[Question #265] HPV throat cancer

35 months ago
I am 57,  just out of a 30 year marriage.  New boyfriend age 60 has had throat cancer caused by HPV diagnosed 18 months ago.  He went through Chemo, Radiation and finally surgery in December 2014 at the end of the other treatments.  At the present I am not sexually active.  I would like to know if starting a sexual relationship with him will expose me to the HPV.  Both oral and vaginal sex?  It sounds like the virus can go away on its own.  However, with the cancer I'm wondering if his is still there?  Or does the virus do its damage to cause cancer and then be inactive or gone?  I'm worried about starting a new relationship especially with the HPV.  
Thank you,
Mary
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome to the forum. Thanks for your question.

There has been a lot of publicity about HPV in recent years, including media attention to pharyngeal (throat) cancer. However, cancer remains an uncommon outcome of HPV infections; pharyngeal cancer is especially rare (far less common than all the other cancers like breast, colon, lung, prostate, etc); and HPV infections in general are less dangerous than the media attention might imply. The bottom line is that a sexual relationship with your new partner will not risk you getting HPV any more than sex with anyone else, and definitely will not materially raise your risk of pharyngeal cancer. Here are the reasons:

First, it is not likely your partner still has transmissible HPV either in his oral cavity or genital tract. In other words, the answer to your first two questions is that his virus likely is gone by now.

Second, that your prospective partner was diagnosed with HPV or a complication of it does not raise the risk you will be infected any more than any other potential sex partner. Asymptomatic infections that were not diagnosed are far more common in the general population than HPV infections that actually cause symptoms or health problems.

Third, it is possible you have already had HPV 16 yourself, assuming you and/or he have had average sexual experiences, i.e. several different sex partners in your lives Almost all sexualy sexually active people have or have had HPV, and HPV 16 is among the most common types. If you happen to have had it, you are resistant and probably immune to catching it again.

Fourth and most important, even if he still has it and you were to become infected, the chance it will actually cause cancer, pre-cancer, or any health problem is very low. That HPV (almost certainly type 16, by far the main one that causes throat cancer) caused throat cancer in him does not increase the chance if will do so in you. HPV 16 is one the HPV types most likely to cause cancer, but even with this strain, the vast majority of infections remain entirely asymptomatic and never lead to cancer. To be maximally safe, once you start a relationship it might be reasonable for you to resume having pap smears, even though paps generally are no longer recommended at your age. Discuss with your gynecologist, including her recommendations about timing and frequency of testing.

Finally, you could discuss HPV vaccination with your primary care doctor and/or gynecologist. It isn't normally recommended for people over 26 years old, but the vaccine is harmless and might reduce the chance you would acquire HPV 16, if you haven't yet had it unknowingly. It is partly effective a month after the second vaccine injection, but full protection requires a third dose at 6 months. However, personally I would not recommend vaccination to you or to any of my own patients if they had circumstances like yours. The chance it will actually do any good is very low and the cost is high at around $500, perhaps not covered by insurance because of your age.

So my advice is that if you are attracted to this gentleman and the relationship seems promising from a personal and romantic perspective, I strongly advise you go for it! The chance of any problem related to his presumed HPV infection is very low in contrast to the upsides of a new and promising relationship. At least that's how I see it, and how I would proceed personally if somehow I were in your circumstance.

I hope this has helped. Let me know if anything isn't clear.

HHH, MD


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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
In point "Third", he means your former husband. In "Fourth", me means your boyfriend. Sorry for any confusion.

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