Michael Douglas and HPV

Michael Douglass recently announced that his battle with throat cancer was instigated by HPV.

We have known for a long time that males can benefit from the HPV vaccine series. I wrote this back in 2011:

CDC recommends HPV vaccine for boys!

It would be great, for women, if boys got the vaccine too. Of course, boys cannot get cervical cancer, but they can carry the virus and infect women and give them cervical cancer. Eliminated boys as carriers protects women. BUT…

We cannot, ethically, ask boys to get a vaccine that has risks with no/little benefit to themselves just to protect other people.

...

Back in the day, everybody smoked. Or chewed. Or did something disgusting and dangerous with tobacco that caused lots and lots of oral cancers. All this tobacco use was overshadowing oral cancers caused by HPV! Now that tobacco use is not fashionable anymore, we can finally see the impact of HPV on oral cancers:

Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States.

For example, HPV prevalence by Inno-LiPA increased from 16.3% during 1984 to 1989 to 71.7% during 2000 to 2004.

And then this in 2012:

HPV and head/neck/throat cancer

Of the 124 samples, 50 tumors were positive for HPV-16.  Thats at least 40.3% of oral squamous cell carcinomas whos root cause was HPV.

I say ‘at least’ because the methods utilized in this study were very specific– Though 19 variants of HPV are associated with cancers, they only looked for the variant HPV-16 (which is included in both Gardasil and Cervarix).  Other HPV variants could have been causing some of the HPV-16-negative lesions.

We *know* HPV causes head/neck/throat cancers in both genders, but I dont think parents prioritize getting their male children vaccinated (not that they prioritize getting the vax for their female children either...).

I hope Michael Douglas 'coming out' about the cause of his cancer will raise more awareness for the HPV vaccines and how they help *both* genders.

The vaccine works. Make sure your kids get it.

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Correlation is not causation, but I must point out that a whole bunch of the hysterical anti-vaccination crowd are also the anti-GMO folks.

Thankyou for this post.
Uptake of vaccine by young men has not been good, perhaps partly due to the mistaken idea that men are not at cancer risk from HPV. The reality is that head and neck cancers thanks to HPV are increasing, and more than 80% of those are in men. Evidence suggests they are performing more oral sex acts than in olden times.

Here's a pointer about a recent review that has incidence rates for various HPV associated cancers:
http://www.cancer.gov/newscenter/newsfromnci/2013/ReportNation You'll see tidbit like HPV-associated anal cancer incidences increasing in both men and women, with rates higher in women. Get it together out there.

"Correlation is not causation,"

I think thats what the *know* 2 words before "cause" was for.

By Something else (not verified) on 04 Jun 2013 #permalink

Theo51 intended no reference Abbie's article I believe, but is saying vaccination and GMO opinions are correlated in the wild (in the USA, perhaps). Maybe intent is to disparage anti-GMO folks. Or I'm not getting something.

PS: I should have added earlier (#2) that the head+neck cancers are more deadly than the cervical ones (which have better early detection), so I wondered if the mortality from HPV is actually now greater in men than women, and the benefit of vaxing greater in men as measured by something like quality-adjusted years of live saved. That might get some takers.

Abbie,
Could you explain to us laypeople why Gardasil may only be given to age 26 and below. Why are all older people excluded from the benefits and protection of this vaccine? I can google of course, but I am not satisfied with the answers I've seen and I don't feel that I know enough about modern vaccines to adequately avoid the bullshit.
So, what is your opinion?

Why are all older people excluded from the benefits and protection of this vaccine?

The statistically valid observation that by age 26, absent the vaccine, most people are colonized. And, yes, there are obvious exceptions -- but from a public health standpoint they're not the slam-dunk case that younger people are.

By D. C. Sessions (not verified) on 04 Jun 2013 #permalink

I think boys/males should get the HPV vaccine. The fact that they are the carrier of the disease should be important to parents. Even though they may not get the virus the risk of them getting neck and throat cancer from the virus is still very high. If they parents take this seriously they can help to stop spreading the virus and also help also with contraction of the that type of cancer as well.

DC the "most older people have it already" argument is not valid because there is a currently available blood test for HPV and many, like myself, do not have it. So why shouldn't I be able to get the vaccine?

It's never "great" when anyone gets any sort of cancer, but Michael Douglas has managed to squeeze some good out of his situation. Last I read all the god botherers were down with the line that HPV vaccination somehow sent a message to girls that the squeak and giggle is just fine with Jesus. Now the script is going to need a re-write.

By George Chadick (not verified) on 11 Jun 2013 #permalink

Brakeman, you can still get it, but insurance won't cover it past age 26. It's a 3-shot series, and I was 26 for my first but 27 for the last 2 and they let me get it still. In fact, my doc was pushing for it; I thought that because I'm married and not gonna be with anybody else, that I could skip it, but I'm glad I got it. It does hurt a lot more than other vaccines I've had, though!

#10: Oh no. I looked at that southweb blog, and it was horrifying to see that post (and several others like it) cherry pick factlets and spinnig half-truths. It'd take thousands of words to clear up everything slanted about it, but here are some whoppers.
1) The relationship between HPV and cancer is merely hypothetical conjecture. This is baloney to anyone who remotely tries to learn the facts. For example, if this is true, why do pap smears save lives? Why are cervical cancers almost always HPV-16 (and 18) positive? Why are head+neck cancers incidences rising, with more being HPV+. Oh, there's lots of really basic science about the mechanism for how HPV makes cancer too - there are dozens of papers about that every year (cause we don't know everything, but we know fairly much).
2) there is no actual evidence that the vaccine can prevent any cancer. A grain of truth in there is that the evidence is not direct: we will have to wait years to directly show that vaccinated people die later on average. What we do know is that women got the precancerous diagnosis less often. Since this almost invariable precedes frank cancer, there's very good reason to think it will reduce cancer deaths. To wait 15-30 years for more direct evidence has risks of causing people to die. That the situation is not super-simple allows almost any spin an unethical (or ignorant) author wishes to apply. I think the authors know the truth about this, but would rather deceive you - the ends justify the means for them perhaps.
3) the vaccine only works on 4 strains out of 40...so the chance of it actually helping an individual is about about the same as the chance of him being struck by a meteorite.
HPV-16 and 18 do almost all the damage, from what we now know. Is the author ignorant of that fact? Highly doubtful. Is the author being disingenuous, and using a known crappy argument to influence the ignorant? Yes, they are essentially willing to lie for the cause.
4) Then there's the adverse events. I liked the sarcastic commenter who noted they started eating a certain breakfast cereal a few months before brain tumor diagnosis, so clearly the cereal is evil. The crank authors always try to make it seem like every reported event is in fact caused by the vax. That's not nearly true. We may have gotten nearly as many reports with placebo.

The commenters severely depressed me in both conspiracy think, and in focusing on utopian solutions.
Note: whether vaxing costs too much in terms of money or side effects compared to the decrease in morbidity and mortality from not vaxing can be debated by experts - I'm not saying Guarasil (for example) is obviously worth every penny or risk, with emphasis on "obviously". It's a non-trivial calculation, harder than for common childhood illnesses by far. I don't expect careful consideration of the math at southweb.

I garbled Gardasil pretty bad, sorry.

Thanks, rork. I figured something was odd about that.