[Question #89] Hpv and oral cancer

99 months ago
Hi Dr!
I have hpv for two years now I start with cin 1 and last pap I was ascus. 
But I am really concern about all this hpv and oral cancer I can't even sleep anymore, I got a cold back in May and since then I have been experiencing oral issues like burning and numbed in my throat, my left ear it's like clog feels like somebody it's blowing air and feel hot sometimes, weird feeling my tongue it's burning, I went to the ent dr where she scope me and didn't find anything wrong, just last week went back for a CT Scan and it's came back normal, so where all this symptoms coming from cause it's not normal feeling this i am in pain, and I know anxiety it's bad but after the ct scan I should feel better but I don't!! This is taking over my life my constant fear of getting cancer from this Hpv it's taking my joy and peace away. I have read a few of your post before and you said that oral cancer it's low and rare but it does happen and it's growing. What I should do go for a second opinion?! Don't know what else to do I feel so lost, I am afraid I have something and by the time they find out it's going to be too late!!! 
H. Hunter Handsfield, MD
99 months ago
Welcome to Ask the Expert.

First of all, oral HPV causes no symptoms at all. It is not a possible cause of the symptoms involving your throat, ear, or tongue. And if HPV were causing oral cancer or a pre-cancerous lesion in your throat, the ENT doctor would have seen it or the CT scan would have found it. I have no idea what is causing your symptoms, but for sure it isn't HPV.

Second, it is true that throat cancer due to HPV is on the rise. However, it is still rare -- far less common than cancers like breast, colon, lung, and prostate. Further, throat cancer is due entirely to only one HPV type (HPV 16); and that type probably is not the cause of your abnormal pap smears, since HPV 16 usually causes changes more advanced than CIN1 and ASCUS. Anyway, most people with genital HPV do not also have it in the mouth or throat. It is possible, but most such infections go away entirely without treatment and never progress to cancer.

If you are under age 26 and have not been immunized against HPV, discuss vaccination with your doctor. It will prevent infection with the most troublesome HPV types (those you haven't had up til now), including HPV 16, the main type that causes throat cancer.

So I don't think you need a second medical opinion. Of course you are entitled to that, and could discuss it with the ENT doctor or your primary care provider. But even if done, you should expect to have the same opinions and advice you have already had from the ENT doc -- and now, from me as well. Ths simply shouldn't be a concern for you.

I hope this has helped reassure you. Best wishes--   HHH, MD

99 months ago
Thanks for your respond dr!!
I am 36 years old so the vaccine won't work for me, and I trying to find out my strain I think my obg doesn't do it but know some people that have hpv 16 and have cin 1 or even normal pap!
 That been say and I know everybody it's different it's could be possible that I have all those oral symptoms because all my anxiety and being so concern about it?!!
 I feel this hpv have change my life, that I have to be worry for the rest of my life about this feeling like later or soon something it's going to happend to me because this virus!! 
And if goes away Will come back?
Can I ever will remarry with out any problem or causing any problem to somebody?
99 months ago
Also dr I heard that like you said hpv doesn't cause any symptoms and that's why I was more concern thinking that it could be more going on there, I am so scared, feeling like this make feel something it's wrong!
Dr since I wake up until I go to sleep all I have in my mind it's hpv it's like I have not a normal life anymore!!
 If hpv will cause oral cancer or anal, cervical how long it will take for the cancer to show?'
  What's the damage for a male parthner( I don't planning to have anybody but I had a parthner when I found out)
Sorry for so many questions and thanks for your responds but I just so confused with all this, and scared that this won't let me live a long and happy life!! 
H. Hunter Handsfield, MD
99 months ago
Sorry for the delay in responding to these follow-up questions.

First, the vaccine works fine at age 36. The reason it isn't recommended over age 26 is that new HPV infections are uncommon after that age, so usually there is no benefit. For that reason, I agree you need not be vaccinated.

Could "all those oral symptoms" be from anxiety? Certainly many of them could be. And whenever a person suspects his or her own symptoms have an emotional or psychological origin, usually s/he is correct.

There is no rational reason for the level of anxiety you are feeling. Your HPV infection will be cleared by your immune system. Follow your doctor's advice if s/he recommends follow-up pap smears or other exams. But otherwise, you're just like the millions of other women who have had high risk HPV infections and probably will never have any further problem from it. All humans carry viruses and bacteria that live normally on and in our bodies, and some of them (E. coli, staph, strep, chicken pox virus, the virus that causes mononucleosis, and many, many more) sometimes cause dangerous disease, but usually they do not. You don't lose sleep over those, right? HPV is no different. It's really no cause for worry. Furhter, once your immune system suppresses your virus, you won't transmit it to partners. And if you do, nothing bad will happen to them.

Reallly, do your best to mellow out. Foillow your doctor's advice about follow-up of your abnormal pap smears, but otherwise no worries at all.

99 months ago
Thanks a lot Dr for your respond because I am really losing sleep over this and my really main concern it's the oral risk cause paps with can help to manage but for oral it's nothing!! How long will take for oral cancer I left you another question there the third one don't know if you saw it! Thanks again!
H. Hunter Handsfield, MD
98 months ago
Usually it takes a very long time for pharyngeal cancer to develop. It hasn't been carefully studied, but most oral HPV 16 infections probably are acquired between the ages of 15 and 30, and pharyngeal cancer due to HPV 16 is rare before age 40 and most cases are over 50.

In any case, the risk of pharyngeal cancer is very, very low even in people with (or exposed to). If cancer takes you away someday, it is far more likely to be one of the common ones like breast, colon, etc. This truly isn't something to lose any sleep over. Do your best to move on without worry about it!