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Can oral sex really give you cancer?

Actor Michael Douglas' comments about throat cancer have thrown a spotlight on risks from HPV, a virus spread through sexual contact. Experts say HPV is a growing cause of certain types of oral cancer. (June 3)

Whether oral sex did cause Michael Douglas’ bout with cancer really doesn’t matter. What does matter are the questions and resulting conversations that came from his interview.

Before an overabundance of “Oral sex gave me cancer” headlines, the likelihood is that most HPV-related conversations focused on vaccines for young women. Instead, people are now left wondering, “Can doing that really lead to cancer?”

Well as it turns out, yes, it can. At least in some cases.

The Centers for Disease Control lists HPV as the most common sexually transmitted infection, with more than 40 types that affect both men and women’s genital areas. But while a person’s genitals may be the most commonly infected area of the body, the mouth and throat as areas susceptible to infection as well.

Although most people who contract HPV never develop any symptoms (with most cases clearing themselves up), there are rare cases in which the infection can lead to more serious conditions, including cancer.

Dr. Douglas Frank, chief of the division of head and neck surgery at Long Island Jewish Medical Center and director of head and neck surgical oncology at the North Shore LIJ Cancer Institute, said the number of people who will develop any form of cancer from HPV is very small.

“The vast majority of us are able to clear it, our immune systems just clear the virus,” Frank said. “There’s a small population of people that don’t clear it, and an even smaller population of those people that are susceptible to get the cancer from it.”


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For those that reside within the smallest of those percentages, transmission is not necessarily as lewd as the headline writers might have you believe. “Probably, a certain component of it is oral sex,” confirmed Frank, “but another component is probably just kissing, like French kissing.”

Unlike other sexually transmitted infections, HPV can be transmitted through “relatively casual” sexual contact, he said. “It’s not like HIV where it has to be more explicit sexual contact, this is a little bit more casual,” said Frank, reiterating, “ . . . and the vast majority of us clear it.”

However, Frank did admit that the number of cases -- though small -- are growing, citing HPV as a contributing factor.

Though the risk of developing cancer from HPV is small, the risk of being exposed to HPV is great -- upward of 90% of the population, Frank said -- so it is still important to be aware of the signs and symptoms of oropharyngeal cancer.

“You don’t have to be a big partyer or drinker or smoker to get it,” Frank said. “You could just be a regular American and in that 90-some-odd percent of the population that’s at least been exposed.”

Frank said signs of the disease include a lump in the neck that may not even cause pain in the throat. In other cases, where the tumor may be larger, patients will complain of a sore throat, difficulty swallowing, a change in the voice and even difficulty breathing.

What can be done to protect yourself?

Administering the Gardasil vaccine to adolescent boys as well as girls has become a popular prevention method because “the predominant population that’s getting HPV associated throat cancer are men,” Frank said.

He said that for the long term treatment of this infection, parents should vaccinate their children against HPV. In a statement on the CDC's website they say: Gardasil is recommended for 11- and 12 year-old girls, and also females 13 through 26-year-old who were not previously vaccinated. Gardasil is also recommended for 9- through 26- year-old males to protect against some genital warts.

For adults, however, Frank said there’s not much else to do but be self-aware and proactive about your health.

Ultimately, it comes down to simple prevention steps. “Women need to continue getting their Pap smears and men need to be on the lookout for a lump in the neck,” Frank said. “If the throat’s a little bit sore, even occasionally an ENT exam.”

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