Canadians and Throat Cancer: Is Oral Sex to Blame?

Oral Sex Linked to Rise in Oral Cancers

Canadians and Throat Cancer: Is Oral Sex to Blame?

What does your sex life have to do with your cancer risk? More than you might realize.

This month, recognized as Oral Cancer Awareness Month, take a few minutes to understand how your sex life may affect your risk of oral cancer.

Although tobacco use and heavy drinking are the main risk factors for oral cancer, in recent years a growing number of cases have been linked to infection with the human papillomavirus (HPV).

HPV is one of the most common sexually transmitted diseases in the United States; it’s estimated that most Americans will be infected at some point during their lives.

Because it usually causes no symptoms, those who are infected may not know they have the virus.

How do you get HPV?

HPV is passed on during sexual activity, through skin-to-skin contact involving the mouth, vagina, vulva (the external female genitalia), penis, anus, or fingers.

When it’s transmitted during oral sex, it can lead to cancers in the oral cavity (inside the mouth) or the oropharynx, which includes the base of the tongue, the soft area just behind the roof of the mouth, and the tonsils.

Your odds of getting HPV are higher if you smoke, most ly due to the effects of smoking on the immune system.

“About 70 to 80 percent of adults in the U.S. population show evidence of current or prior HPV infection,” notes Martin C. Mahoney, M.D., Ph.D., Chair of Roswell Park’s Cancer Prevention & Detection Center.

How many people develop oral cancer as a result of HPV?

The number of HPV-linked cancers of the oropharynx has tripled over the past 20 years. The Centers for Disease Control and Prevention (CDC) reports that about 9,356 men and 2,370 women are diagnosed with HPV-linked oropharyngeal cancers every year.

Those totals are expected to double over the next 10 years.

The CDC notes that those statistics are just part of the picture: “These numbers are cancers in specific areas of the oropharynx and do not include cancers in all areas of the head and neck or oral cavity.”

Oral cancers are caused by specific types of HPV

There are more than 150 types of HPV, each identified by a number, and most do not cause cancer. But about 12 types can cause cancer. One of those, HPV 16 is responsible for almost all cases of cervical cancer and many cases of anal and genital cancer. HPV 16 can also lead to squamous cell oral cancer.

In most cases, the HPV virus clears up on its own, the same way in which a common cold goes away. But in some people, HPV infection can hang on for years, thriving in the warm, moist mucosal tissues found in such places as the genital areas and the mouth and throat.

If it doesn’t clear up on its own, the virus “can change the normal cells and cause dysplasia, or pre-cancer,” explains Peter Frederick, M.D., Director of Minimally Invasive Surgery and Assistant Professor of Gynecologic Oncology at Roswell Park Comprehensive Cancer Center.

“Over time, that dysplasia can change into cancer.”

The period from infection to the development of cancer can take as long as 30 to 40 years. Most people develop oral cancer after age 50.

Who’s at greatest risk?

  • Men are six to seven times more ly than women to develop HPV-linked oral cancers.
  • Risk increases significantly among those who have engaged in oral sex with six or more partners.
  • Even if you have had sex with only one partner, if that person was infected during sex or oral sex with other people, you can acquire HPV (and other sexually transmitted diseases).

Early detection is important

When oral cancer is detected early, the chance of a cure is very good. When it has spread, or metastasized, it is more difficult to treat. If you have any symptoms of oral cancer that do not go away after two weeks, see your doctor promptly.

Symptoms of oral cancer

Symptoms of oral cancer can vary, depending on where the cancer is located. It’s important to remember that these symptoms do not necessarily mean you have cancer; they can be due to other medical conditions. See your doctor if you have:

  • A mouth sore that bleeds or doesn’t heal
  • Red or white patches inside your mouth or the back of your throat
  • A lump or swelling in the mouth or neck
  • A sore throat, or hoarseness that won’t go away
  • Pain in your ears, neck, or throat
  • Trouble chewing or swallowing, or pain in the jaws/tongue
  • Loose teeth, or dentures that no longer fit well

What’s the best defense against oral cancer?

  • Tobacco use increases your risk of oral cancer. If you smoke or use chewing tobacco, quit now. Need help? The New York State Smokers’ Quitline has the tools you need, from nicotine-replacement patches or gum to coaching and other support.
  • Limit your alcohol consumption. Compared with nondrinkers, heavy drinkers have six times the risk of developing oral cancer. The CDC defines heavy drinking as more than two alcoholic beverages per day for a man or more than one for a woman.
  • Remember that your risk of developing HPV-related oral cancer increases if you engage in oral sex, especially if you have many partners. You can decrease that risk by getting the HPV vaccine. 

If you think you are at high risk for oral cancer you may be eligible to participate in Roswell Park’s Early Oral Cancer Detection and Diagnosis Screening Program. For more information, call 716-845-5972.


Michael Douglas statement draws attention to HPV-related throat cancer

Canadians and Throat Cancer: Is Oral Sex to Blame?

Isabel Teotonio Life Reporter

Michael Douglas’s revelation that oral sex caused his throat cancer — a statement later withdrawn by his spokesperson — has drawn attention to the sexually transmitted virus HPV and its link to throat cancer.

In Canada, cases of throat cancer have risen dramatically as a result of an epidemic of HPV (human papilloma virus), say experts.

Michael Douglas cancer cunnilingus transcript

Indeed, the incidence of this cancer has more than doubled since the mid-1990s, says Dr. David Palma, a radiation oncologist at London Health Sciences Centre.

In the 1970s and ’80s, throat cancer was most often seen in males in their 60s and 70s with a history of heavy smoking and drinking. But in the past decade, there has been a rise in throat cancers linked to HPV in younger patients, says Palma.

In the 1980s, he says, one in five throat cancers was caused by HPV. Today four of every five cases are caused by HPV. Moreover, many throat-cancer patients today are in their 40s and 50s and are non-smokers and non-drinkers. These cancers typically take more than 20 years to develop.

Women can also be infected with the virus from performing fellatio. However, three-quarters of those affected are men.

“It’s a huge change,” says Palma, who is currently conducting a clinical trial to see which treatment options give patients with throat cancer the best quality of life. “The rate of HPV-related throat cancer is increasing so quickly that by 2020 it is projected that there will be more HPV-related throat cancers than HPV-related cervical cancers.”

“If the projections hold true there will be a big public-health impact.”

It’s estimated there are between 1,000 and 2,000 Canadians diagnosed with throat cancer each year — up to 80 per cent of them linked to HPV. (Throat cancers related to smoking and drinking are on the decline.)

“This is the fastest-emerging cancer in the developed world,” says Dr. Brian O’Sullivan, who heads up the Head and Neck Oncology Program at the Princess Margaret Cancer Centre. “This has become an epidemic.”

The link between HPV and throat cancer isn’t well known, says Dr. Vinita Dubey, associate medical officer of health at Toronto Public Health (TPH).

But it’s important the public are aware of the risks and protect themselves against the virus because there is no cure and no antibiotics to treat infection, she says.

That’s why on June 14, the TPH will present a report to the Board of Health calling on the province to extend funding for the HPV vaccine to boys. Currently, all girls in Ontario from Grade 8 to 12 have the option of getting the vaccine to protect against cervical cancer.

“Toronto Public Health would to see boys and girls offered the vaccine,” she said. “Boys have a lot to gain from it, and girls have a lot to gain if boys are vaccinated as well.

“This vaccine — because it’s only given to girls — has this sexual stigma attached to it, but as soon as you start giving it to boys and girls it will just become a cancer-prevention vaccine, which is the way it should be seen.”

On Sunday, The Guardian newspaper reported that Michael Douglas was asked whether he regretted years of heavy smoking and drinking. That was presumed to be the cause of the 68-year-olds’s throat cancer when he was diagnosed in August 2010.

But the star of HBO’s Liberace biopic Behind the Candelabra, replied, “No.”

“Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus,” said Douglas.

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After publication of The Guardian story, the actor’s spokesman, Allen Burry, said Douglas does not blame oral sex for his cancer but rather was trying to explain what causes oral cancer.

Either way, the story has people talking about the link between oral sex and throat cancer.

HPV is the most common sexually transmitted infection. About three four Canadians will have at least one infection in their lifetime, according to Toronto Public Health. Often a body’s immune system can fight the infection, but if it doesn’t go away on its own it can progress to cancer.

The virus has been associated with cancer of the cervix, genitals, head and neck, and can also cause genital warts.


Canadians and Throat Cancer: Is Oral Sex to Blame?

Preventing the human papillomavirus is critical for reducing rates of certain cancers.REUTERS/Jessica Rinaldi

This article originally appeared on Medical Daily.

Oral cancer made big headlines in 2013 when actor Michael Douglas blamed his throat cancer on oral sex. The 72-year-old star said he contracted the human papilloma virus (HPV) through oral sex, which triggered his cancer. Douglas' revelation stirred a debate about whether oral cancers, throat cancer and mouth cancer, can be a sexually contracted disease.

More than 3,100 new cases of HPV-associated oral cancers are diagnosed in women and more than 12,600 are diagnosed in men annually in the U.S. In fact, most adults are at risk of contracting HPV, and 80 percent of people will test positive for HPV infection within five years of becoming sexually active. The truth is, most of us have been infected, but few of us are affected.

There are more than 100 strains of HPV, but roughly 15 are known as high-risk HPV types. It's important to note that detecting the HPV virus in a sample of people who have oral cancer doesn't mean that HPV caused the cancer. Rather, the virus becomes part of the genetic material of the cancer cells, which triggers them to grow.

Typically, HPV found in the mouth is sexually transmitted, meaning oral sex is the most common way of contracting the disease. It's not known how common HPV infection in the mouth is, but a recent report released by the Canadian Cancer Society and Public Health Agency of Canada found rates of HPV mouth and throat cancers in males increasing.

A 2011 study in the Journal of Clinical Oncology found that the proportion of oral cancers related to HPV increased from 16.3 percent to 71.7 percent from 1984 to 2004. Previous data presented that same year at the American Association for the Advancement of Science annual meeting proposed HPV was overtaking tobacco as the leading cause of oral cancers in Americans younger than 50.

Meanwhile, risk factors for oral cancers have been linked to sexual behavior, such as ever having oral sex, having oral sex with four or more people in your lifetime, and among men, first having sex at an earlier age (under 18). HPV is so common that nearly all sexually active men and women will get at least one type of HPV at some point in their lives.

“In most cases, the virus goes away and it does not lead to any health problems. There is no certain way to know which people infected with HPV will go on to develop cancer,” says the Centers for Disease Control and Prevention (CDC).

However, when cancer does occur and it's detected early, patients have an 80 to 90 percent survival rate.

This is why early protection against HPV is advised. The CDC and the American Academy of Pediatric srecommends both boys and girls get the HPV vaccine between the ages of 11 and 12. The vaccine is most effective if it's administered before a child becomes sexually active.

HPV vaccines and practicing safe oral sex can help reduce the number of cases of HPV infection in women and men. This will make it less common in the general population, and minimizing the cases of HPV-related cancers in years to come.


Oral sex can cause mouth and throat cancer – and the HPV virus is to blame

Canadians and Throat Cancer: Is Oral Sex to Blame?

IT IS known that smoking and drinking can increase a person's risk of developing cancer of the mouth and throat.

But, another of life's pleasures is contributing to a rise in the disease.

Michael Douglas claimed his throat cancer was caused by performing oral sexCredit: Getty Images

Sex – oral sex to be precise – can also trigger cancer.

And the explanation involves the human papillomavirus (HPV), which is linked to a number of forms of the disease.

In 2013 Michael Douglas hit the headlines when he blamed his throat cancer on oral sex.

The 72-year-old actor said he believed his cancer was triggered by the HPV virus, which he says he contracted after performing oral sex.

While many ridiculed his theory, experts say there is growing evidence to support his claims.

The HPV virus is incredibly common.

In fact, most adults are at risk of contracting HPV, and 80 per cent of people will test positive for HPV infection within five years of becoming sexually active.

The human papilloma virus (HPV) is a very common sexually transmitted disease which affects at least half of people who are sexually activeCredit: Getty Images

The HPV virus has long been linked to cervical cancer, but now doctors in Canada have predicted that the rate of HPV-related mouth and throat cancers in men is poised to surpass the rate of cervical cancer diagnoses in women in the country.

The special report on HPV-associated cancers also revealed that about one third of HPV cancers in Canada are in the mouth and throat.

Earlier this month singer and Loose Women panellist Stacey Solomon revealed she had contracted the HPV virus from an ex-boyfriend.

A 2011 study in the Journal of Clinical Oncology found that the amount of oral cancers related to HPV made a staggering increase from 16.3 per cent to 71.7 per cent in just twenty years between 1984 and 2004.

Previous data presented that same year suggested HPV was overtaking tobacco as the leading cause of oral cancers in Americans under the age of 50.

The HPV vaccine is currently offered to girls aged 12 and 13Credit: Getty Images


According to the NHS, the types of HPV found in the mouth are almost entirely sexually transmitted, so it's ly that oral sex is the primary route of getting them.

Although the HPV virus is incredibly common, there are ways people can protect themselves from contracting the disease.

  • use a condom (even during oral sex). Condoms don't just protect you against unwanted pregnancies, they also go a long way in making sure your sexual health is in ship shape
  • get vaccinated. The HPV vaccine is currently offered to schoolgirls aged 12 and 13 to protect them against cervical cancer. While there is currently no conclusive proof that the vaccine will protect against oral cancer, it is thought ly, because HPV causes mouth, throat and anal cancer in the same way that it causes cervical cancer

Use condoms during oral sex to protect yourself against the HPV virusCredit: Getty Images


There are certain risk factors that increase your chances of developing oral cancer.

Some of the factors can't be helped.

But there are other lifestyle factors that can be changed and improved.

You’re at greater risk of developing oral cancer if you have one or more of the following risk factors:

  • a lot of sexual partners. According to the NHS, the risk of developing the HPV virus increases with the amount of sexual partners a person has in their lifetime. In a recent study, 20 per cent of people with more than 20 sexual partners had an oral HPV infection
  • you smoke any form of tobacco – cigarettes, cigars and pipes, as well as bidis (Indian cigarettes) or hand-rolled cigarettes
  • you drink large quantities of alcohol
  • you have other mouth conditions that affect the cells in your mouth
  • you regularly expose yourself to the sun or ultraviolet (UV) light, as this increases the risk of cancer developing on your lips
  • you have a weakened immune system – people who have HIV/AIDS, or who are taking medicines that weaken their immune system, are more ly to develop mouth cancer
  • you eat a poor diet containing few fruits and vegetables or limited amounts of vitamins A or C

For more information visit the NHS website

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