Cancer from oral sex? Douglas sparks debate
A report that actor Michael Douglas blamed oral sex with women for his throat cancer has sparked a medical debate.
For many years, smoking and drinking were considered the dominant risk factors for cancers of the throat. But on Monday, The Guardian, a British newspaper, reported that Douglas believed his throat cancer was caused by an infection acquired during oral sex, highlighting a trend that has alarmed many scientists.
Douglas, 68, yesterday denied the story. But The Guardian stuck to its guns and posted an audio clip of the interview
on its website, insisting that Douglas had been referring to his own cancer being caused by cunnilingus.
Douglas had previously speculated that years of smoking and drinking played a role in his disease, and his spokesman later said that although the actor had discussed oral sex’s link to cancer, he did not say it was the cause of his own cancer.
But The Guardian quoted Douglas as saying, “Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes from cunnilingus.”
Indeed, in recent years scientists have documented a steep rise in throat cancers caused by a strain of HPV that can be transmitted through oral sex. The virus, human papillomavirus Type 16, also causes many cases of cervical cancer in women.
In the 1980s, only a small number of throat cancers were linked to HPV infection. Historically, patients who developed the disease were in their 70s and were heavy smokers and drinkers.
Now, about 70 percent of all throat cancers are caused by HPV, up from roughly 15 percent three decades ago. Patients are now more frequently middle-aged husbands and fathers who are economically well off, nonsmokers and not particularly heavy drinkers. Men are three times more likely to be diagnosed than women with HPV-related throat cancer.
There are many strains of HPV, and the virus is so common that at some point most sexually active adults are exposed to it.
A majority of people fight off the infection and do not develop symptoms. But in a very small number of people chronic infection causes oropharyngeal cancers near the base of the tongue and the area just behind the mouth.
Throat cancers caused by HPV are easier to treat than those caused by tobacco, doctors say. Rates of these cancers are increasing but are still fairly uncommon, striking about 3 in 100,000 people. Studies have not proved that vaccines against HPV prevent throat cancers, but many doctors believe they will.
The cancers typically occur decades after initial infection with HPV, and the diagnosis can raise delicate questions for spouses who wonder how partners were infected and worry that they, too, may contract the virus.
“It is a sexually transmitted virus, so that by itself obviously creates uncomfortable discussions between my patients and their partners,” said Dr. Robert Haddad, the disease center leader of the head and neck oncology program at the Dana-Farber Cancer Institute in Boston.
In 2009, Tony Simotes, 62, learned that he had a tumor in his throat, which was diagnosed as Stage 3 oropharyngeal cancer. Simotes had never been a smoker or a drinker. He and his wife, Lucy, were relieved at first to learn the cancer was HPV- related, because that raised the odds that he could be cured.
“But then I started going through all the motions of what does that mean for me, too?” said Ms. Simotes, 50. “Because this cancer came from a virus, and I may or may not have it.”
She said she had a Pap test that came back negative.
Because both partners had been previously married, they were comfortable discussing the cancer and its cause, said Mr. Simotes, the artistic director and president of Shakespeare & Company in Lenox, Massachusetts.
“We know that we’ve lived pretty full lives until we met each other,” he said. “The reality is that a lot of times people carry the virus and it doesn’t affect them.”
Mr. Simotes underwent chemotherapy and radiation, and his cancer is in remission.
In a study presented last weekend at a conference of the Amercian Society of Clinical Oncology, Haddad and other researchers showed for the first time that the partners of people with throat cancers caused by HPV were not at greater risk of developing oral HPV infections themselves. The study involved more than 200 people followed for about a year.
Haddad said the findings suggest that spouses and longtime partners do not need to take special precautions or change their sexual behavior.
Douglas denies blaming oral sex
In Los Angeles, Douglas’ spokesman Allen Burry said the “Fatal Attraction” star had discussed the link between oral cancers and oral sex, among
other risk factors, but was not referring to his own specific case.
“Michael did not say cunnilingus was the cause of his cancer,” Burry told AFP.
“He certainly discussed oral sex in the article, and oral sex is a suspected cause of certain oral cancers, as the doctors in the article did point out. But he did not say this was the specific cause of his personal cancer.”
In the newspaper interview Douglas, who stars in the justreleased biopic of flamboyant entertainer Liberace, “Behind The Candelabra,” said his cancer was caused by HPV.
According to the audio clip, the Guardian journalist asked him: Do you feel, in hindsight, that you overloaded your system? Overloaded your system with drugs, smoking, drink?
“Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus,” Douglas replied.
Douglas’ spokesman said the actor was talking in general, not personal, terms. “This is not the cause of his cancer,” he said.
A spokesman for Guardian News & Media noted that Burry “has claimed that the actor did not say in an interview with the Guardian that his particular cancer was caused by cunnilingus.
“We have posted the relevant audio and transcript to prove that he did,” he said.
“The Guardian firmly denies this charge of misrepresentation. Mr. Burry was not present at the (interview); the only two people present were Mr. Douglas and the Guardian writer, Xan Brooks,” the paper noted online.
Burry, who did not immediately respond to request for further comment after the audio clip was posted, said earlier that he had not sought a correction from the British newspaper.
“I’m not asking the Guardian to do anything, I think they did enough already,” he said.
The two-time Oscar winner revealed in 2010 that he was battling with stage-four cancer, but beat the disease thanks to a grueling regime of chemotherapy and radiotherapy.
“I have to check in regularly – now it’s every six months – but I’m more than two years clear,” he told the Guardian. “And with this kind of cancer, 95 percent of the time it doesn’t come back.”
Research studies from Malmo University’s Faculty of Odontology and in The New England Journal of Medicine both suggest a correlation between oral sex and throat cancer.
HPV infection is also the cause of 99 percent of cases of cervical cancer, according to studies cited by Britain’s National Health Service (NHS).
Douglas’ wife, Oscar-winner Catherine Zeta-Jones, in April received further treatment for bipolar disorder.
The Welsh actress, 43, won an Academy Award in 2003 for her supporting role in “Chicago” and has appeared in films such as “Traffic” and “Ocean’s Twelve.”
– New York Times, AFP