When I was first diagnosed with tonsil cancer, I presumed it was because of my history of drinking.
I was wrong.
What I have learned about HPV and oral cancer in the past six weeks is frightening. If you are a parent of a child between the ages of 9 and 12, or if you will ever be a parent of a child between the ages of 9 and 12, PLEASE read on.
I had heard of HPV before; I knew it was linked to nearly all cases of cervical cancer in women. I knew a vaccine existed (Gardasil is the one I had heard of) but that there was some controversy surrounding the recommendation to vaccinate girls as young as 9, because it is considered a sexually transmitted disease.
I filed all this information away in my head, and resolved to talk to Greta's pediatrician about it when she got a little older. Until my own recent experience, I never would have known that HPV is an issue that effects Finn, too.
Here is what I didn't know: HPV is behind what doctors are calling a "growing epidemic" of oral cancers in young adults - people as young as their 30s and 40s (typically, "lifestyle" induced cancer - oral cancer caused by excessive alcohol or tobacco use - doesn't present until people are in their 50s or 60s). A doctor at Dana Farber in Boston was quoted recently as saying that he is seeing "at least 2 or 3 new cases of HPV+ oral cancers a week."
BOTH men and women (although men make up the majority of the HPV+ oral cancers) are at risk for HPV+ oral cancers, which means that BOTH boys and girls should be vaccinated, and doctors are recommending this as early as age nine, as oral HPV is easily transmitted - from skin to skin contact. It is said that it will become known as "the kissing disease".
The statistics surrounding HPV are staggering. As many as 24 million Americans are actively infected with HPV at any given time, with an additional 6 million new infections per year. The virus is typically short-lived (up to about a week) and asymptomatic. Most people never know they had it.
By age 50, 80% of women will have been infected with HPV.
Caveat: I am clearly not a medical doctor, so I am relating in layman's terms what I have learned from my team of doctors in the following paragraphs.. obviously consult your own physician for more information about HPV before making any decisions to vaccinate your child.
What makes HPV tricky is that a person is typically infected in his/her teens or early adulthood. The virus is 'live' in a person's system for about a week - this is the ONLY time a person is infectious. After the virus leaves the system, the person is no longer contagious, and is also immune.
However, for a small percentage of people, the virus leaves a remnant behind, at a cellular level. If this remnant becomes entangled (for lack of a better term) with the DNA of healthy cell, thus creating an abnormal cell, then tumors develop. This process can take decades to develop. Most people infected in their teens (or young adulthood) don't develop HPV+ cancers until years down the road, and for oral HPV there isn't a reliable way to test for its presence in your system.
Being HPV+ does not mean you will develop cancer. In fact, the majority of people who are HPV+ will not get cancer because of it. To date, though, it is not known why some people get cancer and some don't.
HPV is relatively simple to find in the cervix, and a check for HPV is routinely done during an annual pap smear. A vaccine for the most dangerous strains of HPV is available for girls (and now boys) starting at age 9, and to date it is the only known weapon against preventing HPV related cancers in the future.
It is not possible, however, to reliably test for the presence of oral HPV, as there are too many 'nooks and crannies' for the virus to hide in.
The bottom line?
PLEASE talk to your child's pediatrician about HPV. This is not just a cervical cancer virus anymore, so mothers of boys - especially because MORE men than women will get HPV+ oral cancers - need to talk about getting their boys vaccinated as well.
Some parents are hesitant to talk to pediatricians about it, or to vaccinate their children, because HPV carries a stigma of being a sexually transmitted disease. Some parents are concerned they are encouraging promiscuous behavior by vaccinating their children at such a young age. I'm here to tell you that a simple first kiss, or other innocent skin-to-skin contact, can also transmit this virus.
As I lie in my immobilization mask with radiation beams aimed at my increasingly sore neck and throat, I think a simple vaccine is a very wise step to take indeed.
For more information about oral cancer, including symptoms, click here.
For more information about HPV and oral cancer, click here.
For more information about the HPV vaccine, click here.