Hmnn, got your attention. Just a quick excerpt from the Continuing Medical Education Certification on OPSCC HPV+ Cancer on why Monogamy and Faithfulness are your best bet:
(yea! I even got a certificate from Medscape for getting all the answers right: #39663878)
[quote]For example, in contrast to smoking-related cancers, there is no evidence that dose [ie, the amount of exposure to carcinogens or other risk factors] is important in HPV-positive disease. For smoking-related cancers, the number of cigarettes you smoke, the amount of time that you smoked, and the intensity of smoking all increase the risk of developing a malignancy in the oral cavity. Whereas in HPV-positive HNC, although there is an increased risk with increasing numbers of sexual partners and certain sexual acts, there is no evidence that the number of sexual acts one engages in with the same partner alters the rate of development of HPV -- even if the partner and the affected individual are HPV infected.
[/quote]
Talk about an attention-grabbing headline...:) In our small village of 20,000 people, we know of 6 other families that have faced this same cancer, including a husband and wife couple. She was diagnosed one year after he was...:(
As long as we're on the "S" topic, I have another question...how long, post treatment, until is the patient cleared for close contact? How long until all the crap is pumped into their system is it out, until they are no longer "glowing in the dark"? Yes, after (almost) 25 years of marriage, we were too chicken to ask the doc this question, pathetic, right?
I don't think there's any risk to anyone else if one has undergone normal radiation treatments. If you go under some kind of scan that requires a radioactive contrasting agent they generally tell you to stay away from children and pregnant women for a day or so, although I think that can be longer with certain thyroid scans. But I wouldn't imagine your husband would present any problem to you.
No energy levels and whatnot, that's a different story. Even if I'd had a significant other at the time I wouldn't have been ready for any sort of fun for a good 3 months post-RT.
The elephant in the room, in my mind, is the question of whether or not the rad/chemo treatment for the oral/throat cancer also destroys the HPV-16+ virus and makes it possible to be intimate again post-treatment without concerns about passing the virus to a sexual partner. Also, if the sexual partner of the oral/throat cancer patient is an HPV16+ carrier without symptoms, can the patient treated with rad/chemo have a new oral/throat cancer emerge because of re-infection with the HPV16+ through intimate contact with the carrier-sexual partner? Has anyone seen any data or medical studies addressing this issue?
Al
If you reread my initial post here, it indicates that there isn't any concern about increased cancer between the same sexual partners. The statement that even if both have HPV there is no increased risk implies that there is no increased risk if only one partner has it
I periodically raise the issue of sex, because posters mistakenly think HPV is somehow like HIV or AIDS or even syphilis or gonorrhea. It's not like most sexually transmitted viruses or bacteria, where if one infected person has it, then the partner usually gets the same symptoms and disease. People don't just process syphilis instead both get it and both need to be treated. Instead most people process HPV right out of their system. Don't forget that just having HPV doesn't mean getting cancer.
It's sad to see some posters (not you) in the past try and "blame" their partner for cancer. Unfortunately, it's our own bodies that have betrayed us.
I never heard of any study or scintilla of data remotely suggesting that an oral cancer patient would end up "reinfecting" themselves through a "carrier sexual partner" and causing a recurrence in one or a cancer in the other.
Unless all 8,000 plus OCF members are celibate, if having sex with your monogamous partner whether or not he/she has HPV, caused a recurrence or cancer at all, we would have lots and lots of couples posting here together as cancer patients.
Almost every study done has a lot less than a 16,000 patient data base for it's conclusions. Yet no one such post ever. The closest thing is AnaD's post about a couple in her town, but they could have both been smokers or drinkers and HPV may not be involved at all. Or they both may have had multiple sex partners before settling down so it'd be coincidence not causal.
IMO this is a "pink" or imaginary elephant in the room
Of all the things that have a basis in fact to worry about, sex with your partner is not one of them. With today's tabloid TV shows, you can be sure that if it were, there would be "shocking" interviews and even a reality TV show.
Just like it's hard to find data and studies on unicorns, I don't expect to see such studies or data.
Charm
My wife and I had sex throughout my treatment and of course continue to this day. There was a few weeks during Tx that I was totally unable to hold UP my end of the bargin and I was sure glad when that phase passed!
There is more about the virus that we don't know than there is that we do know.
We do know that by age 50 appx 80% of all females have been exposed to the virus. We don't have that information on males as presently there is no test suitable for males.
We do know that it is passed easily thru sexual contact including possibile French kissing.
We do know that only 4 of over 200 strains of the virus are oncogenic.
We do have a vaccine that can protect both males and females from those strains and if all presexually active boys and girls were vaccinated then we could put an end to over 7 different HPV related cancers.
We do know how the virus converts a normal cell into a cancerous one.
We do know that radiation will kill those HPV+ cancer cells and basically nothing else will.
We do know that HPV+ SCC responds better to traditional oral cancer treatment than HPV- SCC and therefore has a less recurrence probability.
We do think that the virus can lay dormant for decades in the body.
We do know that our immune system regularily clears the viirus from a large % of the population before it goes to the dark side.
We do think that one will reacquire the virus multiple times throughout their sexual lifetime.
We do know that only a very small % of the population will ever have HPV+ SCC.
We don't know why sometimes our immune system doesn't do it's job.
We don't know how to identify someone who has an immune system that is prone to allow this to happen.
We don't know how to effectively boost one's immune systemt to provide the constant protection necessary to prevent HPV from altering our cells.
Ok David, Vince tolerated treatment extremely well, however in this dept, hats off to you! Not to be too indelicate here, but the main body functions we were able to keep going were Vince's eating and pooping, that took all of his energy.
My question about sex was actually not a concern about HPV risks. Early on after diagnosis, the med onc went out of his way to impress upon us that the great majority of adults (80% +) have HPV at some point in their lives. If you're sexually active, the assumption is you've been exposed. He also said that they have no idea why in a very small number of folks, it turns into cancer and that the cancer could have come from an exposure that happened decades ago, in V's teens.
My quesiton was more a treatment related concern about the toxins pumped into my poor husband's body during 600 + hours of chemo, plus contrast from scans, etc. They had us take precautions (i.e. nobody else use his toilet, double flush toilet) We simply assumed that it must take some time for the chemicals to clear from his system, but had no idea how long that was....a week? a month? longer?
Ana
Wow, we had no such restrictions from our doctors. Whew, I'm glad your question is just about sex and not HPV issues since the safety of sex after cancer is pretty straightforward.
My understanding was : Don't swallow or swap any bodily fluids from the chemo patient for about 2 to 5 days after treatment. It's important to remember that there are two totally different elimination rates of chemo: first the actual drug through the kidneys, usually between 48 to 60 hours, then second, for platinum at least, the persistence in blood plasma for much longer but not relevant unless you are into Twilight or True Blood Vampire sex. Sometimes what doctors and institutions don't say is just as important as what they do say. Take a look at this National Cancer Institute piece on sex after TX. Not one word about danger .
NCI Sex after TX You can also do a basic Google search and discover that everybody from the Mayo Clinic to Yahoo Answers point out the problem is that more guys and gals fall into Vince's experience than David's. (Our resident superstud) By the time most guys and gals are feeling up to it, there's no danger at all.
Very similar to heart disease.
Myself, my libido starts dropping midway thru TX, plumments immediately after and then comes back slowly but surely,
Charm
Thank you David and Charm! Very informative and interesting.
Warning: this Post may be TMI (too much information) for the prudish, the bashful , or maybe even the tasteful. Only consenting adults with a erotic sense of humor should read
Ana's post and the NIC summary mention what is usually unmentioned: sex during TX. Just like you use a crutch when you've injured your ankle or leg, or a brace/sling for your arm, consider some assistance during this period. Based on my personal experience, (backed up by Internet porn videos)
Guys are easy: we are just like old Model T Fords, prime the engine and just grab hold of the handle and crank it up. Eventually the engine turns over. (Note: unlike the instructions to the Model T, it is not necessary to use just the left hand and turn to the left in order to avoid having your arm broken). Soon you can resume normal driving
Gals are more complex but here a vibrator is a girl's best friend. The gold standard is the Hitachi Magic Wand, which look big and needs to be plugged in but is magic. Avoid cute nternet substitutions. Bonus, it's sold as a back massager so not embarrasing store or boxes.
Enjoy
Charm
Oh my goodness!!!! I never...
Charm, what do you mean in the previous post when you said "HPV issues since the safety of sex after cancer is pretty straightforward." What do they say about it? Kevin and I never stopped and kissing is a must. Is this dangerous for me?
By the way...just kidding about the first line!! No prudes here.
Kathy
This is so cool! "What You Always Wanted to Know About Oral Cancer Related Sex But Were Afraid to Ask". Answers given in a clear, precise, informative, friendly manner with a little humor thrown in to ease the experience for any who might be a little bashful or prudish. Thank you, Charm and all who participated.
Thank you for the info on the chemical risks Charm. I figured some smart person on here would already know the answer.
Re: the info on the "primer", good lord what have I started! Your "engine tuning" instructions are quite entertaining, particularly those for us women...you have cracked me up...:)
P.S. I reached out tonight by email to the wife of the local couple I referenced earlier, got some info back. I don't know them well, but they heard about my husband, and all things being a small town, reached out to offer support, very nice people. She clarified their situation; he had cancer in '96, hers was in '02. Both non-smokers, only sexual partners each other have ever had. The HPV link wasn't as known back when they were being treated. That said, she's recently gotten curious, will be going back to her records to see if the tumor was HPV tested. To her knowledge, they are the only couple who have both had the same cancer. The only other family ties she's aware of is a mother and son in Georgia.
Kathy
What I meant was that it was straightforward that there is nothing wrong or dangerous about patients and caregivers having sex. Everything I've read or heard says that fear of having sex is not based on facts.
As DavidCPA's post spelled out, the issue of HPV has lots of unknowns and so can't be characterized as "straightforward".
As I tried to make clear in this thread, there is no indication that sex between the caregiver and the patient in a monagamous relationship causes cancer regardless of the HPV status of those two partners. I hope you and Kevin set the sheets on fire forever.
Charm
Ana,
I doubt any HPV testing was done as the scientific community has just recently (within the last 6 or so years) has started testing OC slides for the presence of the virus.
Thanks David, I didn't know the timeframe on the HPV connection, I'll let her know as well. Thanks, Ana
Charm....trying! He gets home from a 4 week hitch in Alaska tomorrow!!!!
;o)