[Question #919] Hpv

50 months ago
I was recently treated for genital warts. I went forward with talking to my partner. He proceeded to tell me that he had throat cancer in the past that was caused by hpv.  He failed to tell me anything until I mentioned my issue to him.  It was a high risk type of hpv that caused his cancer according to my understanding. If I have a high risk type as well that hasn't showed up yet, could it cause oral cancer, cervical, or other types of cancer in the future?  Is there any testing that can be done to detect oral cancer?  Will the warts come back again?  I have not had the HPV vaccine. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Welcome to the forum. Thanks for your question.

HPV seems more frightening than it is, because of media attention and lots of assumptions; and because many doctors don't understand some of its details very well. The main things for you to know are that 1) your gental warts have nothing to do with your partner's oral HPV infection (which is probably no longer present and may have been gone for years) and 2) you are not at increased risk of cancer (cervical, throat or any other) because of your partner's HPV.

High risk HPV types don't cause warts, so your warts are a separate problem. To the extent you are at risk for cancer in the future, it is extremely low. Even with high risk types, the large majority do not progress to cancer, even without treatment. (Think of it like smoking and lung cancer:  high risk HPV increases the risk, but just like most smokers don't get lung cancer, most HPV doesn't lead to cancer either.)  So even if you caught your partner's high risk HPV, or if you acquire a high risk infeciton yourself in the future from him or anyone else, the chance of cancer is low. And even with HPV infections that might progress toward cancer, following standard instructions about follow-up visits and testing are effective in early detection when the problem is easily cured, long before dangerous (invasive) cancer develops.

And probably you didn't get either your high risk HPV or the strain causing your warts from your current partner. It's possible, but there's no way to know -- and as I said above, if his throat cancer has been treated and cured, the HPV causing it probably is gone as well. If so, he couldn't have infected you with that particular virus. Of course, all sexually active people get genital HPV, so either of you could have acquired genital infections from other partners. Most people with HPV never know when and from whom they caught it, and it doesn't matter.

You are not at increased risk of oral cancer either. Just because your partner had it doesn't mean your risk is elevated for that complication. It is not. There are no special tests for oral cancer, except to be examined once a year, e.g. by your dentist during routine visits for mouth and dental care.

Will your warts come back? Probably not; once cured, they usually don't recur. But sometimes they do. If so, just return to your doctor for another round of treatment. No serious harm will come.

So please don't blame your partner. He was not wrong to have not told you about his oral cancer. I can understand how you might think otherwise, but truly it would have made no difference in your risks. Nobody ever needs to tell any partner about past HPV infection that have cleared up. Some couples do that, but it's a personal decision that can be different for different couples. Similarly, you don't necessarily need to tell future partners about your warts, once they are gone.

Finally, you should go ahead and be vaccinated against HPV. The vaccine covers 9 types, including both types that cause warts and 7 others that cause 90% of cancers. It is unlikely you have been infected with all 9 types, and you'll be protected against the types you have not. (But not if you're over age 26. After that, the risk of new HPV is low enough that vaccination isn't recommended. You also should follow standard guidelines for pap smears. If in doubt, ask your doctor about what schedule is right for you.

I hope this information has been helpful. Let me know if anything isn't clear. Best wishes--

HHH, MD
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50 months ago
Do lots of people get HPV related cancers and die from them?  I had this same issue with warts about 12 years ago and they just now came back.  Do I have the same strand of HPV or could it be a different type? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Most cancers due to HPV are easily treated. Death from such cancers is rare, and almost always occurs because the patient didn't follow doctor's advice about follow-up examinations and treatment. If you get regular pap smears, get dental check-ups, and see your doctor soon if you ever get any unxplained bumps or sores in the genital or anal area, you definitely will not die because of an HPV related cancer.

It is rare for warts or other HPV problems to reappear after 11 years. It could happen, but more likely you have a newer HPV infection, i.e. your current warts probably are due to a different HPV strain than last time.

As I said above, the types of HPV that cause warts are different than the cancer causing ("high risk") types. So your warts do not indicate a high risk for future cancer due to HPV.

I know it can be worrisome to be told of a partner's past HPV related throat cancer, and to see all the media stories about HPV and cancer. But if you'll just study the facts, you'll be reassured. I've tried to start you down that path. Truly, this is NOT a high risk situation for you and should not be frightened by all this. Almost all sexually active people get HPV at one time or another (most of us have several infections in our lifetimes). You are at no higher risk than anyone else -- all your friends, co-workers, and women you see walking down the street -- for a serious HPV problem. Just keep a level head, follow your doctor's advice (and mine), and do your best to stop worrying.

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