HPV vac­cine may cut oral can­cer risk in men

Sun Sentinel Broward Edition - - VOICES & OPINION -

The HPV vac­cine that helps pre­vent cer­vi­cal can­cer 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 oralHPVin­fec­tions 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, but­more than 2 per­cent of un­vac­ci­nated men had them.

“There­may be ad­di­tional ben­e­fits to vac­ci­nat­ing your son or daugh­ter” be­sides the prob­lems the vac­cine al­ready is knownto pre­vent, said Dr. Maura Gil­li­son of the Univer­sity of Tex­asMD An­der­son Can­cer Cen­ter.

Re­sults were re­leased Wed­nes­day by the Amer­i­can So­ci­ety of Clin­i­cal On­col­ogy ahead of pre­sen­ta­tion at its an­nual meet­ing next month.

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 per­cent of can­cers in the mouth and back of the throat. About 11,600 of th­ese oc­cur each year in the U.S. and rates are ris­ing 5 per­cent per year. They’re four times­more com­monin men thanwomen.

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. While “oral sex does not give you can­cer,” the in­fec­tion in rare cases can de­velop into can­cer over many years, she ex­plained.

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 forHPV.

In­fec­tions with wor­ri­some HPV strains were found in far fewer peo­ple who had re­ceived any shots — an 88 per­cent lower risk. The re­sults in men were strik­ing — no in­fec­tions in the vac­ci­nated group ver­sus 2.13 per­cent 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 is 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.

The bot­tom line is that the vac­cine helps, and “so few peo­ple who should be get­ting it are,” said Dr. Richard Schilsky, chief med­i­cal of­fi­cer of the on­col­ogy so­ci­ety who had no role in the study.

Scott Courville wishes it ex­isted when hewas young. The 43-year-old con­struc­tion in­spec­tor fromSt. Mart­inville, La., was treated last year for HPV-re­lated ton­sil can­cer that spread to lymph nodes.

“I went through 33 rounds of ra­di­a­tion and six rounds of chemo­ther­apy,” lost 100 pounds, and now has dam­aged taste buds and si­nuses, and con­stant ring­ing in his ears, he said.

His three teenage sons and step­sons are get­ting the vac­cine.

“There was no ques­tion at all” that they would, only how­soon, he said.

Tom Jack­son also 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 are rec­om­mended mostly for young peo­ple, ide­ally be­fore they’re ex­posed toHPV.

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 through26, it’s ap­proved­for pre­vent­ing anal can­cer and gen­i­tal warts. A newer ver­sion of Gar­dasil that in­cludes more HPV virus types is ap­proved for males 9 through 15.

JOHN L. MONE/AP

Tom Jack­son, of Hous­ton, shows where he no­ticed a tu­mor from his HPV-re­lated ton­sil can­cer, found in 2013.

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