Don

I took the article to answer your first question with a resounding No. The way I read it implied that it was males giving females oral sex that causes OC via HPV and not females giving males oral sex especially considering the physical method described. The reference to AIDS scare I took to be when the hetero population learned the Michael Jordan defense: too many women. I put those extracts below with bolded emphasis.
[quote]The virus can be contracted through oral sex when it is lodged in a woman's vagina. The virus then becomes trapped in the soft tissue and tiny pockets of the tonsils and base of tongue, where it gradually can cause cancer.

Men are far more likely to contract HPV-caused tonsil and base-of-tongue cancer. The Centers for Disease Control and Prevention said a study from 1998 to 2003 found men were more than three times as likely to acquire them.

Lydiatt said DNA testing of tonsil and base-of-tongue cancers now reveals the presence of the virus in the majority of those cases. The virus appeared in less than one-quarter of those cases 30 years ago, he said.

Lydiatt said the sexual revolution of the 1960s and the AIDS crisis beginning in the 1980s led to more oral sex, which is mistakenly viewed as safe sex. He said the virus also can probably be transmitted through French kissing.

Dr. Robert Haddad, a head and neck cancer specialist at the Dana-Farber Cancer Institute in Boston, said the link between the virus and cancers of the tonsil and base of tongue is clear.

�We know that the incidence is rising significantly,� Haddad said. He attributed it to sexual behaviors such as oral sex and people having multiple sex partners.
[/quote]
Charm

Charm,

Thanks for this very informative post.

Brian,

In the Globe you said that both you and your wife get tested regularly to see if HPV has returned (or do you mean active). What is the test and how will your behaviors as a couple be affected if the results are positive? Would one have to abstain from sex with their spouse until the next test was negative? I apologize if I am invading your privacy. I don't mean to. I only ask because this topic is thought-provoking and of concern to me.

I understood that the reason younger people (high school) chose oral sex over traditional sex was to avoid pregnancy. Anyway, there is an overwhelming need to educate everyone about OC. Let's keep the candle burning.

Anita

First, Haddad and the other doctor are not virologists, nor experts on HPV. We don't even know the entire life history of the HPV16 virus, so it is pure speculation that you could have a long latency period, or that the virus goes dormant. The absolute truth TODAY is that is speculation and there is no proof that it does or does not behave that way. It is just as likely that since the virus is so common, that you get infected and repeatedly clear it, having periods of activity, and non activity in testing as a result. There are viruses that behave both ways, and what this particular HPV does no one knows. Another misconception is that all people who have been exposed to it will develop a serum antibody that matches it, and that, while it does happen often, is far from an absolute. I have said it many times before here, that we only have been able to culture HPV16 outside a host in the last two years. That should give you an idea how far behind the 8 ball we are on understanding this thing. If you can't examine it and test it in a laboratory environment, learning everything about it can be difficult, and without that ability you have numerous cofounders that make what you find out far from absolute.

I had to laugh at that description of the virus lodging in the folds of the vaginal walls or tonsillar crypt though, that is a sophomoric description of an incredibly complex and elegant organism's behavior. Do they get how small a virus is? Trapped in the folds of tissue? Really? These little guys penetrate cell walls, they don't have to hide in crevices...

Since 30 years ago we were not aware that the HPV16 virus was anything of consequence, we don't have many oral tissue samples (in any significant numbers) that would allow anyone to have a percentage of growth from current peer reviewed published data..... that would only be available in the cervical world, then extrapolated into what is likely to be happening in oral. There is a retrospective study about to be published, and it also has a projection for the next 5-10 years by Gillison et. al. funded partially by OCF, and the future is really staggering bad looking. Yes, it has been ramping up, for some period of time and that is accelerating, it is hardly remaining at 3% per year.

Testing for Ingrid and I is cervical in her, and oral in me. The testing I have done is not available to the public, and is not fun. I don't do it to "watch out" for anything, but for scientific purposes that benefit someone else's knowledge. As to invading my privacy, I have none by design. I have been the poster boy for HPV+ oral cancer on TV and in articles for years. Ingrid used to cringe when I talked about our sex life in public venues, but not anymore, and if people like me are not willing to discuss things openly, then it is hard to advocate for the disease. I wouldn't have chosen to do all this, it chose me. For the record, I have not changed my sexual behavior with my wife in the last 12 years since my OC. It is clear from the many tests that Ingrid's immune system defends well against the virus. Obviously mine does not do a very robust job of things.

I do not think there is a proven scientific reason for the propensity in the numbers for males to get HPV+ oral cancers in far greater numbers than women. I would make a layman's guess that just as men men go south on women as vice versa. Speculation would be that this is a virus that has been infecting women for years, (high reservoir of virally infected females, since it can take a year+ to clear the infection) that environment attracts it (Squamous cells everywhere) and men's penis on the exterior has less of a propensity to harbor the virus. It lives in the urethra which is significantly smaller but lined with squamous cells.

Brian: bravo.
d2

Thanks, Brian.

Brian

OOPs, look like I linked to the Glenn Beck of HPV - sorry.
Out of all the points you make, IMO the fact that you have continued the same love life pre and post cancer is the take away message. Not being cavalier, but unless OCF somehow attracts only robust immune caregivers, I'd expect to see more responses on this thread about - be careful, my spouse had OC and now I have it too.
Seems like an unvoiced fear on some of the threads, one which I think unfounded. Which admittedly is (as you note) pure (impure?)speculation on my part
Charm

After watching many patients on their paths, after reading voraciously every research article that the disease generates for a decade, I have learned that we do not know enough about oral cancers that come from HPV to speak with ABSOLUTE certainty about it. What we do not know is staggering, given how long this virus has been known.

I try to speak factually, and keep my opinions to myself, as the two (and my gut beliefs) do not aways coincide with each other. My opinions are also colored by conversations with experts like Maura who has many clinical impressions from her treatment and research experience. The woman has epiphanies about this that spin off into her research efforts, which so far have been dead on. I am colored by her insights and best guesses, which are just that- guesses, even if educated.

That a patient could pass a virus to another person or mate, who would also have an immune system that did not recognize it as a threat is certainly possible, but the mathematical odds are low, but certainly not zero.

For all those that read my opinions, Please - read them carefully, I try to state what is fact, and if something is my opinion I try to say that also. I can't count the number of times in my life that I have been wrong. I do my best not to spread innuendo, cause fear, or even create unrealistic hope. We learn something new about the oral cancer and HPV situation literally every week. When I know it, I will pass the relevant things on, often in the news section of the web site first.

To add another perspective to this not every woman, who tests positive for HPV will develop cancer and that might translate to OC as well and for all of the reasons that Brian stated in his exceptional posts. It is certainly a very good question however, and being one of those that probably had an HPV induced OC, I do wonder about my wife's risk factor (although since I was simultaneously Dx'd with HCV, HPV is the least of my worries). My doctors can't give me any answers for any of these questions (and believe me, I've asked).

Hi Don

I am going to place my spin on the prevalence of male dominated HPV+ cancer on this forum vs the rest of the country/world. It strikes me that we have more than our fair share of young and non-smoking survivors too and I have put it down to the fact this forum is web-based, therefore attracting a younger crowd less likely to be the stereotypical smoking, drinking oral cancer victim. I hadn't noticed this preponderance of male HPV+ve survivors but will pay attention from now on.

I have also noticed nearly all carers are women - which means their carees are often men (not all the time). Surely there are male carers out there but for some reason this forum doesn't appeal to them (silly buggers).

Re the gay community comment/question: Yes there is an epidemic of HPV+ cancers in gay men. Part of the push for free vaccinations for boys comes from the gay community who are surviving HIV only to be struck down with anal cancer. Anal transmission is not uncommon amongst the gay community and likely overshadows the oral cancer transmission as the most stigmatised of the two.

There is a lot written about this in Australia (although rarely in the mainstream press), maybe because we have an epidemiologist who has taken to riding this as his new high horse.

Well it's a chicken and the egg thing. Obviously women don't infect themselves and now the pap smear, in the US includes an HPV panel. IMHO men or women can be a carrier.

Viruses such as HCV and HPV are in the frontier of modern medicine, I would bet there there are many epedemiologists who find this a subject of great interest.