HPV

[tante76]

Hello Dr.

I think I am over reacting, perhaps you can assure me please.

I am worried about oral cancer due to HPV.

I have an ulcer on my lip that has been there for roughly 8-10 days and is healing I think. The pain is not constant and only when I apply ulcer remedies. I think in America, ulcers are called cankers.

I have given roughly 6 men unprotected fellatio -the most recent was one year ago, spanning back 3-4 years. I am a male.

I do not smoke, and do not drink either. I am 22.

The pharmacist said to me that a persistent ulcer could be a sign of mouth cancer. I was just worried about oral HPV and causing cancer.

I had an ulcer a couple of weeks ago too which cleared quickly. I have been under stress -  bereavement in the family and have been told that stress can also cause an ulcer.

I usually only get an ulcer if I accidentally bite my lip.

1 I have been hiccupping recently, (in the past day) Is this combined with an ulcer a heath issue?

2 Would I be right to say that an ulcer alone is not really indicative of mouth cancer and that if one were to have it there would be other more pronounced symptoms?

3 Also, have you ever seen a healthy 22 year old who does not smoke or drink develop mouth cancer caused by HPV?

4 The fact that I have had ulcers when biting the skin is not a problem is it?

5  In light of the above should I forget these worries?

6 I was told that ulcers/canker sores are not a sign of herpes - I have had cold sores before in past. Correct?

Thanks a lot.

[tante76]

Thank you Dr. Take care and all the best.

[Edward W Hook, MD]

Correct on both counts.  This risk of serious complications, IF you were to get HPV, is too small to be worried about. EWH

[tante76]

Thanks Dr Hook.

So the fact that the present canker sore has been there for 8-10 days tops does not present a problem? I was told a canker sore can take up to a couple weeks to heal.

Finally, should I discount the fellatio performed on men as any risk for HPV related oral cancer?

[Edward W Hook, MD]

Welcome to our Forum. My sense is that you may be getting your information from unreliable sources- perhaps the internet, perhaps your pharmacist.  Either way, I am confident that the oral lesion you describe is not a cancer.  HPV-related oral cancers do not occur on the lip but inside of the mouth; oral cancers do not heal; oral cancers virtually never occur in persons 22 years old as it takes years and years for the cancers to develop; oral cancers, even in high risk persons are VERY, VERY, rare.  

In answer to your questions:
1.  1 I have been hiccupping recently, (in the past day) Is this combined with an ulcer a heath issue?
No, the combination of hiccupping and a sore on your lip does not suggest cancer or any other serious problem.

2 Would I be right to say that an ulcer alone is not really indicative of mouth cancer and that if one were to have it there would be other more pronounced symptoms?
Skin and oral cancers can present as LONGSTANDING (i.e. present for months) sores which do not heal. they may not have other symptoms associated with them.  For a sore present for only five days, there is no reason to worry about cancer.

3 Also, have you ever seen a healthy 22 year old who does not smoke or drink develop mouth cancer caused by HPV?
No- never.  

4 The fact that I have had ulcers when biting the skin is not a problem is it?
No, it just means you are biting your lip too hard.  

5  In light of the above should I forget these worries?
Yes, my advice is not to worry about oral cancer at all.  

6 I was told that ulcers/canker sores are not a sign of herpes - I have had cold sores before in past. Correct?
Cold sores are most often due to HSV-1.  Canker sores are unrelated.  

I hope these comments are helpful. I urge you not to worry about the sore on your lip unless it is present without healing for at least a3 weeks or a month. If it is still present at that time (I am confident it will not be), then go on and see a dermatologist for advice.  EWH