Meet the New STD (that Looks A Lot Like the Old Ones)

You may think you’ve heard all about sexually transmitted diseases, but now a new one poses a threat to your sexual health and wellbeing, albeit looking a lot like one of the old ones. According to wellness writer Charles Bankhead, ‘Once the scourge of older patients with a history of smoking and heavy alcohol use, head and neck cancer has evolved into a disease that strikes people – mostly men – in the prime of life. The driving force behind the molecular transformation is the same one that has received so much attention for causing cervical cancer in women: human papillomavirus (HPV). What’s more, the same oncologic strains drive both types of cancer.’

 

Bankhead notes, ‘About 37,000 new cases of head and neck cancer are diagnosed each year. HPV infection accounts for about two thirds of the total, according to the CDC. The “classic” tobacco- and alcohol-related head and neck cancer tended to be oral-cavity malignancies. In HPV-positive majority, oropharyngeal cancer predominates. Many people who were unaware of the role HPV plays in head and neck cancer probably learned about it last summer when actor Michael Douglas announced publicly that his head and neck cancer was caused by HPV infection, which he attributed to oral sex…Douglas’s announcement drew public attention to what authorities in the field have known for years: Head and neck cancer is essentially an STD, or at least a manifestation of one.’

 

Anil Chaturvedi, PhD, of the National Cancer Institute, points out that the incidence of oral-cavity cancer remained stable from 1973 to 1984, and then began a decline that continues today, reflecting trends in tobacco and alcohol use. The incidence of oropharyngeal cancer, on the other hand, increased gradually until about 2000. The proportion of HPV-positive oropharyngeal tumours has increased from 16% in the late 1980s to 72% since the turn of the century. Chaturvedi explains, ‘The increase in oropharynx cancer has come exclusively from an increase in HPV-positive cancers, which increased by 225. In parallel over the same period, the incidence of HPV-negative oropharynx cancer has declined by about 50%.’

 

Bankhead points out, ‘The emergence of HPV-positive oropharyngeal cancer has been driven almost entirely by oral HPV infection, which has become incredibly common. Data from the National Health and Nutrition Evaluation Survey showed a 7% prevalence of oral HPV infection among US adults – one in 14. Oral HPV infection occurs two to five times more often in men than women…Current prevalence estimates are 10.1% among men and 3.6% among women. Infection rates in both sexes are driven predominantly by sexual activity, accounting for more than 80% of cases in women and almost 90% in men. The risk of infection increases with the number of sex partners in both men and women and with smoking, rising with the number of cigarettes smoked.’

 

Amber D’Souza, PhD, of Johns Hopkins School of Public Health, admits, ‘It’s been hard to say which [sexual] behaviours transmit the infection. We know that it can be transmitted by oral sex. We know that performing oral sex on a woman increases the risk of acquiring HPV infection and that performing oral sex on a woman appears to have a higher risk of infection than performing oral sex on a man…It is a sexually transmitted infection. It is not casually transmitted.’ She adds that three-quarters of infected individuals clear the infection within two years. ‘Then there’s this subgroup of people who have persistent infection,’ she says. ‘We still think most of them will not develop HPV-positive oropharyngeal cancer.’ As many as 85% of patients survive without recurrence or with effective treatment at recurrence. However, that leaves 15% who don’t do so well, and the reasons remain a mystery.

Categories: head and neck cancer, HPV, hpv infection, hpv positive, neck cancer, oral cavity, oral hpv, oral sex, Oropharyngeal Cancer, performing oral, positive oropharyngeal

Can Acupuncture Relieve Your Dysphasia? Study Says No

When your wellbeing is affected by head and neck cancer (HNC), dysphasia is a common adverse effect of chemoradiation therapy. Previous reports suggest that complementary wellness techniques, such as acupuncture, may help to provide some relief from dysphasia, but a new study has found this is not the case. The research, which was presented at the 10th International Conference of the Society for Integrative Oncology (SIO), found that active acupuncture provides no more of an improvement to your wellness than sham acupuncture, or a placebo.

 

The study was presented by lead author Weidong Lu, MB, PhD, MPH, an instructor in the Department of Medicine at Harvard Medical School and a staff acupuncturist at the Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, in Boston. Lu commented that while some improvements were shown, there wasn’t enough of an improvement for the results to be statistically significant. ‘Acupuncture is a safe intervention, and it is feasible for head and neck cancer patients,’ he said. ‘Improvements were observed in both arms of the study, and more studies are needed to establish the clinical benefit of acupuncture in head and neck cancer.’

 

The cohort involved 42 patients diagnosed with stage III or IV HNC who had no evidence of distant metastasis and who were receiving curative-intent chemoradiation. For the study, the patients were given 12 sessions of active or sham acupuncture. The sessions were undergone once a fortnight, starting, during and continuing until 20 weeks after chemoradiation. A total of 35 patients (83%) received at least eight sessions of acupuncture, and 28 (67%) received all 12. Lu noted that HNC patients might require more frequent or a longer duration of treatment in order for researchers to more thoroughly investigate the efficacy of acupuncture in this setting. He explained that the biweekly nature of the sessions ‘is among the weaknesses of the study,’ but the researchers needed to make this modification during the recruitment phase of the study because prospective participants ‘did not like needles.’ The researchers changed the timing so that participants would sign up for the study, but Lu asserted that ‘in the next phase, it should be once a week in order to get better results.’

 

According to Richard Lee, MD, assistant professor of general oncology at the University of Texas M.D. Anderson Cancer Centre in Houston, even though the results of the study were negative, that is not to say that there wasn’t a benefit with acupuncture. Lee explained, ‘It may be the style of acupuncture — manual or electrostimulation — or the point selection. These different factors could modify response. It’s the same with medicines, even within one category; you can have different response rates with different medicines. With acupuncture, everyone is using different points and different techniques, so that can account for the differences that are seen in studies. It may very well be that for dysphasia, there is not a specific effect, but it requires more research to determine whether that really is the case.’

 

In randomised trials, sham acupuncture is used as a placebo, meaning that the researchers either insert the needles superficially or else they do not penetrate the skin. In theory, this means that the sham acupuncture should not achieve the same impact as active acupuncture, and so the wellness experts are speculating as to why patients who received sham acupuncture showed similar improvement. Lee surmised, ‘With acupuncture, there are “non-specific effects” or placebo effects. I suspect that part of that placebo response is related to the care and attention from the practitioner. That is why you get some response with sham acupuncture.’

Categories: active acupuncture, acupuncture, cancer, Dysphasia, neck cancer, Patients, Research, sham, sham acupuncture, study

Warning: Having Oral Sex Could Give You Mouth Cancer

In a controversial television interview, actor Michael Douglas recently explained that his throat cancer had actually been caused by a sexual health problem.  He claimed that having oral sex with his wife had caused him to contract the human papillomavirus (HPV) which caused his head and neck cancer.

 

So, is oral sex always a threat to your wellness and wellbeing? Experts claim that this is simply not the case and that the reports that are around at the moment are causing people an unnecessary level of worry.

 

Some have proposed that a change in sexual behaviour should be advised due to the risks of contracting HPV, but experts say that these types of conclusions are premature. Whilst oral sex may be one risk factor for certain types of head and neck cancers, at this point the link is mainly speculative. In addition to this, there are many, many other elements that play a role in whether or not someone develops cancer, including how strong their immune system is, the experts say.

 

In general, if two people are in a monogamous relationship, there is really no need for them to restrict their sexual activities as long as they are both in good health.

 

Contrary to reports, cases of head and neck cancer are not on the increase. In fact, when studied as a group, cases of these types of cancer have actually declined in the United States of America during the last 25 years. On the other hand, there has been an increase in the number of head and neck cancer amongst younger people, and these cases are primarily caused by HPV.

 

HPV is generally sexually transmitted, and the virus causes nearly every case of cervical cancer. It can also cause anal cancer and genital warts.

Categories: cancer, caused, head, HPV, nbsp, Neck, neck cancer, oral, oral sex