This week in The Sex Detective: Michael Douglas inadvertently makes the case for HPV vaccination—for boys and girls.
As a fan of Hollywood gossip, it saddens me that no photos have yet emerged of the moment Catherine Zeta-Jones heard that her hubby, Michael Douglas, had blamed his throat cancer on human papillomavirus (HPV) contracted through oral sex. Being Welsh, like Zeta-Jones, and knowing the white-hot rage my compatriots are primed to fly into at a moment’s notice, I wouldn’t be surprised if her reaction was a catalyst for the hasty clarification rushed out by his PR people, to the effect that Douglas can’t be 100 per cent sure his cancer wasn’t caused by too much drink, or just bad luck, instead.
Still, while Douglas’s foray into the field of sexual carcinogens may have been unwise, he has helped shine a light on a previously underappreciated bedroom danger. While HIV, chlamydia, and that unwelcome new addition to the party, drug-resistant gonorrhea, have been grabbing all the headlines, HPV has been quietly sneaking up.
HPV can already take credit for genital warts, cervical cancer, and 90 per cent of anal cancers. Now it has overtaken smoking and drinking to become the leading cause of throat cancer in people under 50, too. (Actually, if you want to be technical, what we’re talking about here isn’t actually throat cancer, it’s oropharyngeal cancer, which affects the base of the tongue and the tonsils. But oropharyngeal is unpronounceable to anyone who doesn’t make their money wearing surgical scrubs, so: throat cancer.)
“The number of cases is increasing quite rapidly,” says David Palma, a radiation oncologist at the London Health Sciences Centre, where they’re trying out a whizzy new kind of robotic surgery to treat that type of cancer. Palma says that in the 1980s, three out of four throat cancers were caused by smoking and drinking, and the rest by HPV; today, those figures have reversed. “That’s partly because of a decrease in smoking overall in the population,” he says, “but also because of an increase in the rate of oral HPV infection.”
Since you can’t contract HPV from things you put in your mouth, like cups or forks, the increased rate of oral infection comes from one thing—oral sex. It’s really not surprising that we keep giving each other HPV, since the virus is to sexually active people what Tim Hortons is to Canadian street corners. (At any given time, about one in four Canadians under 25 are afflicted.) According to Palma, studies of university-aged students have shown that up to 80 per cent have been exposed to HPV at least once.
Although a 2007 study in the New England Journal of Medicine found that having six or more oral sex partners increased the risk of mouth and throat cancer, Palma says promiscuity isn’t really the issue. “Even though sexual activity is a risk, and the more sexual partners you have, the more the risk goes up, many people who have HPV-related cancers have only had one partner or a limited number of partners. So it doesn’t mean you have to be promiscuous to get this type of cancer.”
In most instances HPV infection is simply eliminated by the body, but in a small number of cases the infection lingers, manifesting itself as cancer years later. Doctors aren’t sure what risk factors cause HPV to become carcinogenic, but they do know that of the 100 or so varieties of the virus, it is HPV number 16 that most often causes trouble.
Luckily, oropharyngeal cancer responds particularly well to treatment. Still, an ounce of prevention is better than a pound of cure and all that, which is why Canada has embarked on a large-scale vaccination drive against HPV.
Although vaccination will protect against HPV-related throat cancer, the program was designed to combat cervical tumours, so in Ontario it is only given free to girls in Grade 8. Some doctors have called for the vaccination program to be extended to include boys, and Alberta’s health department has said it is considering this option.
However, the vaccine is not without its detractors, especially in the States, where bonkers parents vocally fret that the shot will turn their daughters into sex-mad sluts—and Ontario had the lowest rate of uptake in Canada when the vaccine was first rolled out in 2007, coming in well under 50 per cent.
While the vaccine is approved for use in females aged nine to 45 and males aged nine to 26, it works best if it’s taken before you start having sex. So, if you’re reading this, chances are that ship has already sailed. But it’s never too early to start thinking about the health of the next generation.