Cancer from HPV

[kumar87]

Dear doctor,

I am a 23 year old male. In February last year, I received unprotected oral sex and protected oral sex with 6 different sex workers.

Since then, I have not noticed any warts on my penis or genitals. Could I possibly have HPV?

Could it lead to any type of cancer like penile cancer? Should I take any precautions and get my self checked for HPV strains?

I also have a steady girlfriend now and we are thinking of getting married soon and starting a family. We have already had unprotected sex many times and I am worried that I may have passed on the infection to her as she has not yet taken the HPV medication.

Thanks

Kumar

[Edward W Hook, MD]

No, there are no recommended tests for HPV in men.  As I tried to indicate above, this really is not something to worry about.  

Your risk of getting cancer from HPV acquired due to receipt of oral sex is miniscule and not something to worry about.  The recent publicity overstates the risk.  EWH

[kumar87]

Dear Doctor Hook,

Could I get a HPV DNA, High Risk (cervista) test done?

Thanks

Kumar

[kumar87]

Dear Doctor Hook,

Thank you for your quick reply.

Is there any way for me to be fully certain that I do not have HPV? Can I take any tests?

I am worried about getting cancer. I have read that cancer in men from oral sex is increasing at a very rapid rate in men.

I should also mention, that I do not remember seeing any visible sores or lesions on the escorts mouth or vagina.

Thanks a lot

Kumar

[Edward W Hook, MD]

Welcome back to our Forum.  On one hand, your risk for having HPV form receipt of oral sex is rather low.  We know that condoms reduce but do not completely prevent acquisition of HPV and that transmission of HPV through oral sex is rather uncommon.  On the other hand, for better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  For men there is far less risk of any sort.  Thus, in answer to your specific questions:

1.  You may.  HPV can occur without visible lesions.  On the other hand it is not likely and, most importantly, even if you do, it is not likely to be a problem for you or your partner.  

2.  See above. there is no need for you to do anything specifically (other than consider the HPV vaccine- see below).  Your GF should get regular PAP smears.  If she happens to be one of the small proportion of persons who have problems with HPV, regular PAP smears permit early recognition and treatment to prevent cancer.  

3.  I would suggest that both you and your GF consider the HPV vaccine.  It is highly effective at prevention of HIV infection.  It is recommended for all women ages 9-26 and is approved for men.  

Hope these comments help.  EWH