Third Base Gets Short-Stopped

new research links HPV to throat cancer

by by Maggie Lange

An STD that goes straight for the throat: the human papillomavirus (HPV) is found to be responsible for 60 percent of throat cancer cases, according to Johns Hopkins Kimmel Cancer Center. Oropharyngeal cancer (throat, tongue, and tonsil) was thought to be exclusively caused by drinking and smoking. Now, John Hopkins research reveals that HPV causes more oropharyngeal cancer cases than tobacco and alcohol. Throat cancer is also fatal, killing about 12,500 per year. That’s 7,500 deaths each year caused by sexually transmitted throat cancer.

Up until now, HPV has been mostly known for its connection to cervical cancer. Roughly 20 million Americans are currently infected with HPV, according to the Center for Disease Control, with 6.2 million new infections
each year. Every year also sees approximately 11,000 new cervical cancer cases, according to the National Cancer Institute. Most women’s immune systems clear the virus naturally; however, if the virus doesn’t clear, it can percolate, robbing women of their fertility and sometimes their lives. Now, it’s clear that 60 percent of men are susceptible as well—HPV can lead to genital warts, throat cancer, and penile cancer. Although HPV-related cancer in men is much less common than in women, it is just as disabling.

According to Dr. Carolyn Nemec with the Cleveland Clinic, “HPV causes half of HPV-linked penile cancer globally. Although penile cancer is rare, approximately 7,000 cases could be prevented annually.” 

At this rate, about half of sexually active men and women will get an HPV infection at some point in their lives, making HPV the most common sexually transmitted virus of our time. Naomi Ninneman, a health specialist at Brown Medical School, confirmed, “HPV has been the fastest growing infection in college students.”

Ninneman also noted that while HPV doesn’t have a gender bias (as was once believed), it does have an age skew. Most reported cases of throat cancer associated with HPV are from the teen-and-20-something generation. As of yet, there is no test to determine if someone has
oral HPV; regular dentist appointments are the most important in oropharyngeal cancer prevention. More shocking, though, is that there is still no approved test for detecting HPV in men. This means that men cannot know if they are HPV carriers, or if they are at risk of HPV-caused penile or throat cancer.

The good news? Oral cancer is extremely rare, and most people with oral HPV will not get cancer. However—for the unfortunate minority—oral cancer is vicious. According to the American Dental Association, oropharyngeal cancer kills about half the people who get it within the first five years of diagnosis. Still, throat cancer linked with HPV responds much better to treatment than throat cancer caused by smoking or drinking, according to University of Michigan researchers.

Since 2006, the FDA has campaigned for young women to get the Garadsil Vaccine to fend off the virus. Responding to recent findings, the drug is now recommended for men as well as women. Nemec explained, “On September 9th, a Food and Drug Administration panel voted that the vaccine is safe and effective for blocking HPV in males of the same age as the women it is recommended for, ages nine to 26.” While these recommendations come from an advisory committee, “the FDA usually follows the group’s guidance.” The preventative vaccine for HPV, Garda-sil, protects against four types of the human papillomavirus—two of those responsible for cervical, penile, and throat cancer. While Gardasil is not completely effective, it does lead to a 90 percent reduction in disease. Despite these statistics, Nemec says that men ages nine to 26 won’t be scrambling to line up for three semi-painful shots at $130 a pop: “While an approval could theoretically double the market for Gardasil, experts don’t see a run on the vaccine.” The threat of two fairly uncommon cancers might not be enough to lure them.

It’s also unclear why there was such a delay in approving a vaccine for men, as the vaccine has no negative side effects for either sex. Monetary concerns of the pharmaceutical industry might have caused the delay. Nemec explains that, Merck, which owns Garadsil, “was probably interested in making the most dollars out of the research effort. So focusing on women made sense to them financially. Many more women will get the vaccine to stop cancer than will men. It’s just not as immediate a concern to men.”

Nemec also suspects a gender bias: “I believe that the immediate concern was to directly halt HPV in women and HPV causes cervical cancer—a very prevalent cancer in women. Penile cancer in men is much less common. It is a valid point though—women contract HPV from men.” It’s unclear whether the FDA prioritized women because cervical cancer is more prevalent, or if was continuing a trend of gender inequality—exemplified by the delays on the development of men’s birth control (see Rebekah Bergman’s “40 Barren Years,” September 24). Although the harm caused to men might be minimal, they are carriers of the disease—putting their partners’ health in jeopardy. This delay in approval clashes against logical sexual protection policies of defending both partners.

MAGGIE LANGE B’11 never understood baseball metaphors.