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Can HPV Infection Decrease The Chance Of Oral Cancer?
Question: I've been married and monogamous for 31 years. About 15 years ago during a time of family stress I developed a genital herpes outbreak. My husband got tested twice and doesn't have herpes. Now I take 1000mg Valtrex daily so that he won't contract herpes. I suspect it was my first husband who infected me. I developed a lesion about 40 years ago when I was with him but was told by a physician at the time it wasn't herpes. (It was in an atypical location on my skin near the inguinal crease because he'd 'pulled out', probably not wanting to infect me.) My second husband was livid that I had unknowingly exposed him to VD but blessedly I haven't passed it on to him.
Maybe 5 years ago I was tested for HPV for the first time during a routine Pap and this, too, came back positive. My gyn said it was common for sexually active people, and that I'd likely clear it without treatment. Pap smears have been normal. I should have told my husband when I found out about my positive HPV test. But since I have been faithful to him and there was so much turmoil over the XXXXXXX of the herpes infection, I chickened out and didn't tell him about this second infection. I thought of it as my problem that could be conscientiously followed by Pap smears. He found out yesterday by seeing stuff I had printed out by the computer. Now he says I have endangered his life by exposing him to risk of developing oralpharyngeal cancer.
My questions are: is it true that we will decrease the chances of his developing oral cancer if in the future he were to use a dental dam when giving me oral sex? Or does my assumption that 'it's too late to close the door after the cow has left' apply? If I were to get a hysterectomy would I be less likely to give him HPV? We're both in our 60's. Is it too late for him to get Gardasil? Does he need to starting using condoms?
Maybe 5 years ago I was tested for HPV for the first time during a routine Pap and this, too, came back positive. My gyn said it was common for sexually active people, and that I'd likely clear it without treatment. Pap smears have been normal. I should have told my husband when I found out about my positive HPV test. But since I have been faithful to him and there was so much turmoil over the XXXXXXX of the herpes infection, I chickened out and didn't tell him about this second infection. I thought of it as my problem that could be conscientiously followed by Pap smears. He found out yesterday by seeing stuff I had printed out by the computer. Now he says I have endangered his life by exposing him to risk of developing oralpharyngeal cancer.
My questions are: is it true that we will decrease the chances of his developing oral cancer if in the future he were to use a dental dam when giving me oral sex? Or does my assumption that 'it's too late to close the door after the cow has left' apply? If I were to get a hysterectomy would I be less likely to give him HPV? We're both in our 60's. Is it too late for him to get Gardasil? Does he need to starting using condoms?
Brief Answer:
Answers to specific queries related to Hpv
Detailed Answer:
Hello. Thank you for writing to us
I am dr.kakkar(dermatologist). I jave gone through your query and i have noted your concern
Not all Hpv types are asdociated with cervical or oral cancer. Only certain types like Hpv 16,18,31,33 are associated with cancer types. Genital Hpv infection is commonly (in more than 90%) caused by Hpv types 6,11 which are non-cancerous.
So the first and foremost thing would be determine the Hpv type of your genital infection.
Dental dam would definitely reduce Hpv transmission risk if the infection has'nt already been transmitted. This is because it would ensure that there would be no direct contact with the genital mucosa.
Since Hpv can infect genital mucosa i.e vagina as well as perineal skin and not just cervix alone therefore i dont think that hysterectomy would be protective against Hpv transmission during oral sex.
Gardasil is a quadrivalent vaccine against cancer causing Hpv types i.e types 16,18,31,33. If your Hpv infection is by different Hpv types then this vaccine would be protective against future new Hpv infection with cancer causing Hpv types.
Of course, a condom would reduce the risk of infection during penetrative sex if it has'nt happened already but a condom is not 100% protective.
Regards
Answers to specific queries related to Hpv
Detailed Answer:
Hello. Thank you for writing to us
I am dr.kakkar(dermatologist). I jave gone through your query and i have noted your concern
Not all Hpv types are asdociated with cervical or oral cancer. Only certain types like Hpv 16,18,31,33 are associated with cancer types. Genital Hpv infection is commonly (in more than 90%) caused by Hpv types 6,11 which are non-cancerous.
So the first and foremost thing would be determine the Hpv type of your genital infection.
Dental dam would definitely reduce Hpv transmission risk if the infection has'nt already been transmitted. This is because it would ensure that there would be no direct contact with the genital mucosa.
Since Hpv can infect genital mucosa i.e vagina as well as perineal skin and not just cervix alone therefore i dont think that hysterectomy would be protective against Hpv transmission during oral sex.
Gardasil is a quadrivalent vaccine against cancer causing Hpv types i.e types 16,18,31,33. If your Hpv infection is by different Hpv types then this vaccine would be protective against future new Hpv infection with cancer causing Hpv types.
Of course, a condom would reduce the risk of infection during penetrative sex if it has'nt happened already but a condom is not 100% protective.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Even though we haven't used condoms or dental dam for greater than 30 years, you recommend that we start using them now to decrease odds of him getting HPV? Can't it be reasonably assumed that he has been exposed? Or is each new genital contact increasing odds of oropharyngeal cancer? And will Gardasil be administered to a 68 year old man?
With all due respect to the dermatologist who provided a prompt opinion, could my case please be reviewed by a sexual medicine specialist?
I do not have genital warts. I asked what type HPV I have and as I recall from all those years ago I have the potentially cancerous type. But at the time I didn't know of the risk it could pose to my husband. I thought diligent Pap smear follow-up was adequate.
From what I have read from sexual medicine specialists at this site, the CDC says it is statistical certainty that anyone having greater than 4 sexual partners in a life time has HPV. So I am presuming my second husband likely also had HPV even before our monogamous relationship. Is this true?
I am having a hard time accepting that after decades it would now be of value to start practicing safe sex. Please have a sexual medicine specialist review.
With all due respect to the dermatologist who provided a prompt opinion, could my case please be reviewed by a sexual medicine specialist?
I do not have genital warts. I asked what type HPV I have and as I recall from all those years ago I have the potentially cancerous type. But at the time I didn't know of the risk it could pose to my husband. I thought diligent Pap smear follow-up was adequate.
From what I have read from sexual medicine specialists at this site, the CDC says it is statistical certainty that anyone having greater than 4 sexual partners in a life time has HPV. So I am presuming my second husband likely also had HPV even before our monogamous relationship. Is this true?
I am having a hard time accepting that after decades it would now be of value to start practicing safe sex. Please have a sexual medicine specialist review.
Brief Answer:
Both of you should test for hpv to know if the infection is still there
Detailed Answer:
Hi. I am dr.kakkar (MD, dermatology and STDs). I am qualified to handle queries related to STDs
Most of the times body's own immunity takes care of hpv infection and the majority of those infected with genital hpv are free of the virus after 1-2 years of infection. So it is very likely that you now dont even have Hpv and the infection had already been taken care of by your body's own immunity. Moreover since you never developed visible genital warts! as well as had normal Pap smear results. However, a nucleic acid based screening test would be required confirm this likely possibility considering that you had earlier tested positive 5years ago.
As far as risk of exposure to your second husband is concerned he may likely have been exposed already. Only tests can confirm whether presently he has hpv or not and also hpv types. If he already has hpv of type 16, 18, 32,33 then there is no point giving Gardasil as the vaccine is only preventive. However as i said before, majority of hpv infection cures by themselves aided by body's immunity.
If he can take a swab test from oral and genital mucosa that would clarify his status of hpv infection at these sites. I think you should also repeat hpv testing to know your current status, whether you still carry the infection or not?
Regards
Both of you should test for hpv to know if the infection is still there
Detailed Answer:
Hi. I am dr.kakkar (MD, dermatology and STDs). I am qualified to handle queries related to STDs
Most of the times body's own immunity takes care of hpv infection and the majority of those infected with genital hpv are free of the virus after 1-2 years of infection. So it is very likely that you now dont even have Hpv and the infection had already been taken care of by your body's own immunity. Moreover since you never developed visible genital warts! as well as had normal Pap smear results. However, a nucleic acid based screening test would be required confirm this likely possibility considering that you had earlier tested positive 5years ago.
As far as risk of exposure to your second husband is concerned he may likely have been exposed already. Only tests can confirm whether presently he has hpv or not and also hpv types. If he already has hpv of type 16, 18, 32,33 then there is no point giving Gardasil as the vaccine is only preventive. However as i said before, majority of hpv infection cures by themselves aided by body's immunity.
If he can take a swab test from oral and genital mucosa that would clarify his status of hpv infection at these sites. I think you should also repeat hpv testing to know your current status, whether you still carry the infection or not?
Regards
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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