HPV and Men: what you need to know

Can men get HPV?

In men, high-risk HPVs don't cause symptoms and are often very difficult to diagnose. In this situation, the most common are the genital warts that usually appear on the penis, on the scrotum, in or around the anus, or on the groin. For men, HPV infection — including those that can cause cellular changes — produce no symptoms, so diagnosing HPV in men is difficult. The diagnosis of HPV in men is made from the presence of external genital warts.

Since there is no treatment for HPV that does not produce symptoms, most men with the infection are not treated. Sometimes, a health care provider can see small warts that might have otherwise gone unnoticed. In general, HPV infection does not place a man at a significantly higher risk for health problems. However, HPV prevention is still important for men, as the virus has been linked to uncommon cancers such as penile, anal, and head and neck.

Some people who are known to be at a high risk of having anal HPV and of developing anal cancer may be offered an anal smear. Men who have anal sex are more likely to have anal HPV and are at an increased risk of developing anal cancer. The risk for men and women with HIV is greater still, regardless of their sexual orientation.

The anal smear is very similar to a cervical smear, and involves collecting cells from the anal area using a special wipe. An HPV DNA test can also sometimes be done during an anal smear. However, anal smears are not widely available. If you are in a high-risk group and more likely to have anal HPV, you can talk to your doctor about whether you should have regular anal smears.

http://www.youtube.com/watch?feature=player_embedded&v=-GL77P2l3gI

Other HPV related cancers

 HPV can cause cancers in other genital areas, like the vagina, vulva, penis and anus, as well as some types of cancer in the mouth and throat. As with cervical HPV infections, using a condom can reduce the risk of spreading HPV.

Vaginal, vulval, penile and anal cancers are less common than cervical cancer, but the statistics show an increased number of patients that developed these types of cancer due to HPV infection in the past years.

HPV infection also increases the risk of some types of mouth and throat cancers. Rates of mouth cancer especially tongue and tonsil cancers are on the increase, especially in people in their 40s, 50s and 60s. Estimates of how many of these cases are caused by HPV have varied, but it seems to be greater than 40% and the proportion of cases linked to HPV is rising. Mouth cancers linked to HPV have a better prognosis than cases which aren’t linked to the infection. There is still much more to learn about how HPV behaves in the mouth and how people can reduce the risk.

The main risk factors for HPV are the same for genital and oral infection. Having a high number of sexual partners increases your chance of picking up an infection.

How can HPV cause cancer

Normally, HPV infections start in the deepest layers of the skin. During an infection, HPV causes skin cells to divide more than usual. New virus particles are then made inside these cells.

This fast skin growth can cause warts to develop, but often it doesn't cause any symptoms at all. The types of HPV that cause warts are not the same types that cause cancer. In some people with persistent ‘high-risk’ HPV infections, the virus damages the cells' DNA and causes cells to start dividing and growing out of control. This can lead to cancer.

As a conclusion:

HPV is spread through sex, and it can cause an infection in the cervix. The infection usually doesn't last very long because your body is able to fight the infection. If the HPV doesn't go away, the virus may cause cervix cells to change and become pre-cancer cells. Pre-cancer cells are not cancer. Most cells with early pre-cancer changes return to normal on their own. Sometimes, the pre-cancer cells may turn into cancer if they are not found and treated.

Understanding HPV

Human Papillomavirus (HPV) is the main responsible of one of the most common sexually transmitted diseases worldwide and persistent infection is the major risk factor for the development of cervical cancer.

Nearly two decades ago, experts discovered a relationship between infection with HPV (human papillomavirus) and cervical cancer. Since then, they have learned much more about how HPV can lead to cervical cancer.

But what is HPV?

HPV, or human papillomavirus, is a virus that infects the skin and the cells lining body cavities. It is spread through close skin-to-skin contact. It is a very common infection which usually causes no symptoms at all.

Up to 8 out of 10 people will be infected with the virus at some point in their lives. HPV infections are usually on the fingers, hands, mouth and genitals. For most people, the infection will get better on its own and they will never know they had it. But in some people the infection will stay around for a long time and become persistent.

There are hundreds of different types of HPV. Most are harmless but around 15 types of HPV can cause cancer. These are called ‘high-risk’ types. People with persistent infections with ‘high-risk’ HPV types are those who are most likely to go on to develop cancer.

Some types of HPV are known to increase the risk of developing particular types of cancer and are known as high-risk HPVs. The types most often associated with cancer are types 16 and 18. High-risk HPVs can lead to abnormal changes in the cells, which is sometimes called dysplasia. Although dysplasia is not cancer, it's sometimes described as being pre-cancerous.

Other types of HPV can cause warts and verruca. These may appear on different parts of the body, but are more commonly seen on the hands and feet, in the genital area and around the anus. The types of HPV that cause visible warts and verruca are less clearly linked with cell changes that can increase the risk of cancer. They are known as low-risk HPVs.

“High-risk” types of HPV (HR)

There are more than a dozen types of "high-risk" HPV that can cause abnormal cells to form on the cervix. These abnormal cell changes may gradually develop into cervical cancer if not removed. The 13 types of high-risk HPV that are of most concern are known by the numbers 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82. Types 16 and 18 are the most dangerous, since they cause about 70 % of cervical cancers. In one study, the National Cancer Institute found that about 10 % of women with HPV type 16 or 18 developed advanced, pre-cancerous cervical disease within three years (compared to just 4 % of women with any type of HPV), and 20 % did so in 10 years (compared to 7 %).

“Low-risk” types of HPV (LR)

There are about 12 types of HPV that are called "low risk" because they cannot cause cervical cancer. They can, however, cause genital warts or very minor cell changes on the cervix. These low-risk types of HPV are known by the numbers 6, 11, 40, 42, 43, 44, 53, 54, 61, 66, 72, 81 and 89. Types 6 and 11 – which are linked to about 90 %of genital warts – are the most common.

and genotypes with “Probable high-risk” (PHR)

20, 26, 53, 66, 69, 70, 71 and 74

Keep in mind that of those infected with HPV, 50% of them will fortunately clear the virus within 8 months, 90% of them within 2 years. Therefore, it’s more likely than that if you have been infected sometime in the past, you either may have cleared the virus already or have acquired a non-cancerous strain.

In most countries, cervical screening using a Papanicolaou (Pap) test  is used to detect abnormal cells that may develop into cancer. If abnormal cells are found, women are invited to have a colposcopy. During a colposcopic inspection, biopsies can be taken and abnormal areas can be removed with a simple procedure.  Treating abnormal cells in this way can prevent them from developing into cervical cancer. 

The second type of test is the HPV DNA, which is relatively new and can be done during a Pap test with a gynaecologist. It involves taking a small sample of cervical cells with a cotton swab or a small brush.

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Since 99.7% of cervical cancers can be attributed to HPV, the importance of a simple HPV test from your gynaecologist cannot be overstated.

Tens of different Papillomavirus types infect humans, but only a handful are harmful. Mapping HPV types by genus (see Figure) reveals that certain species often cause similar warts and lesions, with most of the HPV types that cause cancer coming from the same species. However, shared pathology doesn't always indicate close family ties; HPV types 1, 2 and 4, which all cause common skin warts, are distant relations.

January - Cervical Cancer Awarness Month

As the month of January brings cervical cancer into focus, it’s time to increase public understanding of the disease, including its prevalence, approaches to screening, prevention and treatment options.


Cervical cancer is one of the most common types of cancer affecting women, but in the same time, is the only gynecological cancer for which there is a screening test available.  Screening can help find this cancer early, when treatment can be most effective.

Cervical Cancer affects a lot of women every year and still kills a lot of them, as you can see in the diagram of the World Health Organization from 2008.





But what is Cervical Cancer?

Cervical cancer is defined as cancer that starts in the cervix or lower part of the uterus - the cervix is the part of the body that connects the uterus (or womb) to the vagina (or birth canal).

Cervical cancer occurs when abnormal cells on the cervix grow out of control, can often be successfully treated when it's found early and  is usually found at a very early stage through a Pap test.



What causes cervical cancer?

Most cervical cancer is caused by a virus called Human Papillomavirus  or HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus but not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.

You can have HPV for years and not know it. It stays in your body and can lead to cervical cancer years after you were infected. This is why it is important for you to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.

Besides the Human Papillomavirus infection (HPV), there are also other several risk factors that can increase your chances of developing this type of cancer:  

*   Smoking          
*   Diet          
*   Family history          
*   Taking birth control pills over a long period of time          
*   Immunosuppression (HIV or AIDS)          
*   Chlamydia infection          
*   Having had three or more full-term pregnancies          


What are the symptoms?

Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:

*    Bleeding from the vagina that is not normal or a change in your menstrual cycle that you can't explain.         
*    Bleeding when something comes in contact with your cervix, such as during sex or when you put in a diaphragm.        
*    Pain during sex.        
*    Vaginal discharge that is tinged with blood.



How is cervical cancer diagnosed?

As part of your regular pelvic exam, you should have a Pap test. During a Pap test, the doctor scrapes a small sample of cells from the surface of the cervix to look for cell changes. If a Pap test shows abnormal cell changes, your doctor may do other tests to look for precancerous or cancer cells on your cervix.

Your doctor may also do a Pap test and take a sample of tissue (biopsy) if you have symptoms of cervical cancer, such as bleeding after sex.



How is it treated?

The treatment for most stages of cervical cancer includes:

*    Surgery, such as a hysterectomy and removal of pelvic lymph nodes with or without removal of both ovaries and Fallopian tubes.          
*    Chemotherapy.          
*    Radiation therapy.

Depending on how much the cancer has grown, you may have one or more treatments. And you may have a combination of treatments. If you have a hysterectomy, you won't be able to have children. But a hysterectomy isn't always needed, especially when cancer is found very early.



Can cervical cancer be prevented?

The Pap test is the best way to find cervical cell changes that can lead to cervical cancer. Regular Pap tests almost always show these cell changes before they turn into cancer. It's important to follow up with your doctor after any abnormal Pap test result so you can treat abnormal cell changes. This may help prevent cervical cancer.

If you are age 26 or younger, you can get the HPV vaccine, which protects against two types of HPV that cause cervical cancer (even though my doctor which is also one of the researchers that launched Gardasil, at the European Cancer Conference in Paris, France told me the vaccine can be done at any age, as long as the patient is in good health – the vaccine was only tested on women under the age of 27. It was believed that women 27 and older were so likely to already have HPV, so cutting off at 26 meant they had a higher proportion of HPV-free patients. There's no reason to believe that it won't work on women in their late 20's or 30’s, 40’s or that it is unsafe. But this hasn't been verified through clinical trials; therefore you should talk to your doctor about this).
                                                                          
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It's common to feel scared, sad, or angry after finding out that you have cervical cancer. Talking to others who have had the disease may help you feel better. Ask your doctor about support groups in your area. You can also find people online who will share their experiences with you.

Why this blog?

It was the beginning of autumn 2005 when I was told I have Cervical Cancer. At barely 23 years old, with a lot of yet unfulfilled dreams and hopes left behind, the news came as a bolt from the blue and everything that followed made me see life different, become more understanding but  less patient and tolerant in the same time. 

I've been through all the possible emotions, from shock when the doctor told me I had cancer,  desperation and fear when I was told they need to remove my uterus, to anger and despise when I found out the first doctor had made a mistake on diagnosing me with cancer in the first place. 

Looking back, I realize I was somehow lucky, even though "luck" is a word I rarely use or better say, a word that doesn't define me.  After new PAP smear and HPV testing, colposcopy and echography done early December, the outcome was different than what I was told before: Class II PAP smear (atypical cells).  

Mid-December brought me a Laser Vaporization conisation (use of laser to destroy cervical tissue), a few weeks of recovery, a long period of fear and 6-months PAP smears and HPV tests for the following 3 years. January 2008 I started the Gardasil vaccination.

The reason why I started this blog is simple: even though I was spared from this terrible disease, Cervical Cancer did however influence my life. From early September to mid-December, I did have my share of despair and anxiety, anger and disbelief...I was all alone and I hope that you, beautiful WOMAN that reads my blog in search of information and some kind of "comfort" will not be as alone as I was.                                                                                                

                                                                                                                                  

                                                                                                                                          Anna