Vac­cine may cut HPV in­fec­tions, an oral cancer risk, in men

The Hamilton Spectator - - HEALTH - MAR­I­LYNN MAR­CHIONE

The HPV vac­cine that helps pre­vent cer­vi­cal cancer in women also might lower the risk in young men of oral in­fec­tions that can cause mouth and throat can­cers, a new study finds.

These can­cers are ris­ing fast, es­pe­cially in men, and re­search sug­gests that HPV, the hu­man pa­pil­lo­mavirus, is spread­ing through oral sex. The ac­tor Michael Dou­glas brought at­ten­tion to this risk sev­eral years ago when he blamed his cancer on it.

This is the first study of whether the vac­cine might pre­vent oral HPV in­fec­tions in young men, and the re­sults sug­gest it can. No men who had re­ceived at least one dose were later found to have in­fec­tions of HPV strains linked to cancer, but more than 2 per cent of un­vac­ci­nated men had them.

“There may be ad­di­tional ben­e­fits to vac­ci­nat­ing your son or daugh­ter” be­sides the prob­lems the vac­cine al­ready is known to pre­vent, said Dr. Maura Gil­li­son of the Univer­sity of Texas MD An­der­son Cancer Cen­ter.

Re­sults were re­leased Wed­nes­day by the Amer­i­can So­ci­ety of Clin­i­cal On­col­ogy. THE VIRUS HPV is very com­mon — most sex­u­ally ac­tive peo­ple have been ex­posed to it. Some types cause gen­i­tal warts. Usu­ally, the virus causes no symp­toms and goes away, but some peo­ple de­velop long-last­ing in­fec­tions of strains that can cause cancer.

The vac­cine was ap­proved in 2006 to pre­vent cer­vi­cal can­cers in women, and later, for some others in­clud­ing anal cancer in men. But ac­cep­tance has been slow — only about half of those el­i­gi­ble are get­ting it now, ac­cord­ing to the lat­est in­for­ma­tion.

Now, aware­ness is grow­ing of HPV’s other risks — oral in­fec­tions are blamed for 70 per cent of can­cers in the mouth and back of the throat. Rates are ris­ing 5 per cent per year. They’re four times more com­mon in men than women.

There are now more mouth and throat can­cers caused by HPV in the U.S. each year than there are cer­vi­cal can­cers.

Oral sex is the main risk fac­tor for get­ting an HPV in­fec­tion in the mouth or throat, Gil­li­son said. THE STUDY She led the study, funded by the Na­tional Cancer In­sti­tute, while pre­vi­ously at Ohio State Univer­sity. Re­searchers in­ter­viewed 2,627 men and women ages 18 to 33 years in a na­tional health study from 2011 to 2014 about whether they had been vac­ci­nated, and tested oral rinse sam­ples from them for HPV.

In­fec­tions with wor­ri­some HPV strains were found in far fewer peo­ple who had re­ceived any shots — an 88 per cent lower risk. The re­sults in men were strik­ing — no in­fec­tions in the vac­ci­nated group ver­sus 2.13 per cent of the others. The study was ob­ser­va­tional, so it can’t prove the vac­cine was re­spon­si­ble. But it may no longer be eth­i­cal to do an ex­per­i­ment where one group gets no vac­cine, be­cause its ben­e­fits for pre­vent­ing other can­cers are known. It might be pos­si­ble to do such a study in peo­ple over 26, the age limit now for HPV vac­ci­na­tion, Gil­li­son said. If a ben­e­fit were shown, it might lead to ex­pand­ing the group for whom the vac­cine is rec­om­mended. WHAT PA­TIENTS SAY Tom Jack­son had an HPV-re­lated ton­sil cancer, found in 2013, and works to fight stigma over an in­fec­tion that is largely sex­u­ally spread. As a school board trustee in Hous­ton, “I be­lieve strongly that all chil­dren should re­ceive all vac­ci­na­tions,” Jack­son said. “The hor­ror of HPV cancer is tremen­dous,” and not to be “white­washed” by squeamish­ness or re­luc­tance to dis­cuss preven­tion, he said. THE VAC­CINES The vac­cines are rec­om­mended for young peo­ple, ideally be­fore they’re ex­posed to HPV. Merck’s Gar­dasil is ap­proved in the U.S. for fe­males 9 through 26 to pre­vent cer­vi­cal, vul­var, vagi­nal and anal can­cers and gen­i­tal warts. For males ages 9 through 26, it’s ap­proved for pre­vent­ing anal cancer and gen­i­tal warts. A newer ver­sion of Gar­dasil that in­cludes more HPV virus types is ap­proved for males 9 through 15. Glax­o­SmithK­line’s Cer­varix vac­cine is ap­proved for fe­males 9 through 25 to pre­vent cer­vi­cal cancer. All re­quire two or three shots, depend­ing on age. Other ways to help pre­vent oral HPV in­fec­tions are lim­it­ing the num­ber of sex part­ners and not smok­ing. Con­doms or den­tal dams may help.

Signs and symp­toms of mouth and throat can­cers may in­clude a long-last­ing sore throat, ear­aches, hoarse­ness, en­larged lymph nodes and pain when swal­low­ing.

JOHN L. MONE, THE AS­SO­CI­ATED PRESS

Tom Jack­son, 65, of Hous­ton, shows where he first no­ticed a tu­mour re­lated to his HPV-re­lated ton­sil cancer.

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