HPV

[lvhmbh]

I'm sure you've all seen the TV ad cautioning us to have our young people vaccinated. DH was recently diagnosed with throat cancer (in treatment and doing well). The kicker was that it was from HPV. He's almost 74 and the Dr. said it was unlikely at his age but the test came back positive. Now that's good news as the rate of recovery for HPV caused cancer is much higher than for other causes (smoking, 2nd hand smoke, etc.) but is was a shocker. Our G-nephew, who is almost 22, is getting vaccinated (takes 3 shots over a period of time) as our Dr. says it's never too late. Just a cautionary tale to suggest that you get your young children and g-children vaccinated.

 

[Jan M.]

What is HPV?

HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). 79 million Americans, most in their late teens and early 20s, are infected with HPV. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening.

How is HPV spread?
You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms.

Anyone who is sexually active can get HPV, even if you have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected. This makes it hard to know when you first became infected.

Does HPV cause health problems?
In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.

Does HPV cause cancer?
HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).

Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.

There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including those with HIV/AIDS) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.

How can I avoid HPV and the health problems it can cause?
You can do several things to lower your chances of getting HPV.

Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. (See “Who should get vaccinated?” below) CDC recommends 11 to 12 year olds get two doses of HPV vaccine to protect against cancers caused by HPV. For more information on the recommendations, please see: https://www.cdc.gov/vaccines/vpd/hpv/public/index.html

Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.

If you are sexually active

• Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV;
• Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

Who should get vaccinated?
All boys and girls ages 11 or 12 years should get vaccinated.

Catch-up vaccines are recommended for boys and men through age 21 and for girls and women through age 26, if they did not get vaccinated when they were younger.

The vaccine is also recommended for gay and bisexual men (or any man who has sex with a man) through age 26. It is also recommended for men and women with compromised immune systems (including those living with HIV/AIDS) through age 26, if they did not get fully vaccinated when they were younger.

How do I know if I have HPV?
There is no test to find out a person’s “HPV status.” Also, there is no approved HPV test to find HPV in the mouth or throat.

There are HPV tests that can be used to screen for cervical cancer. These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years.

Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.

How common is HPV and the health problems caused by HPV?
HPV (the virus): About 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that almost every person who is sexually-active will get HPV at some time in their life if they don’t get the HPV vaccine.

Health problems related to HPV include genital warts and cervical cancer.

Genital warts: Before HPV vaccines were introduced, roughly 340,000 to 360,000 women and men were affected by genital warts caused by HPV every year.* Also, about one in 100 sexually active adults in the U.S. has genital warts at any given time.

Cervical cancer: Every year, nearly 12,000 women living in the U.S. will be diagnosed with cervical cancer, and more than 4,000 women die from cervical cancer—even with screening and treatment.

There are other conditions and cancers caused by HPV that occur in people living in the United States. Every year, approximately 19,400 women and 12,100 men are affected by cancers caused by HPV.

*These figures only look at the number of people who sought care for genital warts. This could be an underestimate of the actual number of people who get genital warts.

I’m pregnant. Will having HPV affect my pregnancy?
If you are pregnant and have HPV, you can get genital warts or develop abnormal cell changes on your cervix. Abnormal cell changes can be found with routine cervical cancer screening. You should get routine cervical cancer screening even when you are pregnant.

Can I be treated for HPV or health problems caused by HPV?
There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:

1. Genital warts can be treated by your healthcare provider or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number.
2. Cervical precancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment. For more information visit www.cancer.org.
3. Other HPV-related cancers are also more treatable when diagnosed and treated early. For more information visit www.cancer.org.

Where can I get more information?
STD information

HPV Information

HPV Vaccination

Cancer Information

Cervical Cancer Screening

CDC’s National Breast and Cervical Cancer Early Detection Program

STD information and referrals to STD Clinics
CDC-INFO
1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English, en Español

CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
E-mail: npin-info@cdc.gov

National HPV and Cervical Cancer Prevention Resource Center American Sexual Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC
27709-3827
1-800-783-9877

 

[DaveNV]

Jan, it’s good to hear your husband is responding well to treatment. Good luck to you both, going forward.

There are a number of “sleeper” illnesses we may have and not know it. Spouse was going to have a surgical procedure done on a salivary gland, and since it required general anesthetic, they did a bunch of lab tests. During the review of the results, the doctor asks, “How long have you had Hepatitis C?”

Say what?? Had no idea! Best we could figure out was it came from a blood transfusion in California years before. Luckily, insurance paid for the treatment, and things are as cured as one can be for that. But what a shocker to be asked a question like that!

Dave

 

[Panina]

I'm sure you've all seen the TV ad cautioning us to have our young people vaccinated. DH was recently diagnosed with throat cancer (in treatment and doing well). The kicker was that it was from HPV. He's almost 74 and the Dr. said it was unlikely at his age but the test came back positive. Now that's good news as the rate of recovery for HPV caused cancer is much higher than for other causes (smoking, 2nd hand smoke, etc.) but is was a shocker. Our G-nephew, who is almost 22, is getting vaccinated (takes 3 shots over a period of time) as our Dr. says it's never too late. Just a cautionary tale to suggest that you get your young children and g-children vaccinated.

Thank you for sharing. I wonder why the medical community is not testing the more mature for HPV. I know my doctor insisted I get tested for Hepatitis C. I will ask her next time why not HPV.

I send my prayers your way for your husband to have a good recovery.

 

[magmue]

I wonder why the medical community is not testing the more mature for HPV

I'm a recently retired CNM/women's health care NP, so this is a subject I know quite a bit about.
As a woman, if you've been in for a well woman exam with Pap smear in the last 5 years or so, you probably have been screened for high risk cervical HPV - that test has been around for >10 years now and we know how and when to use it. It's the reason we have been able to stop doing a Pap (which looks for abnormal cervical cells) every year. Current guidelines are to do a combined pap and HR-HPV - if pap is normal and HPV is negative, OK to go 5 years between Paps. It turns out that with the exception of DES daughters, virtually all cervical cancer starts with a HR-HPV infection - there are cells at the cervical opening that are susceptible to mutation over time, and that can progress into cervical cancer over a number of years.

 

[magmue]

The thing is - there are more than 100 Human Papilloma Viruses (HPV) out there. 13 of them fall into the high risk group. There is another group of "low risk" HPV that can cause more mild abnormal changes that never progress into cervical cancer. And then there's a bunch of HPV types that cause "warts" that are unsightly and embarrassing but are benign.

When it comes to cervical HPV, 80% of women will clear the virus on their own over the next 1-2 years, and might never know they had it. And the high risk HPV types don't always progress into cancer in the 20% of women who are persistently positive - when women harbor the virus long term, we just have to keep a closer eye on them testingwise.

 

[magmue]

You also can develop symptoms years after you have sex with someone who is infected.

In many cases, there are no symptoms.

A healthcare provider can usually diagnose warts by looking at the genital area.

The genital warts that can be diagnosed by visual inspection are generally the benign/low risk ones. If you have external genital warts, your NP or physician can offer treatment that burns away the wart/s over time, but that does not get rid of the virus that caused the warts in the first place. Your own immune system has to get on top of the virus, similarly to the common cold.

 

[mdurette]

My 12 yo daughter just went for her annual physical. It was offered now or next year. We opted for next year to start. But; what surprised me a bit is the doc mentioned our neighboring state school system requires once 13 years old to attend public schools.

Good for them for getting on top of it. A vaccine that could potentially scare away future cancer. Wish there was one to scare all cancers away.

 

[magmue]

If your daughter starts before age 15, she will only need a total of 2 shots 6-12 months apart. Starting later means 3 shots altogether.

 

[Jan M.]

Jan, it’s good to hear your husband is responding well to treatment. Good luck to you both, going forward.

There are a number of “sleeper” illnesses we may have and not know it. Spouse was going to have a surgical procedure done on a salivary gland, and since it required general anesthetic, they did a bunch of lab tests. During the review of the results, the doctor asks, “How long have you had Hepatitis C?”

Say what?? Had no idea! Best we could figure out was it came from a blood transfusion in California years before. Luckily, insurance paid for the treatment, and things are as cured as one can be for that. But what a shocker to be asked a question like that!

Dave

Dave,

Not my husband. This thread was started by lvhmbh and it is her husband. I too am glad her husband is responding well to treatment. I posted the information I found online because after reading her post I found there was a lot I didn't know about HPV. Like magmue I was trying tactfully to suggest to lvhmbh that she should be tested for cervical cancer or even suspicious cells. From what I read her husband may have contracted HPV many, many years ago and been asymptomatic all this time but due to his age and lowered immune system developed the cancer. However cervical cancer from HPV is a threat to women of any age.

Sorry to hear your wife had to deal with Hep C. A couple of years ago the early 30's daughter of someone I know wasn't feeling well and was discovered to have Hep C. She was sincerely mystified about how she could have gotten it. Her mother was devastated, sure it was going to be a death sentence for the daughter and also sure it meant that someone had been doing something they shouldn't have been doing since her daughter never had a blood transfusion. Both she and I started reading online, found out it can be contracted in ways we hadn't known about and that it responds well when detected and treated, the earlier the better. Thirty years ago someone we knew took a very bad fall on icy steps and ended up having to have his spleen removed. Within a month or so he was found to have Hep C from one of the several blood transfusions he received. They had three kids under 5 and his wife was convinced he was going to die young from the Hep C or cancer from it. Thankfully he was still under the doctors care and being watched. He's still alive and looking well!

 

[DaveNV]

Dave,

Not my husband. This thread was started by lvhmbh and it is her husband.

Whoops! So sorry, I named the wrong poster. That's what I get for replying on my phone, instead of my computer. Apologies to both of you.

The Hep C diagnosis was quite a shock for us both, since there were no symptoms. Treatment was very straightforward, thank goodness, (albeit very expensive without insurance, which we did have, so saved a bundle), and after about three months of a daily pill regimen, careful eating, no alcohol, and whatever else, things were basically undetectable, aka "cured." Barring a reinfection, they should stay that way. For the record, I tested negative. We've been together twenty years, and I was told I could easily have contracted it by accident. Tricky stuff.

Dave

 

[Paumavista]

4 years through cancer treatment for a HPV related cancer - no signs, no symptoms; never had a positive HPV test during any GYN exam. Identified my cancer during my very first colonoscopy (which I waited till 56 to even do....based on the fact that I have no family history of related cancer, no signs, symptoms; I'm very active and fit). You never know...….So advise the young people you know to be vaccinated and monitor yourself by getting all regular age related tests. Treatment was ROUGH, but I am doing well right now and enjoying life......every single day!

 

[magmue]

...cancer treatment for a HPV related cancer - no signs, no symptoms; never had a positive HPV test during any GYN exam. Identified my cancer during my very first colonoscopy

I had a patient who I had been seeing for more than a decade, normal Paps and negative cervical HPV testing. Had repeatedly said "no thank you" to referral for routine screening colonoscopy. At 60, she came in for a well woman exam - had odd looking bumps around her anus that she had not noticed and were not bothering her. Didn't look like typical "genital warts", so I biopsied. Pathology showed severe dysplasia (pre-cancer) related to HPV 16 or 18, the most aggressive of the high risk HPVs. It turned out she had anal cancer, and needed surgical treatment.

It turns out that HPV related anal cancer can begin without sexual activity

 

[VacationForever]

The thing is - there are more than 100 Human Papilloma Viruses (HPV) out there. 13 of them fall into the high risk group. There is another group of "low risk" HPV that can cause more mild abnormal changes that never progress into cervical cancer. And then there's a bunch of HPV types that cause "warts" that are unsightly and embarrassing but are benign.

When it comes to cervical HPV, 80% of women will clear the virus on their own over the next 1-2 years, and might never know they had it. And the high risk HPV types don't always progress into cancer in the 20% of women who are persistently positive - when women harbor the virus long term, we just have to keep a closer eye on them testingwise.

In the 80% of the women who clear the virus on their own over the next 1-2 years, can the virus come back during a time when the women's immunity is low?

 

[magmue]

can the virus come back

Latest research suggests that the virus goes dormant to the point of being undetectable in that 80%, but can reactivate, sort of like chicken pox can come back as shingles. Menopause seems to be a higher risk time for cervical HPV to return.

It can be disconcerting to realize how much of what we accept as black and white is not. It took me years working in health care to fully understand and accept that A Test is Only A Test.

 

[VacationForever]

Latest research suggests that the virus goes dormant to the point of being undetectable in that 80%, but can reactivate, sort of like chicken pox can come back as shingles. Menopause seems to be a higher risk time for cervical HPV to return.

It can be disconcerting to realize how much of what we accept as black and white is not. It took me years working in health care to fully understand and accept that A Test is Only A Test.

But drs normally stop pap smear in older women after several years of negative hpv tests. If hpv stays dormant and can come back, shouldn't older women continue to have the tests?

 

[lvhmbh]

I have been tested for cancer as I'm 2 years recovered from laryngeal cancer. Dr. said that he probably contracted the HPV many years ago. Thanks for the hopes for his recovery!

 

[lvhmbh]

My cancer was diagnosed as second hand smoke (I quit many years ago). We used to spend alot of time in the casinos in Aruba (lived there in a timeshare for 42 weeks of the year). I started to develop a problem one year when I was there. Was misdiagnosed as having silent acid reflux which I now know I never had. Anyway, finally got with a very good surgeon. Radiation followed and the voice is still very raspy. I WAS tested for HPV.

 

[Paumavista]

But drs normally stop pap smear in older women after several years of negative hpv tests. If hpv stays dormant and can come back, shouldn't older women continue to have the tests?

I was also told that the virus will stay with you forever....(although it may go into a dormant state.....that is basically undetectable; and I do not think it was even checked for during my annual GYN appointments)…..so my personal suggestion would be that people should continue most preventative checkups i.e. colonoscopy, and seeking medical attention for irregular symptoms (until they decide that they wouldn't seek treatment regardless of the test results). I don't believe there is a reliable HPV test that would completely rule out the possibility of a HPV related cancer. Since HPV is obviously in my body I could also possibly get another outbreak of the same cancer (not a recurrence in the same spot); or one of the other HPV related cancers. I think the shingles example/comparison was a good one.

 

[Beachclubmum]

I have a teenaged son who's starting his senior year of high school. The Ped had wanted to give him the HPV vaccine for a couple of years and I declined. Seemed odd to me to give it to guys, and I was still a bit skeptical about safety since it's a newer vaccine and some people do have reactions to it. However, she did convince me when she said the virus is being spread through saliva and even kissing could spread it and the incidence of cancer in men is rising. He had the shots a year and a half ago.

 

[lvhmbh]

Good for you Beachclubmum!!! Our Nick is going to be 22 and is in the process of getting the shots. The Dr. at his college told him it was a really good idea.