[Question #5471] HPV and other cancers

22 months ago
Hello doctors,

I have a sexual history of HPV-16, and it appears to be persistent for the last several years, if not longer.  A girlfriend 8 years ago had an abnormal pap that later cleared (unknown which HPV strain), and my last two girlfriends over the last several years have gotten abnormal paps from HPV-16.  It's unclear whether I gave the first girlfriend the virus or not, but either way, I have been exposed to HPV-16 and it is a still-persisting infection.

I know that it is possible that it will go away, and also possible that it will not. However, the more I read about HPV's association with other cancers, the more scared I'm becoming. It's bad enough knowing that I have a drastically higher risk of oropharangeal, penile, and anal cancer now, but it appears that there are now scientific studies showing strong correlations being between HPV and Lung, Prostate, Bladder, and Breast cancers as well, in addition to male infertility.  To make it worse, traditional alcohol-based hand sanitizers don't seem to kill HPV, so I feel as though every place HPV could infect my body, it has.

I feel like a ticking cancer time bomb, and that it is only a matter of time before I get one, or possibly several, hpv-related cancers.  When you consider how many people get prostate, bladder, lung, and breast cancer, in addition to all of the typical cancers we think of HPV causing, it feels like getting HPV 16, particularly if it is persistent,  almost guarantees a future cancer diagnosis.

I'm in a very dark place right now, not only because my infection is persistent and may never leave me, but because I feel as though my whole body is riddled with this cancer-causing agent that there's nothing I can do about.

Is there anything I can do about this? Is there any hope in recent studies for a cure for HPV from those already infected? Is there any lifestyle change that promotes clearance of the virus?

Please help, I feel lost.
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Welcome to our Forum.  You are in a dark place, darker than is appropriate with respect to HPV.  I'll do my bet to help.

A little bit of additional information would be helpful.  Are you a male (your screen name could be either gender?).  How old are you?  How do you know that you have HPV 16 and how do you know that it is persistent?  Have you had the HPV vaccine? The answers to these questions will help me to answer your questions.  

Now for a bit of general information to get things going.  My sense is that you may have misinterpreted what you have been reading, perhaps on the internet.  First, about HPV. There are over 100 different HPV types.  One of the scientifically interesting things about them is that they all display a quality called "tropism", meaning that different types of HPV have a predilection to infect different types of tissues.  The types that infect the genitals and other mucosal sites rarely infect other parts of the body. Thus, the types of HPV that cause skin cancer for instance are different from the HPV types that cause genital tract infections and cancer.  

Second there data that genital tract HPVs as associated with cancers of the lung, prostate, bladder and breast are shaky and should be discounted.  Did you hear this off the internet- much of what is there is taken out of context. out of date, or just plain wrong and it can be difficult o determine fact from fancy there.  I strongly advise all of our clients to stay off of the internet.

Finally, HPV and the cancers is does cause- i.e. genital tract, rectal and oral cancers.  HPV is widespread and HPV 16 is amongst the most common HPV types.  Over 80% of sexually active, non-vaccinated persons will have HPV at some time, thus that your prior sexual partners may have HPV is not unusual- in fact it is the norm.  Of these, less than 1% will go on to cancer an in nearly all of those, regular reproductive health check-ups will detect pre-cancerous changes early and let them be treated easily and effectively.  The other 99% of HPV infections will cause no have and go away over time on their own. 

I hope that these initial statements will help. You have up to two follow-up questions with which we can continue this exchange.  Please answer my questions first and try to be specific in your follow-up questions.  In addition, I would urge you to review other HPV-related posted on our site.  There are many and I suspect that review of them may help to answer some of your questions or confirm what I have said above.  EWH
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22 months ago
Thank you for your reply - let me give you some further info.

I'm 33 and Male, not vaccinated.  A year ago a girlfriend was diagnosed with a mildly abnormal pap from HPV-16.  I obviously had been exposed to it as well.

A more recent girlfriend just went in for her annual obgyn visit and they found more abnormal cells on her cervix.  While they aren't 100% certain to be from me, it seems highly likely.  I'm also uncircumcised, which I know increases the likelihood that my infection will persist.  I don't know if it has persisted since my 20s when a different woman I was dating was diagnosed with hpv, or if it is from my girlfriend from last year, but it seems highly likely that it has not cleared, which means it may never.

As for the studies I read on other cancers, two were meta-analysis of all studies that looked at hpv in relation to lung, bladder, and prostate cancer.  While none of them concluded that HPV did absolutely cause those cancers, they did show a significant positive correlation between tissue from those organs infected with hpv and the development of cancer.  These articles had been reviewed and published, so they at least have a little merit, I would think.

I get routine throat examinations as part of my dental appointments and see an ENT once a year, but there isn't much else I can do to get screened, and men to my knowledge can't be treated or tested.  It seems like beyond that...all I can do is wait and hope.
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
I have to argue with you about assuming that the detection of HPV/abnormal PAPs in your girlfriends was due to you.  Odds are that both women had prior partners.  To assume that you gave infection to one or both is most unlikely. Further, just in case it matters, typically it takes months between exposure/detection of infection and progression to abnormal PAP smears. Since both women are under care, they will be fine.  For you to blame yourself is faulty thinking.  Similarly, while you were almost certainly exposed, that is really of no consequence.  If you read some of the other HPV-related posts on this forum, that should be evident.  

Again, there is no good evidence that your infection, IF you rare infected, will persist and even less likelihood that it will progress.  If it does, there will be visible changes which you can have dealt with by a dermatologist with little consequence.  

The meta analyses that you saw, described associations which are far from causal.  It sounds like the authors were cautious in their conclusions and your conclusion is quite different from those of us who have studied the infection and read hundreds of articles.  There is much misinformation in the medical literature and it should read with caution.  Just because something was published in a peer reviewed journal does not mean it is high quality research or correct.  

I urge you not to worry.  Read more on this site and the ASHA HPV website.  I think you are more worried than is warranted.  EWH
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22 months ago
Thank you again for your reply.  I have a few follow-up questions.

I know that HPV-16 (specifically 16) is very common.  Do you have any estimate on how many people are exposed throughout their lifetime?  Maybe 5% or less?  Of those people, how many infections would you guess persist to the point of cancer?  It just feels like when you add up the number if people who get hpv related cancers, the likelihood of getting one seems very high with a persistent infection.

I know that HPV can spread from one part of the body to another, even from objects, sex toys, or other things.  Should I just assume that everywhere on my body that could have the infection, likely does due to normal sexual activity, showering, etc?

Is there any way you're aware of that can prompt the body to fight off the infection if it is persisting?

Thank you again for your reply and expertise.
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
 Once again, you are either making improper assumptions or being misled by the Internet. 

.Conservatively, over 50% of sexually active Americans who have not been vaccinated will acquire HPV 16. Of those a fraction of 1% will go on to develop cancer.   The likelihood of you being infected and going on to develop cancer is minuscule. 

 Another misperception. You do not even know you have HPV 16. If you do,  HPV does not spread from one place on a persons body to another and  the infection is certainly limited to your genital tract or other mucosal surfaces. Your statement that HPV 16 is "everywhere" on your body is categorically.  If you had read other posts on this forum you would know that we see no reason to change or curtail your normal sexual activity going forward.

 The immune system already does a fabulous job of controlling HPV infection in nearly everyone who is infected. Once again you are worrying inappropriately. 

 This is my third response to your questions. As you know we provide up to three responses to each question. In addition we reserve the right to delete and not answer repetitive, anxiety driven questions without return of your posting fee.  Once again I strongly recommend that you educate yourself with facts about HPV by reviewing other posts on this forum or the website by the American sexual health Association. There will be no further answers as part of this thread. I wish you luck.EWH
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