18 and 45.

Condoms and dental dams have been shown to decrease the transmission of HPV. Looking to the future, therapeutic vaccines will treat HPV once you are already infected, but these are not currently available. Since 2006, two preventative vaccines for HPV types 6, 11, 16 and 18 have been available. It has been shown that these vaccines can actually protect against cervical cancer, and scientists speculate that the vaccine may help to prevent other cancers as well. The vaccine is for prevention only. It won't work on those already infected. Candidates for the vaccine must be between 9 and 26 years old. The decision to vaccinate yourself or your child should be made after thoroughly weighing the risks and benefits. I recently decided to have my children vaccinated, and they are currently undergoing the three-vaccine series.

A new August 2013 study, published in the journal Cancer Prevention Research, shows that poor oral health is associated with higher risk of oral HPV infection. It's important to use good oral-hygiene techniques, like thorough brushing and flossing to decrease your likelihood of having an oral HPV infection. Factors that will make an HPV infection more likely to turn to cancer include smoking, chewing tobacco, heavy alcohol use and a compromised immune system. People with HIV are much more likely to have HPV-related cancers than non-HIV infected individuals.

A March 2013 study in the journal Nutrition and Cancer showed that transient HPV infections can be reduced by consuming a high amount of certain foods, including whole fruits and vegetables, nuts and fish. Low intake of fruits and vegetables were associated with a three-fold risk of advanced pre-cancer of the cervix.

Remember, there's a high probability that if you have been sexually active, you have or have had HPV, the same type of sexually transmitted disease that Michael Douglas had. Get screened, prevent transmission of the virus with barrier protection, support your immune system and consider vaccinations for your kids or if you are in the appropriate age range.

For more by Jen Landa, M.D., click here.

For more on healthy living health news, click here.

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