In response to news about about my mother's cancer, occasionally I am asked if she smoked. (I'm certain this is a common occurance with other head and neck and lung cancer patients.)

Everyone these days is aware of the hazards of smoking, but many, many factors contribute to causing cancer. My family is wrestling with the news of my mother's cancer, the treatment and the inevitable outcome... to hear the question about smoking, as if that assigns blame or minimizes the severity of the diagnosis; well, it just sort of ticks me off.
I suppose I look at is as medical professionals deserve to know a person's history, but not nosey co-workers and acquaintances! Not sure why the question offends me, but it certainly does.

Simply, my question is this: what is an easy response to this question, without erupting on the inquirer?

I can't count the number of times that I have been asked this question. Close friends and family, of course, knew that I hadn't smoked since I was 18 years old.

As difficult as it is, you have to get past being offended and just answer the question. You could use that time as an opportunity to educate the person as to the many causes of oral cancer as well as the fact that there are times when there is no known cause, such as mine.

Or simply just say yes or no. Leave it at that and then see what they say.

I hope your mom continues to well.

Jerry

My take is that people ask this to find a reason why people get cancer and reassure themselves that it could not happen to them.


M

I agree with Markus. When they ask me and I give the negative reply the looks of astonishment (WHAT?!?!?!) are always there. I believe that it is at that time they feel that they are also vulnerable.

From my experience the did he/she smoke is usually a question a non-smoker will ask.

But my typical answer is just plain, no.

There was an article that I read not too long ago about how underfunded research into lung cancer is and how many patients are ashamed to admit they have it, or feel that they're to blame for it - or something to that effect. (I should try to Google it!) But I think Markus has it right. Its a subtle way that people have to reassure themselves that it won't happen to them.

Mind you, I've never smoked in my life, other than a few when I was 10 or 12 cuz it was cool and when I tell people that they do squirm a little bit.

I agree with Markus, plus I have yet to have a smoker ask if I smoked -- They just don't want to know...

On the other side...When I was told I had SCC I was also told it was caused by a lifetime of heavy smoking and drinking. Since I was a light smoker for a short period in my life and had quit 35 yrs prior to cancer I was ashamed to tell people. Imagine, I had been on a 35 year crusade to convince people to stop smoking because of health reasons and I have to tell them I had cancer due to smoking. Not a conversation I wanted to have.

When I told my doctors that it couldn't be caused by smoking they just looked at me and said "well, what difference does it make, you still got the cancer and the treatment is the same." Well it did make a difference to me. Luckily I found this site and luckily I tested positive for HPV so it validated my reasons for quiting. (Yeah I know...I still got the cancer but hey nobody was there x number of years ago to warn me about HPV, not that that would have done any good, but I digress.)

Now that was 2 years ago and today more non smokers are told about the possibilities of the HPV connection but there still are some who never smoked that test negative for HPV. Perhaps there's another virus yet discovered?

I don't know whether your Mom smoked or not but if she did it might be the perfect time to remind those that ask, that her doctors contribute her cancer to her tobacco use. JM2C's

People continue to baffle me. I have had several people comment on my smoking and not very politely either. Basically you brought this on yourself. Made me feel smaller than small. I wish they would know that I am already hard on myself with this. My doctor said this is emphatically why I have cancer. I have no idea about the HPV virus I still have yet to check that one out but figure why bother cause it was smoking that caused mine.

Until I met one lady who put it so I didn't beat myself up over it anymore. Her comments true or otherwise they certainly made me feel better. Something about we all have cancer in us and if the stars align properly and god willing we will not get cancer. She compared cancer to a twister hits some and misses others. Smoking may have been a contributing factor but she said that was the past and now is now.

I agree with Jerry and just say yes or no and leave it at that!!

My best wishes to your mom also...She is lucky to have a daughter so protective and loving..

Well, thanks to everyone for their insight.

To be fair, I am riding a perpetual roller coaster of emotions and it seems the simplest of questions can tip me off.

I realize people have an inherent need to quantify their decisions in light of awful things happening around them. Yes she smoked, probably because everyone she knew smoked, including doctors. Do I wish she hadn't smoked? Of course, because maybe that caused her cancer. But her illness is no less tragic than if it occurred to a non-smoker.

To be fair, however, my mother-in-law smokes. After not having seen her since we learned about my mother's cancer... well, next time she lights up, I can imagine my blood will boil a bit.

Thanks to this board for its continual support.

I think most people ask us this question because of ignorance of the subject of OC. I tell myself that is the reason I was askedand just give a very short answer. Most people mean well but are tongue tied as what to say.

My parents were life-long smokers and died in their mid-70s of lung cancer and emphysema -- Although less was known back then, I still find myself sometimes angry at both of them for 'cheating' me, and extended family, out of the extra years they could have lived had they stopped smoking before smoking stopped them....

Two years ago when I was told I had SCC, HPV was harder to find than a Snipe at a Boy Scout overnight. Tobacco was assumed to be the culprit. I was lucky to have found my connection to HPV. Last year when I testified before the Fl House NO ONE in Tallahassee had heard about HPV and the Head and Neck Cancer connection and not many H & N doctors readily acknowledged it either. Now jumping 2 years forward to today and HPV is pretty well known at the CCC's but not as well known the farther you get away from them. HPV is now credited with being the cause of appx 70% of new OC in the Oropharnyx region but I believe tobacco is still, percentage wise, the leading cause of all Head and Neck Cancers. Brian, correct me if I have misposted.

It is annoying to be asked about smoking as though you deserved the cancer. I wasn't content with just a no but went on to explain that my mom smoked a pack a day from the time she was 14 until she quit at 70. Not a trace of lung cancer or oral cancer even though she also drank "high balls" daily. Oh and her diet was terrible and when she quit eating out of grief when my dad died of a heart attach - it was the beginning of the end. Her father drank and smoked really heavily right up until he died of liver problems - again zero cancer.
I agree that it seems to be a way for people to reassure themselves that they won't get cancer because somehow I had to be at fault. Although recent studies on HPV and its interaction with gum disease may very well prove (apologies to Jimmy Buffet) "Some people say that there's a (insert cancer cause here)to blame, now I think, hell it could be my fault"

Perhaps we should broaden our horizons a bit beyond just Smoking and HPV.

During my search to know, I found this on www.canceranswers.com and have often notice similar info elsewhere.

Like any cancer, the exact reason why one person gets oropharynx cancer and another does not
remains unknown. However, several"risk factors" have been shown to be be much more likely to be
present in mouth cancer patients:

1. Tobacco Usage--
This is the single strongest risk factor for developing cancers of the head and
neck, and especially mouth, esophagus, and oropharynx. Any form of tobacco taken through the
mouth, whether smoked or chewed, increases the risk over time. It often takes several decades
of use to get cancer but children who use chewing tobacco (often to emulate famous baseball
players) have gotten mouth cancer. The more tobacco that is used, for a longer period of time,
the higher the chance to get mouth cancer. Likewise, when use is stopped, the risk declines
almost to normal over a 5 to 10 year period.

2. Alcohol Usage--
Is the next strongest risk factor after tobacco. Occasional wine or beer may
raise risk very slightly, if at all, but frequent use of strong drinks like whiskey will increase cancer
risk to the mouth, throat, esophagus (food pipe), stomach and pancreas.
Furthermore,combining alcohol with tobacco will have a "super additive" effect to greatly
increase cancer risk for all of these areas. This means that the risk is much more than twice as
high as for using either tobacco or alcohol alone. Like tobacco, people who stop frequent drinking
will gradually lower their cancer risk to nearly that of non-drinkers.

3. Poor Oral Hygiene--
The more unclean the mouth and throat are, the more it is subject to
constant irritation from grime. Each teaspoon of saliva contains about one billion bacteria, which
are making waste products which cling to teeth and tonsils ("plaque"). This allows gum disease
(pyorrhea) to lead to subsequent tooth loss. Although plaque itself is not show to cause cancer, it
helps other chemicals (like in smoke) to stick in the mouth and throat, irritate it, and stimulate the
cells to divide. The more cells divide, the more chance one of them will become cancerous. That
is why the common thread of many risk factors is irritation, leading to lots of cell division.

4. Ill-Fitting Dentures
irritate the gum lining ("gingiva") and trap debris. This can lead to tongue
cancers over time.

5. Betel-Nut Chewing
in Indian populations is strongly associated with tooth loss, mouth and throat
cancer, again the common factor is prolonged irritation.

6. Infections
such as syphilis and some viruses can lead to cancer over time, these cause throat
sores which heal poorly. The constant attempt to heal leads to chronic cell division and thus
more chance for cancer. Viruses can also get into the mouth cells themselves and change the
genes in them to form a cancer cell. This elaborate process is called "oncogene activation".

7. Lowered Immunity
such as from AIDS or transplant anti-rejection drugs will increase the risk for
many cancers, including those of the "aero-digestive tract" (i.e. the area from the nose and
mouth to the lungs and stomach). This will be especially important in combination with the other
risk factors noted above.

8. Precancerous "Plaques"
can develop in the mouth and throat, from chronic irritation. These
may be white in color ("leukoplakia") or red ("erythroplasia") and may or may not become
cancerous. They must be monitored closely.

9. History
of Cancer of the aero-digestive tract can mean as much as 5% chance of a separate
simultaneous cancer, and a 25% chance of developing another cancer in this area over time
(especially if risks like smoking are continued).

A cancer must grow to 1 billion cells to be just 1 cm. (about 1/2) across, so a very early cancer will
have no symptoms and likely go undetected.

And lets not forget endogenous causes!

A) the genotype.
DNA damage will happen regardless of any precautions, this is a fact of life.
Some people have a very efficient DNA repair system, others do not.

B) even if people have efficient repair systems (there are many) that does not guarantee that a damaged DNA in a critical location gets caught in time before it is harmful. It is a chance event and in many ways like russian roulette. All you can do is lower the chances for damage and increase the efficiency of repair systems but the risk will not be zero.

To get an idea for just one type of mutagenic damage. 8-oxoG is a damaged G base that we do not have normally in our DNA. If memory serves my right it was shown that we make and exise gram amounts of this stuff each day. Assume it is just one gram and that each 8-oxoG comes from a damaged DNA segment that means that there were about 10^21 damage events per day. That is 10'000'000 events for each (average) cell/day. These very rough estimate are nevertheless staggering.... and this is just one type of damage!


M

Sorry Don but the fact that your source left HPV out of the equation renders it outdated at best as one can not ignore HPV as a cancer causing agent in as many as 11 different cancers, including H & N and I might be outdated with that number.

David,
HPV is a virus
See item 6
The source lists viruses

Went right past it. I guess I was looking for the letters HPV. My bad.

Don - some of this is not right, and you have to consider what is a KNOWN and proven direct cause, and what is suspected, and what is just urban myth or an old wives tale. You would be surprised at the incorrect information that is on pretty good and reputable web sites. As soon as a site starts making unsubstantiated claims (" Dr. Jonathan Stillwell ( this is the world authority?) and (their site) remains the world's premiere provider of cancer information.") I have a problem with it. Who say cancer answers is the world's premiere provider of information? Typical jargon for someone that has something to sell.

Also this paragraph cut from their site has numbers that are at least 10 years old : Each year in the United States there are about 20,000 new cases of mouth cancer leading to 4,000 deaths annually from this disease. Men are affected twice as often as women. Overall, mouth cancer represents about 3% of all new cancers each year, and it is more common in blacks than whites, and in those of "lower socioeconomic status" (poor people). The average patient is 60 years old.

There is no definitive proof that irritation or trauma causes oral cancer, though it is often cited (poorly fitted dentures which I wrote a really long post on how this is misinterpreted a couple years ago), ditto poor hygiene. Truth be told, the data that exists on that has so much bias in it you wonder how it got published. People with poor hygiene have numerous other issues related to their lifestyle which were not eliminated from the equation. Pre-cancers like leukoplakia are not a CAUSE of oral cancer, they re an intermediate cellular change that is visible in the mouth. Only about 25% of cells in white lesions like these ever progress to dysplasia and cancer. For that matter only 25% of all dysplasias ever progress treated or not. Infections in oral cancers are not tied to each other except in viral infections that being HPV. We don't speak to quid, betel nut, etc. since in the US their use is unknown - though they are known causes of oral cancer in third world countries. So you really have to distinguish what is a cause and what is a facilitator, and what is conjecture without strong documentation.

Lastly related to your link. That is a site that is in the business of selling information and more. I would stick to sites that are non commercial like the NCI, CDC, NIH etc. if I wanted to be sure that the information was current and correct.

David - oncogenic HPV is a known and proven cause of what cancers besides oral and cervical?

Brian,

According to what I have read and been told, HPV can cause cancer of the cervix, esophagus, mouth, throat, larynx, tongue, tonsils, rectum, penis and skin.

The list that is currently put out there where there is no disagreement is oral, cervical, anal, and penis,. You have named a couple that are duplications like mouth, tongue, and tonsil, which all get lumped into oral, some of the other's are still in the grey area without definitive proof, and in those not an established major cause.

Never said major, just a cause and I will always defer to your data base as your obviously much more on top of this stuff than I am. My list came from a slide shown to the Fl House by one of the speakers in support of the Gardasil Vaccination Bill in march 2007. The slide credited the American Cancer Society, Cancer facts and figures 2006.

This board is getting very involved, perhaps disproportionately so, in the questions about HPV. The data is changing daily. One site which is very credible is this one. http://www.ashastd.org/HPV/hpv_learn.cfm But note that even with a good organization like this, the data is wrong on their site. there are more than 120 versions of HPV identified not 70, and this is a reputable group. The issue is the data is changing faster than even their web site. Can you imagine what this means for people that are looking at things that can't be quickly updated, that are in print?

ACS (to their credit) have spent lots of money developing position papers on things like the vaccine http://caonline.amcancersoc.org/cgi/content/full/57/1/7 which they have gotten published in highly credible places like the Journal Cancer.

But the take away that I wish for everyone to get here, is that viruses which are known to cause 7 major cancers, are a reality. We have little protection from them until vaccination became possible for some. But we have no viracide. If we could kill viruses, we would eliminate the common cold which is caused by a rhino virus. The amount of research on viruses in the US is mind boggling, and the data changes every day. Oral cancer is part of all that. I have rewritten parts of the OCF web site HPV page 6 times in the last three months. Next month we will put up PDF's on three important new journal articles as it relates to OC. But it is literally changing that fast. For a disease that had almost no changes going on for 50 years, things are really moving quickly now in he world of OC. That means that what we thought we knew is out dated, and many sources that we trust are behind the curve. Because we (OCF) focus on ONE THING ONLY, OC, we can (even with only a small group of volunteers and researchers that we work with) keep as current as possible. The are no days which go by when some part of the web site is not updated or added to. We are spending 15k in the next 60 days to build additional new parts of the web site that do not exist now.

Brian, regarding the statistics about oral cancers attributable to different causes (smoking vs. HPV vs. no known cause), are the sample data for those coming out of Johns-Hopkins along with other places (which I know aren't all that many) which routinely test for HPV when there is no smoking history or--like in David's case--a history of smoking but only decades ago and for a couple of years? I gather not all cccs do this test, especially since it makes no difference in treatment right now.

I'm just wondering about a possible self-selection bias in the sample leading to those percentages because it sure seems to me that there are over 5% of people here on this board that have had oral cancer on the lateral tongue (not a location associated with HPV) and had no or only a distant history (like David's) of drinking/smoking. Most of the peoploe I have met here who fall into that category are women too. And I recall a conversation several of us had (most of whom fit in that description) where we each had a chronic tooth irritation at the site of our cancer before the cancer. It just makes me think that maybe irritation can be a cause for a small group of people and that doesn't come out as a significant factor because it's hiding in the other factors.

It seems to me that the sample of people who go to J-H for treatment may not represent fairly the population of OC population. They draw local folks, and then they draw people who come from afar because of their reputation and rankings in treating OC. Well who can come from afar? Are they more likely to be male (because men, even if they have kids, can usually more easily leave those kids in the mother's care if they go for treatment)? Are they more likely to be younger? To be older?

I don't know, but I guess before I totally by into what percent of the OC population has a disease caused by HPV vs. smoking vs. other unknown things I would want to know that the sample matched the overall population in important demographics. I assume that is an analysis that has been done at some point?

BTW, related to the original question, in terms of my own history, I did smoke for over a decade but I had quit completely for almost a decade when I was diagnosed. I never drank more than a glass of wine or two a week except maybe back in college when, like most college students, I did have a few too many beers from time to time. I think people who ask the question are asking to make themsleves feel safe and I don't think it's an educational moment to tell them "yes, I smoked but I quite a decade before I got the cancer" since that would imply to anyone who does smoke that there is no point in quitting. I bascially find the way people ask that question annoying usually, although I answer honestly. As everyone else has said, it is probably something genetic in my case there as well that caused the cancer (I say this with more certainty since I have had two kinds of cancer in my 40s).

I am quite outspoken about the benefits of the HPV vaccine, however, espeically in this area where there is a lot of distrust of the pharmaceutical industry around this issue.

By the way, right now, I'd be really happy if we could just come up with a viricide for the common cold! I have been up coughing and sniffling for two nights.....

I'm certainly not a trained scientist but when you consider that there are over 200 different kinds of cancer and they know certain things cause some of those cancers, there still must be some basic link that has escaped the best minds out there. (Remember I like things that can fit in boxes.) Tobacco, for an example, has been linked to many cancers but it doesn't cause cancer in everyone and if it does "cause" cancer the person doesn't get all the cancers it's linked to. So why do some that smoke a little get a cancer associated with cancer and why do some that smoke a lot never get any of the forms of cancer related to tobacco. Why if you smoke and you get OC, why don't you also get lung cancer and vice versa? So so many variables to consider yet "we" know tobacco causes cancer. Same with HPV but so far to a lesser extent.

Maybe one day...

David - cancer is a disease that changes things on a genetic level. It is a disease of genetic aberrations. Those can be naturally inherited, caused by an outside toxin like those in tobacco, the air we breathe, what we ingest, industrial chemicals (etc. ad nasueum), caused by radiation, caused by living organisms like viruses. Everyone one of those things begins by altering/damaging the genetic make up of a cell, starting a cascade of further events. You cannot simplify this they way that you want to. Cancer is over 500 individual diseases. Everybody has to accept that it is in your genes as much as it is in your lifestyle choices. That genetic predisposition is something you can't do anything about. That argument should end things for people, because if you can't get there in your mind, you will never come to terms with "WHY ME" which in many cases there are no absolutes for.

Even if you do identify tobacco (as an example) as the cause of your cancer, you have to match that carcinogenic cause with your individual genome and proteome, which make up your uniquely individual predisposition (or protection) to allow the development of cancer to take place. If you can't get you mind around that it is the combination of these two things, one of which you can't know about completely or control, I can see why you don't understand why tobacco is not a cause of cancer in everyone that smokes, HPV16 isn't a cause in everyone that gets it, not everyone that is infected with the human T-cell leukemia virus#1 gets blood cancer, and so on.

And people who smoked for a decade of their life some time in the past have not necessarily rid themselves of the damage done during that period of time just because another decade has past. Yes our bodies repair, and to some extent (individually) recover as times passes and the physical insult diminishes, but it is not like being a never-smoker. You may have caused damages that are now only peripherally associated with the development of a disease, but still make you less than 100%.

We do not fully know the extent to which HPV and many other causes take us to full malignancy when you compare that to what we know about the tobacco process. We have just had a much longer time, and spent more money, to look at tobacco and its mechanisms for being a cause.

I am going to quit talking about all this. It serves no purpose to most of the people that come to the boards, as it does not alter treatments or choices for them. It takes my time from the emails and other things from people that are in the fight. That does not mean that if I read something that is incorrect on these boards I will not challenge it or just delete it as bad information that should be perpetuated.

For those of you who wish to be activists in this battle, particularly as it relates to the new NPV threat, I commend you, but you need to bone up more than you are if you are really going to make solid arguments about things. I suggest that you start here, and get the basics.

We know that all cancers (neoplastic transformations) result from changes (mutations) in genes which control cell behaviors. Mutated genes may result in a cell which grows and proliferates at an uncontrolled rate, is unable to repair DNA damage within itself, or refuses to self destruct or die (apoptosis). It takes more than one mutation to turn a cell cancerous. Specific classes of genes must be mutated several times to result in a neoplastic cell, which then grows in an uncontrolled manner. When a cell does become mutated to this point, it is capable of passing on the mutations to all of its progeny when it divides. Genetic mistakes randomly happen each day in the course of our bodies replacing billions of cells. Besides these random occurrences, genetic errors can be inherited, be caused by viruses, or develop as a result of exposure to chemicals or radiation. Our bodies normally have mechanisms that destroy these abnormal cells. We are now discovering some of the reasons this fails to take place, and cancers occur.

More about the genetics of cancer, this requires study and can't be spoon fed.

http://www.oralcancerfoundation.org/facts/cancer_genetics.htm

http://www.oralcancerfoundation.org/facts/pdf/oncogenes_and_cancer.pdf

Yeah there are many things I can't seem to get to fit in my box world. I still can't seem to get a grip on how our universe got started...I mean what was there before?, much less that it's still expanding....I mean expanding into WHAT? My genetic pool just won't let me get to the other side.

No matter the reasons for getting cancer it is important to remember that no one deserves or should ever blame themselves for having it.

All people have bad habits, so I feel we should remember the words of George Carlin and try to always be sure we are helping one another do it George�s way:

�Don't take guilt trips. Take a trip to the mall, even to the next county; to a foreign country but NOT to where the guilt is.�

I always get asked if my cancer was because of smoking. I did smoke, but for about 2/3 years so the Doctors don't think it caused the cancer. I do feel that sometimes people think "well it serves her right" if I Say that I did smoke. But maybe I'm just paranoid! No one has actually said it to me though.

I don't know what caused my cancer...All I know is that I have it, I want it gone and I don't want it to come back.

Nobody deserves cancer or ill health. And nobody has the right to act like someone deserves a disease because of something they did or didn't do in life. I don't care if someone smokes five packs a day...they don't deserve this terrible disease. If someone thinks this way; then, they are just ignorant and clueless of life and feelings.

We're all going to die...no way around it. I'm fairly sure..99 percent sure that no matter what we do...we will die from cancer, stroke or some kind of heart ailment. Acting like someone deserves the "Big C" is like acting like someone deserves Alzheimer's because they're living too long...

Cancer is just a terrible disease that needs a cure...It seems like I know too many people that have or had cancer in the last few years...Something is wrong...it's just not right.

And HPV..why now? HPV has been around a long long time...is something triggering it in the last 10 years or so?

Raymond

We are all the architects of our own situation many times in life. If it was going to be an easy, cookie cutter trip through it all, we would never learn anything. Life is a journey... Not a guided tour. I can't count the number of bad decisions that I have made in my life, both moral and lifestyle. Now an old fart, I am starting to finally get some of it, but likely most the big picture will likely elude me until the end. You start out as a raw block of stone, and life chips away at you, finally revealing who you are. Were it not for those blows to chip away bits an pieces, what is inside would never be revealed. But while I am a big proponent of learning from mistakes... some never seem to... I am not a big proponent of beating yourself up for choices that you made in the past. It is an exercise in futility, assuming that you learned something and aren't going to do the same thing again. All that is left to us is to learn and move forward. Anything else, unless it is the sharing of that knowledge with others so they don't step in the same holes, is a waste of thought and effort.

There will always be people that think that we got into this because of our own bad decision making. Some of us did to deny that negates the ability to learn from it. But how does that change things today now that the damage is done? In no way that is productive.

Good judgement comes from experience, you are not born with it. Experience comes from bad judgement. It is just part of the path. As to David's comment about his ability to grasp things, I can only say that our knowledge, his,mine, and everyone else's, is evolving. We re all trying to get our minds around new ideas all the time if we really care about our journey, let alone helping others through theirs. David cares or he wouldn't be here. But lack of knowledge of something hardly means that you came from the shallow end of the gene pool. There is a big difference between ignorance and stupidity. I can't count how ignorant I feel everything I am at a cancer conference with the really bright. But I try to absorb as much as possible. We all need to be better tomorrow than we are today. What others think of us and our situation maters not, and those that don't get it don't merit the argument.

Ray as with any etiology, it takes time for things to reach a critical mass where it actually becomes epidemic, a phrase Gillison often uses when talking about HPV. It is a matter of social behaviors combining with a transferable agent (a virus in this case) and mathematical issues that allow a single person to take something and give it to another, who gives it to three more, who give it to 9 more, who give it to 20 more, who give it to a hundred more, until it because so common place that someone pays attention. Some have speculated that the free love era of the 60-70's accelerated something that would have happened anyway over a longer period of time, and we are just born into a slice of that time line. Be thankful you were not born into a time of black plague.... life could always be worse it seems.

I find it interesting how many people will ask "What do they say caused it?", as if our treatment teams were focused on the causation, not fixing the damage and controlling the spread.

The anti-smoking/drinking folks want to hear that as a cause, the Vegans (that would be the vegetabletarianism people, not the aliens from afar) want to hear it was red meat, the Chastity people want to hear it was HPV, and the land-line wired telephone people want to hear it was cell phones, the Goths want to hear it was sunlight, and so on.

S**t happens, be it genetic codes, oral irritations or something unidentified as of yet -- Like AIDS, there may have been some subtle shift in HPV, coupled with the wrong genetic coding, that is causing the spread.

Better minds than mine are working to find answers as to cause, but that may or may not be useful -- How are we going to fix genetic code defects? Will Microsoft be involved in the update process?

Remember, it wasn't all that long ago that we all believed that stomach ulcers were caused by stress and diet, not a virus!

I couldn't agree more. That will be a whole different kind of "code warrior" than those at Microsoft that figures this out.... Couldn't agree with you more about all the different perspectives. The only one that matters is yours. By the by, it was a bacteria not a virus in stomach ulcers -Helicobacter pylori, but the comment is still valid.

I stand corrected -- Bacteria it is!

People are not limited to pointing the finger at tobacco users. When the article http://www.sptimes.com/2007/04/17/Floridian/Clues_to_the_cancer.shtml
appeared in the St Petersburg Times about my HPV connection some of the reader's responses were negative towards what they thought were my personal habits including one that said I deserved what I got.

Pete,

I was told 2 years ago that HPV can lay dormant for decades before causing trouble. That thinking may have changed in that time but I haven't heard if it did.

People's cruelty to others seems to know no bounds. When these things happen I used to lash out, these days I hope for poetic justice instead, probably and equally maladjusted response to it all.

An individual's ability to think and behave like this often stems from two previous mental set ups. One involves a sense of moral or even physical superiority to the objective person. This is seen in racism and and other situations where people find their lot in life superior, I am white you are black (you can substitute tons of variables here that have allowed genocides to occurs for centuries including the ethnic cleansing of "the Indian heathens" from North America), I am a Christian you are not, which has been at the center of untold conflicts like the Crusades. In the worst cases it requires the antagonist to dehumanize others to allow extreme abhorrent behavior, the killing fields of Cambodia, the holocaust.... you are less than human so what I do matters not. While these are all extreme examples, they are all based in believing that someone else is less. Some people cannot live with others who look, think, or behave differently then themselves. Ironically the person with this belief is the one who is less.

It is still believed that there is a dormancy period for HPV like with many other viruses such as HSV1 and 2. But that has not been scientifically proven. This will require finding it in its non active state somewhere like the HSV residing on the ganglion of our nerves when it is not active.

This was also how much of the straight world, including the President, responded to the gay community in the early days of the AIDS epidemic.