[Question #86] Non 16/18 but worried about Oral

39 months ago
I had a normal pap but tested positive for HPV on my cervix. My question is could my neck/mouth ect have a different strain that carries cancer? Or since I am not carrying 16/18 should I not be too concerned. I am 43 and freaking out
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Welcome to Ask the Expert. I can help, both with some facts on oral HPV and perhaps also with a perspective on HPV infections and human sexual behavior.

There are several reasons you shouldn't be at all worried about oral HPV. First, only HPV16 causes throat cancer -- other types only with very rare exceptions. Second, even cases caused by HPV16 remain rare: although the frequency has doubled in the past decade or so, there are still only around 12,000 cases per year (last I heard) -- a rare cancer compared with breast, colon, lung, prostate, etc. Finally, even if there were concern about oral infection with other types, it is by no means certain you have it, even assuming you regularly have performed oral sex on current or past partners (including whoever you caught your genital infection from). The overall frequency of oral HPV is roughly one tenth that of genital infection, and the vast majority of those infections are cleared by the immune system without having caused symptoms and uncommonly transmitted to partners.

Having HPV, whether genital or oral, should be viewed as a normal, expected, unavoidable consequence of being a sexually active human. No matter how hard you might try to prevent it, the only way to do that is to either not have sex at all, or to limit sex to a single lifelong partner who never had and never will have sex with anyone else -- a very rare human behavior! People can be immunized to prevent infection with some of the potentially most troublesome types, but you're well beyond the age (26) when vaccination is likely to be helpful and routinely recommended.

We are covered with, and filled with, billions of bacteria and viruses that are mostly harmless and in fact often essential to health. We all carry E coli, staph, strep, cytomegalovirus, epstein barr virus (the cause of infectious mono), varicella zoster virus (shingles, chickenpox), and many, many others. Mostly they are harmless, even though all these once in a while cause severe and even fatal infections. But we live with them without worry. Same for HPV. That it happens to exploit human intimacy for its own propagation does not make it worse, more dangerous, or otherwise any greater concern than all the others.

I hope this has helped. Thanks for your confidence in ASHA and our services. Best wishes--  HHH, MD



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39 months ago
Thank you Dr. Handsfield-At 43 and a mom, I am very very very worried. My last question to you is from everything I have read whatever strain I have stays that strain and does not turn into 16/18 correct, unless I am reinfected with a new strain.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
I'm so sorry you remain so worried. There's no good reason for it.

HPV types are unchangeable. One type cannot turn into another. And even if you someday turn out to also HPV 16 or 18, probably it would cause no harm. Even with those types, the vast majority do NOT lead to cancer. Think of it like smoking and lung cancer:  smoking raises the risk, but the large majority of smokers never get cancer. Same with HPV 16, 18, and other high risk types.

As a reminder, on this forum questioners are allowed two follow-up questions for the original posting fee, so you have one more coming. If you want to ask something else, think carefully so you cover everything that might come to mind. In the meantime, try not to worry so much about HPV. You might re-ready my comments above and concentrate on them. They are meant to be reassuring!
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39 months ago
So what are your thoughts on AHCC "the cure" or should I say help with HPV?. I have read  6 months but taking now 8 months..do you think it is too long? I worry that I might be having some reaction to it since all of a sudden my tongue is tingling and at times extremely uncomfortable. Do you know what that could be the cause..? It came on out of no where..
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
I don't know much about the AHCC mushroom extract, except it is controversial. Some scientists believe there is reason to believe it might help HPV clear faster, and a clinical trial is underway to see if it actually works. I also don't know whether it might cause neurological problems like tongue tingling or other discomfort. Given the nature of the toxicity caused by poisonous mushrooms, I would guess that sort of problem might be a possible side effect. Such a symptom also could be psychological. But since there is no way to know, and no proof that AHCC helps speed clearance of HPV, I strongly suggest you not take it -- or at least discuss it with your personal physician. Beyond that, I have no way to guess at the cause of this symptom.

Six months is the earliest HPV infections usually clear up. It's usually longer, typically 6-12 months for low risk types and 12-24 months for high risk HPV. These are averages; your infection may clear up faster or slower. Whether slower or faster, it doesn't change your low risk of cancer, and there is nothing known that makes it go away any faster. (Well, one thing. Tobacco slows clearance of HPV. If you're a smoker, your infection might clear up faster if you stop.)

I hope this discussion has been helpful. However, I am worried that you are still far more concerned about this than you should be; that you haven't really read my comments and advice carefully or understood them; and I am concerned about you pursuing magical treatments like AHCC. I hope you are able to find a way to move on without so much worry about it. You can start by having (another?) discussion with your personal physician. Good luck and best wishes.
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