[Question #5000] HPV

25 months ago
I’m a 37 year old male. I’ve had a past girlfriend who had HPV.  I always performed oral sex on her.  Can you please elaborate on my risks for oral
HPV; and if I am at an increased risk for oral cancer?  Are there any signs/symptoms that can warn me that I have this? Is there anything I can do to prevent it?

I don’t know if this matters or increases my risk for oral cancer but I have already had melanoma and a 4 millimeter nodule was just found on my left lung that the doctors are just “monitoring” for now to see if it goes. 

As always your expertise is appreciated. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
25 months ago
Welcome to the forum. Thanks for your question.

With the media attention to throat cancer and HPV over the past few years, there have been many questions like yours. I'll answer your questions succinctly, but please also read thread no. 3163; and then use the forum's search function and enter "oral HPV"; you'll find many disucssions with still more detail. 3163 also contains a link to American Cancer 
Association data on cancer frequencies, showing how uncommon pharyngeal (throat) cancer is compared with other common cancers like lung, prostate, colon, breast, etc.

In general, it is possible that people who perform oral sex more frequently, or on multiple partners, are at somewhat higher risk of pharyngeal cancer due to HPV type 16. That's the only HPV type that causes throat cancer. Although many media stores refer to "oral cancer" or "head and neck cancers", there are several types of these malignancies, but only one -- throat cancer -- is caused primarily by HPV. In any case, simply having performed oral sex on any particular partner undoubtedly does not raise the risk. And that risk is very low, even among people who acquire oral HPV16.

As for prevention, the main thing is to have regular dental exams. Most dentists take care to look for abnormal growths and other abnormalies of the pharynx, and the mouth in general; if in doubt, ask you dentist to take a look during your regular dental care (which you should be doing once a year for routine oral health). There are no symptoms other than seeing a growth. In the future, it is possible that some sort of standard screening -- e.g. gargling to produce a specimen for HPV16 testing -- will be done routinely, but at this point there are no data to show this helps in cancer prevention. Even if positive for HPV16, the vast majority to not develop cancer; and there is no treatment for asymptomatic infection. in any case, regardless of your oral sex history, you are at much higher risk for other common cancers like prostate, colon, and others. (40% of deaths are due to cancer, but HPV related throat cancer is a very small proportion of that risk -- see the ACS statistics mentioned above.)

That you have had melanoma and have a lung nodule do not, as far as is known, elevate your risk for throat cancer or any other HPV related malignancy. Obviously you need to continue to follow your doctor's advice about these problems. Compared with them, HPV16 and throat cancer should not be a serious concern for you.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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