Hi folks,

I'm a new member, and think this is a great site. It has been very informative. I had a recent scare with my father in Hawaii. He had some symptoms similiar to nasopharyngeal cancer, and I began researching symptoms and advice online. I found my way to this board. Luckily, what he had turned out to be a broken blood vessel in his nostril.

I'm still very much interested in oral cancers. My wife was diagnosed with high risk HPV, and i'm aware of the apparent link to tonsillar and back of throat risks. It seems lately, though, that HPV is trying to be implicated in nearly every kind of cancer. I've read many studies that have tried to implicate it in lung cancer (????) and even breast cancer! I had my own scare recently when I thought I had penile cancer! So far, it seems as if HPV causes cervical cancer, and may cause oralpharyngeal cancer, throat cancer, penile cancer, anal cancer, skin cancer, lung cancer, and breast cancer. Do you guys think this HPV scare is the latest sensationalism in medical media, or what? Here's my rationale:

I've read Dr. Palefsky's presentation on HPV and anal dysplasia at UCSF. He claims, based on his sampling and statistics, that half the population has HPV, and a quarter has the high risk variants. Now, let's restrict this to the age group of 18 and up. This means that nearly 220 million * .5 = 110 million have HPV, and 55 million people have the high risk types. Being that the population is static, and people die and are born every year, that 55 million doesn't change much due to infection rates being static. Based on current CDC #'s, there are about 33,000 oral cancer patients (not including laryngeal) every year. So, the overall yearly risk is 0.06%. Supposedly, an estimated 11,000 of those cancer patients (based on the Johns Hopkins press release) is due to HPV. So your overall yearly risk is even lower, at 0.02%. Now, let's assume that the cancer mostly afflicts people in their 50's and up (based on the latest cancer stats, the risk of developing cancer skyrockets at 50). Based on the age distribution, that's 37% of 301 million people = 111.37 million. Assuming the same HPV distribution as before, that's 27.843 million. Your risk in this age group is now .119%. If you assume that a third of oral cancer is caused by HPV, then your yearly risk in this high risk age group is 0.04%. I believe your cumulative lifetime risk is much higher, but less than 1%. It makes me wonder, is HPV related oral cancer that big?

Okay, there's one thing I neglected, and that's oral sex. We're assuming that everyone has had it in this risk group--which is obviously not the case. But, the strongest link based on the Johns Hopkins report was not on oral sex partners, but on HPV 16 serological antibodies. So, therefore, it might be wiser to restrict the population to only HPV 16 infected folks vs. all high risk types to make the logic stick.

Any thoughts?

And another thing, I know it's not as common for guys to go down on women, but almost every woman i've known has done oral sex on guys... so, why is oral cancer much more common in men than women? I mean, it's six times as common in men than women. If the oral sex is the culprit in transmitting HPV, how does it explain this discrepancy?

Okay, let's assume even distribution in a mathematical sense. For example, it's impossible for guys to have more female sex partners on average than girls having less male sex partners on average. This, mathematically, could never happen... but it was reported so in the daily newswires--meaning men and women lie about their #'s. So, let's assume men and women equally have oral sex. Then, they would equally have the same distribution of oral HPV infections. So, why do men have higher rates of these cancers? It might be due to smoking, but I don't have the historical data on that since that would require the smoker distribution 30 years ago.

Don't you have anything better to do?

Unfortunately much is not known about HPV but what is known is scary. Ever since I found out HPV caused my cancer I have been on a mission to make as many people aware of the male HPV connection as possible. I have also testified before the Florida House in support of a Bill calling for voluntary HPV Gardasil vaccine shots for girls entering the 9th grade which didn't pass. I hope that in the years to come HPV will be eliminated due to the success of both the female and male vaccines and post exposure shots that boost our immune systems response.

There have been news articles linking Gardasil to bad side effects. Although I do realize this may be a good vaccine eventually I don't want someone telling me I have to get my daughter vaccinated. They were trying to make this mandatory and I resent more mandatory vaccines. The government is already way too involved in our lives.

The Bill I testified before the Florida House would have made it "mandatory" for all girls entering the 9th grade and would have been covered under the Free Shots for Florida program meaning that if the girl's shots were not covered by insurance and the parents couldn't afford them, Florida would pick up the tab. The Bill also had an "opt out" feature that allowed any parent to opt out of the shots for any reason whatsoever. A seemingly NO BRAINER that would have given free vaccine shots for those that wanted them and couldn't afford them and would not require them for parents that didn't want them for their daughters. There were 10 speakers who spoke in favor of the Bill including the American Cancer Society, the President of the Florida GYN Association, the Chairman of the Pinellas County Infectious Disease Dept and a HPV cancer researcher from Moffitt Cancer Center. Not one person spoke in opposition to it but it was defeated strictly along party lines lead by the conservative Republicans who controlled the House.

What the Republicans did allow to be passed was a Bill that called for notices to be given to students beginning in 2010 to carry home to their parents (with no signature required by the parents or any proof that the parent even got the notice) that would say that there MAY BE a HPV connection to cervical cancer and that there was a vaccine that claims to be responsive to that virus. Note that it would also not be available for free to those that still wanted it but couldn't afford it.

Well, i'm all for the Gardasil vaccine. In terms of making it mandatory, that might be a good idea, since alot of people haven't heard about HPV much less the potential risks that it may come with.

Hey davidcpa and Brian Hill,

I was wondering, since HPV seems like a strong risk factor for oral cancer, have you guys ever conducted a poll on here to determine the distribution of tobacco users vs. non-tobacco users? That would be something very interesting to look at.

By the way, just to clarify, I have been having sinus and throat issues, and my left tonsil looks pretty weird. I'm not sure, but it could be the beginnings of SCC. It's all very frightening, and this forum has helped me out quite a bunch with symptoms and diagnosis. I'd like to participate and contribute in a meaningful, positive way.

Sorry if it seems like i'm being in-sensitive. I'm just trying to understand the nature of what we have to deal with. I worry for my wife and myself. Any preventive oral care is what I'm interested in.

Get any concerned area looked at and stay on top of your health. Consult with different doctors if need be until you feel comfortable with their opinion.

Re the poll...as long as I've been posting to this site it has not encouraged any polls for obvious reasons, i.e. we are such a small and uncontrolled sample that any results would be meaningless. If you are interested in posters' particulars check out their Signature Line. Most that were confirmed HPV+ state so but there are many that weren't tobacco users that either didn't test positive for HPV or didn't get tested. A recent statistic says that up to 70% of the new oropharyngeal cancers are attributed to HPV. While the tobacco users continue to decrease in the U.S. oral cancers are on the rise and it may be attributed to HPV picking up the slack.