Board: Gynecologists May Treat Men

The American Board of Obstetrics and Gynecology has reversed a September directive that barred its members from treating men for anal cancer. Some gynecologists have been treating men due to expertise gained via cervical pap smears.

Like cervical cancer, anal cancer is usually caused by the human papillomavirus, or HPV, which is sexually transmitted. This type of cancer is rare, but its incidence is increasing, especially among men and women infected with H.I.V. Experts in anal cancer asked the board to reconsider its position, and some started letter-writing campaigns. Patient advocacy groups expressed worry that the prohibition would interfere with research and make it harder for male patients to find screening and treatment. The board had said it wanted to protect the profession as a female specialty and limit the nongynecological work performed by its members. But Dr. Kenneth L. Noller, the board’s director of evaluation, said board members had reconsidered and realized that gynecologists had a long tradition of treating sexually transmitted infections in both men and women, and that HPV and problems related to the virus fell into that category.

HPV Vaccine Cuts Infections By Half

Great early news about the HPV vaccine:

The prevalence of dangerous strains of the human papillomavirus — the most common sexually transmitted infection in the United States and a principal cause of cervical cancer — has dropped by half among teenage girls in recent years, a striking measure of success for a vaccine against the virus that was introduced only in 2006, federal health officials said on Wednesday. The magnitude of the decline in HPV infections surprised public health experts because only about a third of teenage girls in the United States have been vaccinated with the full course of three doses. By comparison, vaccination rates in countries like Denmark and Britain are above 80 percent. Even Rwanda, in East Africa, has reached 80 percent. Yet even with relatively low vaccination rates in the United States, infection with the viral strains that cause cancer dropped to 3.6 percent among girls ages 14 to 19 in 2010, from 7.2 percent in 2006, the officials said.

An HPV vaccine for boys was introduced in 2011.

Quote Of The Day - Michael Douglas

"Without wanting to get too specific, this particular cancer is caused by HPV [human papillomavirus], which actually comes about from cunnilingus. I did worry if the stress caused by my son's incarceration didn't help trigger it. But yeah, it's a sexually transmitted disease that causes cancer. And if you have it, cunnilingus is also the best cure for it." - Michael Douglas, speaking to the Guardian about his recent bout with oral cancer.

The Guardian then spoke with an expert.

HPV, the sexually transmitted virus best known as a cause of cervical and anal cancer and genital warts, is thought to be responsible for an increasing proportion of oral cancers. Some propose that changes in sexual behaviour – a rise in oral sex in particular – are responsible. Such changes might be cultural, but could also be linked to fears about the safety of penetrative sex in the wake of the discovery of AIDS. Mahesh Kumar, a consultant head and neck surgeon in London, confirms that the last decade has seen a dramatic rise in this form of cancer, particularly among younger sufferers. Recent studies of 1,316 patients with oral cancer found that 57% of them were HPV-16 positive.

Kumar went on to dismiss Douglas' claim about the "best cure" for his cancer, although it seems to me that Douglas was likely joking. Douglas has been cancer-free for two years after rounds of radiation and chemotherapy.

RELATED:  Earlier this year National Lesbian & Gay Journalists Association president Michael Triplett died of HPV-related oral cancer.

One Gay Man's Battle Against Oral Cancer

Michael Triplett is a vice president of the National Gay & Lesbian Journalists Association and their most prolific blogger. He's also just reached the first anniversary in his battle against HPV-related oral cancer, about which he's just written for the Good Men Project. An excerpt:

In the past year, I’ve had: three surgeries, 42 days of traditional radiation treatment, five rounds of chemotherapy, and five days of advanced radiation treatment. My medical bills have surpassed the $600,000 mark—thank God for my employer’s great insurance plan. I’ve lost over 50 pounds and all my facial hair, had almost half of my tongue removed, undergone two high-tech robotic procedures, used up over 70 percent of my accumulated sick leave, and had my 76-year old mother living with me for about 12 weeks to assist in my care. From this birthday forward, my gifts better be pretty damn spectacular.

My cancer is part of a growing “epidemic” of oral cancer unrelated to smoking and drinking. Instead, there is an increase—primarily in middle-aged, white men—of tongue and other mouth cancers connected to the human papillomavirus (HPV). HPV has traditionally been connected to cervical cancer in women, but there is growing evidence of the virus being a major risk factor for getting head and neck cancer. I’ve never smoked and never been more than a social drinker. I’ve never even performed oral sex on a woman, which has been a working hypothesis behind the rise in oral cancers for men. While it’s nice to be special and unique, the only real comfort comes from knowing that HPV-related oral cancer is more responsive to treatment and that the prognosis is better than other oral cancers.

Read the entire essay.

Gardasil May Protect Against Anal Cancer

In a small study involving HIV-negative gay men, the HPV vaccine Gardasil was shown to reduce the risk of anal cancer.

The vaccine reduced the risk of lesion recurrence by approximately 50% in the first two years after immunisation. There was some evidence that the protective effects of the vaccine waned after this point. “This is the first study to demonstrate an association between Gardasil after primary disease and decreased risk of recurrent HGAIN [high-grade intraepithelial neoplasia],” comment the investigators, who believe the vaccine may be “an effective post-treatment adjuvant to prevent recurrent HGAIN.” High-risk strains of human papilloma virus are the main cause of anal and cervical cancer. The quadrivalent human papilloma virus vaccine (Gardasil) is highly effective at preventing infection with these strains. Rates of anal cancer are elevated in gay and other men who have sex with men.

As I overshared on Facebook at the time, last month my new doctor surprised me with an anal pap smear, something his practice does routinely for all gay men over 40. My result was thankfully negative, but I mention it here to reinforce how simple and brief the procedure is. Ask for it, regardless of your age. (Tipped by JMG reader Bill)

Oral Cancer Virus More Common In Men

Compared to women, more than twice as many men are infected with oral HPV. Prevalence of the cancer-causing virus increases with the number of sexual partners.

Oral human papillomavirus (HPV) infection is more common among men than women, leading to an increased risk for men of head and neck cancers, a US study suggests. The Journal of the American Medical Association (JAMA) study assessed around 5,500 people aged 14 to 69. Around 10% of men had oral HPV, compared with 3.6% of women. HPV causes the majority of cervical cancers, as well as genital and anal - and head and neck cancers. Smoking and drinking are significant known risk factors for head and neck cancers. But oral HPV infection increases cancer risk by around 50%, according to the research team from Ohio State University Comprehensive Cancer Center.

It's not yet known whether the existing HPV vaccination also guards against oral HPV.

Family Research Council: Don't Vaccinate Boys For HPV, Only Queers Get It

The Family Research Council has issued a statement in reaction to yesterday's CDC recommendation that boys get the HPV vaccine too.

The CDC is quick to point out that the vaccine also protects against anal, mouth, and throat cancer--but they downplay the fact that these cancers are almost entirely the result of men having homosexual sex! Apart from the cost of the shots (upwards of $140 million a year), perhaps the most infuriating aspect of all this is the government's insistence that we look for ways to minimize the impact of promiscuity instead of working to encourage the end of it. Rather than asking young people to change their behavior, society is scrambling to enable it. It's like trying to address the problem of drunk driving by making better airbags. We can't tackle long-term safety with short-term solutions. And unfortunately, tiptoeing around the fundamental problem--premarital sex and homosexual sex--shows how far off course we are.

They really truly want gay men dead.

Tony Perkins: All Whores Must Die

Crazy Eyes' Lies Now Have A Bounty

Bioethicists in Minnesota are offering an $11,000 reward if anybody can come up with the girl that Michele Bachmann claims was made mentally retarded by the HPV vaccine.

Steven Miles, a U of M bioethics professor, said that he’ll give $1,000 if the medical records of the woman from Bachmann’s story are released and can be viewed by a medical professional. His offer was upped by his former boss from the University of Minnesota, Art Caplan, who is now director of the University of Pennsylvania Center for Bioethics. Caplan said he would match Miles' challenge and offered $10,000 for proof of the HPV vaccine victim.

We're guessing this prize will go unclaimed.

HomoQuotable - Dan Savage

"Religious conservatives loved the HPV virus because it killed women. Here was a potentially fatal STI that condoms couldn't protect you from. Abstinence educators pointed to HPV and jumped up and down—they loved to overstate HPV's seriousness and its deadliness—in their efforts to scare kids into saving themselves for marriage. And they fought the introduction of the HPV vaccine tooth-and-nail because vaccinating women against HPV would 'undermine' the abstinence message. Given a choice between your wife, daughter, sister, or mom dying of cervical cancer or no longer being to scream 'HPV IS GOING TO KILL YOU!' at classrooms full of terrified teenagers, socially conservative abstinence 'educators' preferred the former." - Dan Savage, writing for Slog.

Docs Diss Bachmann On HPV Vaccine

The nation's largest pediatricians group has issued a statement denouncing Michele Bachmann's claim that Gardisil causes mental retardation. Bachmann is not directly named in the press release.

"The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation. There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record. The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12. That’s because this is the age at which the vaccine produces the best immune response in the body, and because it’s important to protect girls well before the onset of sexual activity. In the U.S., about 6 million people, including teens, become infected with HPV each year, and 4,000 women die from cervical cancer. This is a life-saving vaccine that can protect girls from cervical cancer."

Perry Flip-Flops On HPV Vaccine

One of the few admirable accomplishments of Texas Gov. Rick Perry's regime was his (short-lived) mandate that middle school girls receive the vaccine for HPV, which is known to cause cervical cancer in later life. But now that Perry is running for president, he's surrendered to the Christianists who claim that preventing STDs encourages promiscuity.

“I made a mistake on that,” Perry said on Iowa radio, later calling it “an error in not having a conversation with the people of the state of Texas.” Perry's decision as governor in 2007 to implement mandatory human papillomavirus (HPV) vaccinations for sixth grade girls took heat from conservatives who faulted Perry for undermining parental authority, implicitly condoning sexual activity and pushing his own agenda. The HPV decision is one of the few failing grades that conservatives have given Perry’s record on social issues. Since hitting the presidential campaign trail on Saturday, Perry has taken several questions regarding the decision. Perry issued an executive decision in early 2007 forcing the vaccine mandate into law despite the opposition of the Texas legislature. The legislature overturned the law a few months later.

HPV causes 70% of all cases of cervical cancer. But hey, that's better than being a slut.

Oral Sex Increases Throat Cancer Risk

From New Scientist:

"People who have had more than five oral-sex partners in their lifetime are 250% more likely to have throat cancer than those who do not have oral sex, a new study suggests. The researchers believe this is because oral sex may transmit human papillomavirus (HPV), the virus implicated in the majority of cervical cancers. The new findings should encourage people to consistently use condoms during oral sex as this could protect against HPV, the team says. Other experts say that the results provide more reason for men to receive the new HPV vaccine."

Calling HPV more significant a factor for throat cancer than smoking or alcohol, the study indicates that those infected with HPV have up to a 32-fold increased risk for oropharyngeal cancer. One doctor cautions against panic, saying, "People should be reassured that oropharyngeal cancer is relatively uncommon, and the overwhelming majority of people with an oral HPV infection probably will not get throat cancer."

As I mentioned here recently, some doctors believe that the new HPV vaccine could help prevent anal cancer in gay men. This latest finding should encourage you to be tested for HPV. For most gay men, it is too late. Approximately 95% of all HIV positive men are co-infected with HPV and about 65% of HIV negatives have it as well. But you should still find out. If you are HPV-negative, a $300 or so vaccine seems like a pretty good bargain.

Cervical Vaccine Might Work For Males

The vaccine against human papillomavirus (HPV). which was approved for girls by the FDA last year, might work to prevent anal cancer, for which gay men have an elevated risk. The European Union has already approved the vaccine for use on boys ages 9-15. Considering the outrageous campaign by the American religious right to keep the vaccine from young girls, I imagine that it will a bumpy road getting the vaccine available for boys as well.

The FDA has not yet approved the vaccine for use in males in this country, but doctors here may administer it "off-label" upon request. The vaccine's manufacturer, Merck, is doing a study on its effectiveness against anal cancer, using a cohort that has a large number of gay men. (It was difficult to find gay men eligible for the study because most already have HPV.)

Gay men develop anal cancer about as often as women developed cervical cancer before the advent of the pap smear. Anal pap smears are recommended for gay men over 50. It is estimated that 95% of HIV positive gay men already have HPV, versus 65% for those HIV negative.

Should this vaccine prove effective in males, it will be very important for all of us to advocate strenuously for its speedy approval and its routine, widespread delivery to American boys, which doubtlessly the religious right will fight with 100 times the fervor with which it fought against it being available to girls.
.