[Question #556] Anal Hpv

44 months ago
Hi dr!! 
This is my second time here and thanks to Dr. Hunter for answerd me before!
I been dealing with hpv like for a year now and still can't cope with this make so ashame of my self, down, sad, depressed and the worse feeling it's to find out how ignorant I was that never new about this virus before, I know is easy to say not to worry that 80% of the population have this but it's not I guess it should be more info about this out there!
Anyways I start with cin 1 then ascus and I guess with all the anxiety and stress I have due to this it went to cin 1 and 2 in a few months I had a leep done in November which my dr said it's came back with clear margins. I am ready to do my 3 months pap and of course my anxiety levels it's in high again, i mention here before my concern about oral hpv cause I was having some issues, luckily my dna test came back hpv 16 or 18 negative. 
I also have an anal pap and came back positive I am so scared about this here are my question??
Do are going to be dealing with this my whole life going to Drs and Drs, test and test?! Now I am not just worrie about cc also I am worrie about anal cancer as well, every day I wake up this is the first thing that comes to my head I can't stop thinking I feel like I am not living and enjoying my life the way I did before!
What's the chance of getting anal cancer from this?
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Welcome back to our Forum.  I tried to go back and see your earlier interaction with Dr. Handsfield to provide context for answering this question and was unable to find it.  That said, Dr. Handsfield and I work closely together and have done so for years and while our verbal styles may vary, we always agree on the basics of our advice. 

That said, let me start by urging you to continue to work through your shame and depression related to your infection.  As you point out, the infections are extremely common and rarely cause lasting damage/harm to those how are infected.  Further, let me also point out that there are few infections of any sort in which knowledge has increased so much so fact.  30 years ago some still questions the role of HPV in causing abnormal PAP smears and cancer.  Since then we have learned much, a vaccine has been developed and and knowledge continues to rapidly accrue. As a result, to beat yourself, or even your past doctors up about this topic and lack of knowledge about it is not productive- the knowledge still continues to come forward very quickly.  HPV is nothing to be ashamed about.  We just need to address the problem and move forward. 

As for anal HPV, there is even less know about this infection than for genital infections.  Like genital infections, anal infections are VERY common and only a tiny proportion of them go on to lead to anal cancer.  We also know that the rates of anal cancer in women are 50% lower in women than they are in men who have sex with other men. How to best manage them is less clear than for genital infections and is a major topic of ongoing research conducted by the NIH which will take a few more years to provide guidance.  Like genital infections however, anal infections most often nearly all resolve without therapy.  Whether or not or how often anal infections should be followed with regular anal pap smears in unclear and no authoritative agency such as the CDC recommend routine anal pap smears at this time.  Treatment approaches vary greatly and none are proven.  My advice would be to repeat your anal HPV test in 6  months or a year. If it remains positive, you may want your doctor to refer you to a proctologist for further evaluation.  the chance of this going on to cancer however, is certainly less than a fraction of 1%.

I hope these comments are helpful.  EWH

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44 months ago
Thanks for your respond Dr. Hook!
I always try to read your and Dr. Haunter post to feel better. I completely understand your point of view and it's easy for the Drs to say this is is so normal don't worry about it but it's impossible or almost impossible not to and of course it's something that we can not talk with anybody cause I am afraid of people judging, I was a unlucky one I guess after 16 years of been married I divorce I had a relation with somebody just a few months later y discover I have this of course I feel like it's my fault I could it prevents but I didn't have any clue about this! 
My post before it was also about oral hpv cause I don't know if the anxiety I have but I have never have some many health issues until I got hpv.  Hera are a few questions:
How about if I don't clean the hpv virus  in my cervix and my anus?
That means I also have oral hpv? 
I am so afraid even to have a drink cause they said that affect ur immune sistem, I have read some histories in the page Inspire and really make me nervous all the stories there! I just so overwhelming and sad with all this maybe I am taking this to the extreme but I am so scared!! 
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

It is clear from your post that your worries about HPV are effecting you and your life.  That is not healthy.  The facts are the facts- virtually all sexually active persons, even those with one partner will have HPV.  If this does not help and you still feel guilt and shame, I urge you to do two very important things - stop searching the internet for information as it will often mislead you and, secondly, consider speaking with a counselor or mental health professional about your persistent guilt.  As professionals they much keep your information confidential and their perspectives may help you to work through your concerns,  Now to your questions:

How about if I don't clean the hpv virus  in my cervix and my anus?
Even if you do not clear your HPV, you can be fine.  Regular check ups including PAP smears for women will detect pre-cancerous lesions BEFORE they progress to cancer and dangerous consequences.  These infections, on those rare occasions when they progress, do so slowly, over a period of year.s.

That means I also have oral hpv? 
That you have cervical and anal HPV does not mean that you have oral HPV.  Oral HPV is only about 1/4 as common as genital HPV.  Even if you do, it progresses to cancer only rarely and again. probably less commonly than genital infections.  If you were to develop a problem, your detist would likely note it.

I am so afraid even to have a drink cause they said that affect ur immune sistem,
Unless you are having cancer chemotherapy or have a SERIOUS illness which might effect your immunity like HIV.

The most important advice I have provided you however is what I said earlier- you are worrying too much and need help in working through this. EWH
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