[Question #9002] Nasal cavity HPV… how?

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37 months ago
A colleague is being treated for nasal cancer and been advised it is HPV positive which is apparently  good news for prognosis.
My mind is now spinning back to my own cervical HPV and, similar to couple recent posters worrying Ive spread it. I havent given oral sex very often in my life which I guess I can see could give it a chance to spread.  But, I have had thrush a lot and I am sure I scratch at night and then have the remnants on my fingers before I then shower in the morning. I know i scratch my nose and face a lot in my sleep and generally as I am just super figety and get itchy a lot with allergies. Is this the way HPV would spread to these places and if so what would be the risk of csncer developing? Thank you.  Please dont laugh at me, my husband thinks I am being dumb but this poor lady got HPV there somehow and I can easily see how I coukd have too so am worried.
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37 months ago
The reason my husband says this is dumb is that the guys he knows from college and so on he reckons wash their hands like never, even after masturbating, and openly and disgustingly pick their noses etc. He rexkons that if hpv spread from “dick to pick” as he is charmingly calling it there would be an epidemic of nasal cancer. I get his point, and I certainly do not behave like them but similar to the previous poster worry about unconscious nighttime scratching spreading from genitals to nose/ face as I am forever bothered by things like thrush and then hayfever etc.
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37 months ago
He also thinks (my husband) that i would have antibodies to the hpv i am already infected with but I thought it was possible to be infected with the same strain at two sites. I just feel confused and worried, any reassurance you can offer would help so much.
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Edward W. Hook M.D.
37 months ago
Welcome to our Forum.  Thanks for your questions.  I hope that my responses will be helpful in reducing your level concern.  I appreciate that you have read other threads regarding HPV, oral cancer, and the minuscule risk of self inoculation of genital infection to oral or nasopharyngeal sites.  The oral and nasal cavities are interconnected and indeed, HPV16 is associated with both oral and nasal cancers.  As we have told others, nasopharyngeal HPV is far rarer than genital infections and, when present is typically cleared without progression to cancer by the immune system.  This is simply not something to worry about.

FYI, when nasal cancer is present it presents as a mass which can be felt.  Unless this occurs, my advice is not to worry about this rare event.  Should it occur,  an ear, nose, and throat specialist can evaluate you.  EWH 
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37 months ago
Thank you so much, this really helps.
I think elsewhere you or Dr HHH have said that something to the effect of hpv and other stis being stis because they aren’t spread through casual hand to mouth (or in this case!) nose or we would see more cases.  My own doctor referred to HPV as being “like glitter” because it gets everywhere which I think has made me pretty worried.
I do also know as of an appt this morning that I have HPV in my anal tract and am being monitored for this as is it has caused a small area of AIN2.
I have never once had anal sex but figure that the general pressures on the whole area during vaginal sex might cause strain and a cut or something that exposed the region there. 
I suppose the oral and nasal transmission is less likely because those areas haven’t been strained through sex and it would be traces on my hands not a potentially infected area of skin on my partner touching them.  I’m sorry, the AIN2 - especially in the absence of an anal activity whatever - and the glitter comment have made me a bit wobbly today.  I was reading the other answers for reassurance and think need to just focus on my own situation.  Any specific reasons not to worry about oral / nasal self infection when I have somehow still managed to get HPV anally from my cervix would help hugely, thank you.


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Edward W. Hook M.D.
37 months ago
Thank you for the additional information.  Perhaps I can provide some context.

The “glitter” comment.  I suspect that your doctor was alluding to two facts.  First genital HPV infections are so common.  It is estimated that more than 80% of unvaccinated adults will acquire HPV, often acquiring more than 1 strain.  Further, in women ano-rectal infections are relatively common- even in the absence of receptive rectal intercourse.  

I do agree with Dr. Handsfield that transmission of any STI, including HPV through transfer on hands and fingers is extraordinarily rare, so rare that the CDC and WHO Classify mutual masturbation, even when partners get each other’s general secretions on one another as safe, no risk sex. Transfer on hands and fingers may occur but it is very, very rare and something that is simply not a major concern.

It sounds to me like you are receiving good medical care and that you are thinking clearly about this. And moving forward I would suggest that you stick with the advice of your doctors and experts and do everything you can to stay off the Internet which is a all too common source of misinformation. EWH 
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36 months ago
Thank you so much for your helpful answer. Final question. And maybe an odd one… have read research that a certain number of people with anal HSIL like I have are found to be seropositive for HPV E6 oncoproteins.  From my understanding of HPV related cancer, for a cancer to develop in any given site you need an initial HPV infection there, be it the cervix, anus or oral cavity and I understand from all your answers here that infection is transmitted mainly through sexual or other skin to skin contact NOT carried through the blood around the body from one site to another.

I also understand that E6 seropositivity is regarded as an emerging biomarker for oral cancers and my question is this: IF my HSIL has caused HPV E6 seropositivity, does that have any bearing on my risk of oral cancers, in and of itself? I understand that as an HPV carrier my risk if any HPV related cancer is elevated in general as clearly I have had contact at some stage with another carrier and that may well have resulted in an oral infection which may have cleared as it has in my cervix, or not, as it hasn’t in my anus.  However, I think I am right in understanding that there is not some biological pathway where my HSIL causes E6 proteins to start floating around my body which then themselves go and cause HPV related cancers in other areas such as the oropharynx like some strange version of metastasis. In short: if there isnt a preexisting HPV infection in the oropharynx, HSIL in the anus doesn’t have a mechanism we know of for causing a cancer elsewhere in the body: doee that sound about right? I am just so thrown by this AIN 2 news and want to really understand what it means.
Thank you so much, this is such a helpful service.
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Edward W. Hook M.D.
36 months ago
The business of HPV E6 proteins is, like so much of what we know about HPV, sometimes a bit confusing. The E6 proteins appear to be a necessary but not sufficient contributor to risk for development of HPV related cancers. The fact that these proteins may circulate however does not indicate or suggest that those circulating proteins would lead to, or contribute to, development of cancer at other parts of the body. HPV related cancers are local processes related to local infections.

As you know, we provide up to three responses to each clients questions. This is my third response. Thus this thread will be closed later today without future replies. I hope the information I have provided has been helpful to you. Please don’t worry too much about your HPV infection.  Regular healthcare and sexual health check ups including testing for HPV will do much to keep you healthy. Take care. EWH
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