HPV and Oral Cancer – not a laughing matter

I originally blogged about the human palliloma virus back in 2011, following a Republican debate, and I am reposting this blog (edited) today, because of the recent revelations pertaining to the cause of Michael Douglas’ oral cancer.

During the Republican debate in 2011, Texas Governor Perry was asked about his role in having young girls vaccinated against cervical cancer, which is linked to the the human pappiloma virus (HPV).  One day after the debate, Michelle Bachmann claimed that she learned from a women that her daughter now suffers mental illness secondary to being vaccinated against HPV, however, without offering any evidence to back this claim up. Now, a serious medical issue is being discussed in the political arena, instead of treating this issue as a medical issue and medical issue alone.  This debate now may trigger a similar reaction, as the now discredited research study from some years ago, which supposedly established a link between the development of autism spectrum disorders and the MMR vaccine.  Although the study has been largely discredited, many parents have opted out of having their children vaccinated against measles, mumps and rubella.  What we now increasingly see, are cluster outbreaks of those diseases, such as the measles outbreak in Southern California (CDC, 2008), or the mumps outbreak of 2006 in the Midwest (CDC, 2009).  Having lived through both of these diseases, as a parent, I would not even think twice about vaccinating my children.  Additionally, the more parents opt out of vaccinating their child(ren), the higher the likelihood of more outbreaks of whatever disease, pure and simple.  As such, the debate should focus on the possibility of decreasing the number of cancers associated with this virus (CDC, 2011), and also the possibility of preventing death due to cancers detected at later stages, such as cancer of the vulva.  Additionally, what yet has to be sufficiently pointed out is the fact that oral cancers in both men and women are on the rise, and further, that an increasing number of reported cases of oral cancers are now being attributed to oral sex and infection with HPV (Freeman, 2011; NIH; 2011).

Now, what is the big deal with vaccinations against cancers correlated to being exposed (and having little to no immunity) to HPV? Well, for starters, it is a cancer correlated to sexual activity, and although as parents we may wish that our offspring delays sexual encounters until they actually think of having children of their own, it is most likely not going to happen.  Most youngsters will NOT be abstinent and will explore and have sex at a rather young age.  However, although we may be able to raise children who practice abstinence, meaning sexual intercourse, most adolescents will most likely engage in behaviors, which are sexual in nature and thus gratifying, however, not considered to be sex as such, such as oral sex.  Third, even IF, and that is a rather big IF, if adolescents do delay sexual encounters until marriage, they can not possibly be sure about the exposure to this virus, that their chosen life-partners had before them.  Thusly, my question is, why be against a vaccine that actually is the first of its kind, which can prevent certain cancers from affecting males and females alike?  Was it the way Perry went about it or his ties to Merck Pharmaceuticals, or was it about controlling natural behaviors of human beings?  As I cannot possibly answer the questions with a rather large level of confidence, and thus only venture educated guesses, I will now just focus on cancers correlated to HPV, and the effects on women and men alike.

According to the CDC (2011), various cancers are associated with HPV infection, thus the HPV vaccine has the potential to decrease the likelihood of women and men to be diagnosed with a potentially life-threatening disease, as well as having to deal with psychological, emotional, and physical effects that those cancers inevitably bring with them (Akyeuz et al., 20o8; Carlson & Strang, 1998; Gamel, Hengeveld, & Davis, 2000; Lagana et al., 2005; Roberts & Clarke, 2009).  Besides the aforementioned effects on general well-being, the treatment itself, as described in many studies, is gruesome to say the least, particularly when treatment involves major surgeries, which in some cases can be only described as mutilation and disfiguration, and thus have profound impact on sexual functioning secondary to surgical interventions, which in turn, inevitably have effects on relationship quality (Carlson & Strang, 1998; Gamel, Hengeveld, & Davis, 2000; Lagana et al., 2005), thus impacting the overall quality of life of both women and men.

Given just some of the research findings described above, the discussion should not be political.  If parents, despite medical evidence that HPV protects against a variety of cancers, choose not to vaccinate, I highly encourage those who are reluctant to read some of the cited studies or research the topic via other means to become convinced that the HPV vaccine may indeed protect their children, boys and girls, not only from the many cancers correlated to HPV, but also, may prevent them from suffering painful consequences secondary to diagnosis and treatment, but may most importantly, prevent death caused by those cancers.   Most parents do not think twice about vaccinating their child(ren) against polio, yet, due to the “nature” of the transmission of the virus, many may feel that vaccinating their child(ren) against HPV will somehow cause them to engage in sexual activities more freely and at an earlier age.  I am not sure if that is the case, because as parents, unfortunately, we only can educate as best as we can, but the ultimate choice of behavior is not made by us.  Thus, I would highly recommend vaccinating children with the HPV vaccine, and if even more further encouragement for doing so is needed, I challenge those who are skeptical or outright opposed for doing so, to just google genital warts and HPV, and look at the images; I am highly confident, that no parent wants this to happen to their child(ren).

References:

Akyuez, A., Guevenc, G., Uestuenoez, A., & Kaya, T.  (2008).  Living with gynecological cancer:  experience of women and their partners.  Journal of Nursing Scholarship, 40(3), 241-247.

Carlson, M. E., & Strang, P.M. (1998).  Educational support programme for gynecological cancer. Patients and their families.  Acta Oncologica, 37(3), 269-275.  doi:10.1080/028418698429577.

CDC. (2008).  Outbreak of Measles — San Diego, California, January – February 2008.  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e222a1.htm

CDC (2009). Mumps.  http://www.cdc.gov/mumps/outbreaks.html

CDC (2011).  Genital HPV Infection – Fact Sheet.  http://www.cdc.gov/std/hpv/stdfact-hpv.htm  Ciolli, A.  (2008).  Mandatory school vaccinations:  The role of tort law.  Yale Journal of Biology and Medicine, 81(3), 129-137.

Freeman, D.W. (2011).  Oral sex now main cause of oral cancer:  Who faces biggest risk?  Retrieved September 16, 2011, from http://www.cbsnews.com/8301-504763_162-20035363-10391704.html

Gamel, C., Hengeveld, M., & Davis, B.  (2000).  Informational needs about the effects of gynecological cancer on sexuality: a review of the literature.  Journal of Clinical Nursing, 9, 678-688.

Lagana, L., Classen, C., Caldwell, R., McGarvey, E.L., Baum, L.D., Cheasty, E., & Koopman, C.  (2005).  Sexual difficulties of patients with gynecological cancer.

National Institutes of Health.  (2011).  Oral cancer:  causes and symptoms & the oral cancer exam.  Retrieved September 16, 2011, from http://www.nidcr.nih.gov/OralHealth/Topics/OralCancer/AfricanAmericanMen/CausesSymptoms.htm

Professional Psychology: Research and Practice, 36(4), 391-399. doi:10.1037/0735-7028.36.4.391.

Roberts, K. & Clarke, C.  (2009).  Future disorientation following gynecological cancer:  Women’s conceptualization of risk after a life threatening illness.  Health, Risk & Society, 11(4), 353-366.  doi:10.1080/13698570903013623