HPV Vaccine in Men Would Save Costs of Treating Throat Cancer

“This is a great article. Men please be sure to read and speak to me during your next visit.”

— Dr. Dale

http://www.usnews.com/news/articles/2015/04/13/hpv-vaccine-in-men-would-save-costs-of-treating-throat-cancer

A new study shows that giving men Gardasil is cost-effective and prevents throat cancer.

By Kimberly Leonard

Controversy over the HPV vaccine has centered on its risks to girls and the idea that protecting them against cervical cancer could also lead them to experiment with sex at a younger age. But a new study underscores the effect of HPV on men, and points out that vaccinating men against the virus could prevent throat cancer as well.

About 9,300 men in the U.S. each year are affected by HPV-caused cancers, among them oropharyngeal cancer that occurs in the middle part of the throat behind the mouth and can develop around the tonsils and the back of the tongue. That number is expected to grow dramatically in the coming years.

“It is projected that by 2020, HPV-related oropharyngeal cancer will become the most common HPV-related cancer in the U.S., surpassing cervical cancer," Dr. Donna Graham, a medical oncologist who led a new study on vaccination in men, said in a statement.

The virus can be transmitted through oral sex, but the cases of throat cancer are four times more common in men than women. Men can also carry the virus in the genitals without knowing it, partly because researchers still have not figured out how to test men for the virus to detect early cancer cells. The new study in which Graham was involved shows that administering the vaccine to more boys could prevent them from getting cancer much later in life.

"People who are exposed to the virus may or may not get infected," says Dr. Lillian Sui, another author of the study who is also staff medical oncologist at Princess Margaret Cancer Centre and a professor at the University of Toronto.

The study, released online Monday in CANCER, a peer-reviewed journal of the American Cancer Society, indicates that vaccinating 12-year-old boys against HPV is a cost-effective strategy for preventing throat cancer.

Researchers applied a statistical model to 192,940 Canadian boys who were 12 years old in 2012, and found that vaccination could save $6 million to $22 million, depending on the cost of the vaccine, its effectiveness, the cost of cancer treatment and the survival rate of patients who get cancer.

Data from the U.S. Centers for Disease Control and Prevention show vaccination rates for males climbed from 20.8 percent in 2012 to 34.6 percent in 2013. Sui says that if more boys were vaccinated, then the vaccine would prevent throat cancer as effectively as it prevents cervical cancer.

For women, the vaccines Gardasil and Cervarix protect against 70 percent of cervical cancers and 90 percent of genital warts cases. They work in the body for at least a decade without becoming less effective and have not been associated with any long-term health problems. Gardasil is the vaccine typically given to men.

Still, rates of vaccination even for women are not as high as they are for other vaccines, and a November 2014 CDC report showed millions of U.S. women are not getting screened for cervical cancer. "Herd immunity," which occurs when large numbers of people become immune to a virus, requires 80-90 percent of people to be vaccinated in order to be effective. Vaccinating more men would help protect women who are not vaccinated as well as protecting men who have sex with unvaccinated men.

Concerns linger over what administering the vaccine could mean to young people, partially because it is recommended by the CDC at such a young age. For boys and girls, the agency has recommended since 2011 that children receive the three-part vaccine at ages 11 or 12. The agency has said that doing so would allow the immune system to build before teens become sexually active.

The most common sexually transmitted disease in the U.S., HPV infects 14 million people a year. It has more than 100 strains, most of which are not harmful and go away within two years. About 30 types, however, can put women at risk for cervical, vulvar or vaginal cancer. Other types cause warts in men and women. Even people who have no symptoms can spread the virus, and cancer can take years to develop after a person becomes infected.

The CDC says that not having sex is the only sure way to avoid HPV entirely – though condoms can reduce the likelihood of transmission.

Sui isn't a pediatrician, so she points out that she doesn't have conversations about the vaccine with young people – but she does see patients down the line who have developed cancer. The vaccines may seem irrelevant at such a young age but parents, doctors and young people should discuss it, she says.

For men, throat cancer develops anywhere from 40-60 years of age, and a test can determine whether HPV is the cause. Women can have Pap smears or HPV tests for early screening efforts, but these types of screening methods do not exist for men. Sui says the incidences of throat cancer found to be related to HPV range from 70-80 percent in North America.

Smoking also can increase the risk of developing HPV-related throat cancer, while the virus can also lead to cancers of the anus and penis. Men are likely to have a better outcome if cancer of the throat is found to be linked with HPV rather than with smoking, Sui says. They are likely to live longer, and this type is less likely to recur, according to the American Cancer Society.

Young Man Bares All (Colostomy Bag Included) for Colon Cancer Awareness

“This is a must read!”

— Dr. Dale

http://www.huffingtonpost.com/will-lanier/young-man-bares-all-colos_b_6988740.html

"You have colon cancer."

It was Friday the 13th of June 2014 when these words left my doctor's lips. At 28, this isn't something that I was prepared to hear. At 28, I thought I was immune to these things. As a fitness professional, I never imagined I'd be susceptible to colon cancer. At 28, I never thought that I'd become the face of a cancer awareness campaign -- posing with my colostomy bag no less.

What followed over the course of the next several, post-diagnosis months, was an interesting turn of events. As a self-certified nerd, I researched the oh-so-many intricacies of the disease -- its symptoms, its various stages, its survivors and those not so lucky.

To give some perspective, researchers recently analyzed U.S. National Cancer Institute data from 1975 to 2010 and realized that the overall colon cancer rate for Americans 20 to 34 rose by 2 percent each year. The study predicts that by 2020 and 2030, colon cancer rates are expected to jump by 38 percent and 90 percent, respectively, among people aged 20 to 34.

If you're my age, are you speechless? When I read that, I was taken aback. Immediately, a ton of questions raced through my head. How can this be true? Why don't more people know this? Why has it taken being diagnosed to find such research and data? If people my age are so susceptible to such a curable cancer, why does every piece of colon cancer awareness documentation urge only those over 50 to get screened?

What do you do with this information? I reached out to a very good friend of mine, Heidi Burkhart, president of cause marketing alliance Saxon/Hart and also an avid fitness buff, who was equally surprised and appalled at the stats concerning colon cancer and how it is affecting our generation at an alarming rate. Being the A-type personalities we both are, Heidi offered to bring her team at into the fray to create a way to bring awareness of colorectal cancer to the public.

Voila! The #BLANKCANCER social media campaign was born. We not only wanted to raise awareness; quite frankly, we wanted to make it as easy as possible for people to "shoot the sh!t" (pun intended).

One of the main reasons there is a lack of awareness is because colon cancer has long been stigmatized -- it presents itself with embarrassing symptoms that most people just aren't comfortable talking about. The good news is, there are easy, non-invasive screening tests available. If you're 20 to 34 years old and reading this, did you know that?

The problem is, NO ONE KNOWS ABOUT THEM!

It's simple. You poop in a waste bag and take it to the lab -- it's as easy as that. Sure it's not a sexy topic, but it can help save your life. If after examination, they find hidden blood in your stool (an indication of colon cancer), you're getting a colonoscopy to dive deeper into the issue. These are called Fecal Occult Blood Tests (FOBT)/Fecal Immunochemical Tests (FIT), and they can be performed yearly.

In December of 2014, I went into the hospital for my final surgery. When I woke up, my colostomy bag was gone, and I was on the road to recovery. It's funny -- the little things. The little things sometimes teach us the biggest lessons in life. This little, microscopic cancer has changed my life in ways I don't even fully understand yet, but it's something I'm looking forward to exploring...for many years to come.

To join in, support the cause and help raise awareness for colon cancer -- and all cancers for that matter -- please print your own #BLANKCANCER sign, take a selfie and share across social media.

HPV : MEN

“Among men who have sex with men (MSM), the incidence of anal cancer is significantly more prevalent and increasing annually. However, the majority of MSM’s know little about the disease, have ever been tested for it, nor know that screening tests exit.

Each year anal cancer is diagnosed in about 2 people out of every 100,000 people in the general population. Current estimates are that HIV negative MSMs are 20 times more likely to be diagnosed with anal cancer. Their rate is about 40 cases per 100,000. HIV-positive MSMs are up to 40 times more likely to diagnosed with the disease, resulting in a rate of 80 anal cancer cases per 100,000 people.

Anal cancer is caused by the same strains of Human Papillomavirus (HPV) that cause cervical cancer in women. Cancer of the anus, like the cervix, develops slowly, beginning with minor cell changes. For women, a simple pap smear is used to detect these cell changes in the cervix in their early stages. The same screening methodology (pap smear) can be used for men to test the anus for cancer and pre-cancerous cell changes.

A growing number of physicians and health activists like myself believe that routine screening, using an anal pap smear, could reduce the incidence of anal cancer as dramatically as it has cervical cancer in women. We recommend that all MSMs, especially those who are HIV+, be tested every 1-3 years depending on their immunological well-being and CD4 count. They suggest that HIV negative individuals be tested every 3 years.

http://www.cancer-network.org/cancer_information/gay_men_and_cancer/anal_cancer_hiv_and_gay_men.php”

— Dr. Dale

HPV and Men - CDC Fact Sheet

http://www.cdc.gov/std/hpv/hpvandmen-fact-sheet-february-2012.pdf

What is Genital Human Papillomavirus (HPV)?

Genital human papillomavirus (HPV) is a common virus. Most sexually active people in the United States (U.S.) will have HPV at some time in their lives. There are more than 40 types of HPV that are passed on through sexual contact. These types can infect the genital areas of men, including the skin on and around the penis or anus. They can also infect the mouth and throat.

How do men get HPV?

HPV is passed on through genital contact—most often during vaginal and anal sex. HPV may also be passed on during oral sex. Since HPV usually causes no symptoms, most men and women can get HPV— and pass it on—without realizing it. People can have HPV even if years have passed since they had sex. Even men with only one lifetime sex partner can get HPV.

What are the health problems caused by HPV in men?

Most men who get HPV (of any type) never develop any symptoms or health problems. But some types of HPV can cause genital warts. Other types can cause cancers of the penis, anus, or oropharynx (back of the throat, including base of the tongue and tonsils.) The types of HPV that can cause genital warts are not the same as the types that can cause cancer.

Note: Anal cancer is not the same as colorectal cancer. Colorectal cancer is more common than anal cancer, and is not caused by HPV.

How common are HPV-related health problems in men?

About 1% of sexually active men in the U.S. have genital warts at any one time.
Cancers of the penis, anus and oropharynx are uncommon, and only a subset of these cancers are actually related to HPV. Each year in the U.S. there

are about:
• 400 men who get HPV-related cancer of the penis
• 1,500 men who get HPV-related cancer of the anus
• 5,600 men who get cancers of the oropharynx (back of throat), but many of these cancers are related to tobacco and alcohol use, not HPV.

Some men are more likely to develop HPV-related diseases than others:

Gay and bisexual men (who have sex with other men) are about 17 times more likely to develop anal cancer than men who only have sex with women. Men with weakened immune systems, including those who have HIV, are more likely than other men to develop anal cancer. Men with HIV are also more

likely to get severe cases of genital warts that are harder to treat.

What are the signs and symptoms?

Most men who get HPV never develop any symptoms or health problems. But for those who do develop health problems, these are some of the signs and symptoms to look for:

Genital warts:

One or more growths on the penis, testicles, groin, thighs, or in/around the anus.
Warts may be single, grouped, raised, flat, or cauliflower-shaped. They usually do not hurt. Warts may appear within weeks or months after sexual contact with an infected person.

Anal cancer:

Sometimes there are no signs or symptoms. Anal bleeding, pain, itching, or discharge. Swollen lymph nodes in the anal or groin area. Changes in bowel habits or the shape of your stool.

Penile cancer:

First signs: changes in color, skin thickening, or a build-up of tissue on the penis.
Later signs: a growth or sore on the penis. It is usually painless, but in some cases, the sore may be painful and bleed.

Cancers of the oropharynx:

Sore throat or ear pain that doesn’t go away Constant coughing
Pain or trouble swallowing or breathing Weight loss

Hoarseness or voice changes that last more than 2 weeks Lump or mass in the neck

Is there a test for HPV in men?

Currently, there is no HPV test recommended for men. The only approved HPV tests on the market are for screening women for cervical cancer. They are not useful for screening for HPV-related cancers or genital warts in men.

Screening for anal cancer is not routinely recommended for men. This is because more research is needed to find out if it can actually prevent anal cancer. However, some experts do recommend yearly anal cancer screening (anal Pap tests) for gay, bisexual, and HIV-positive men – since anal cancer is more common in these men.

There is no approved test to find genital warts for men or women. However, most of the time, you can see genital warts. If you think you may have genital warts, you should see a health care provider.

There is no test for men to check one’s overall“HPV status.”But HPV usually goes away on its own, without causing health problems. So an HPV infection that is found today will most likely not be there a year or two from now.

Screening tests are not available for penile cancer.
You can check for any abnormalities on your penis, scrotum, or around the anus. See your doctor if you find warts, blisters, sores, ulcers, white patches, or other abnormal areas on your penis—even if they do not hurt.

Is there a treatment or cure for HPV?

There is no treatment or cure for HPV. But there are ways to treat the health problems caused by HPV in men.

Genital warts can be treated with medicine, removed (surgery), or frozen off. Some of these treatments involve
a visit to the doctor. Others can be done at home by the patient himself. No one treatment is better than another. But warts often come back within a few months after treatment—so several treatments may be needed. Treating genital warts may not necessarily lower a man’s chances of passing HPV on to his sex partner. If warts are not treated, they may go away on their own, stay the same, or grow (in size or number). They will not turn into cancer.

Cancers of the penis, anus, and oropharynx can be treated with surgery, radiation therapy, and chemotherapy. Often, two or more of these treatments are used together. Patients should decide with their doctors which treatments are best for them.

Are there ways to lower my chances of getting HPV?

A safe and effective HPV vaccine (Gardasil) can protect boys and men against the HPV types that cause most genital warts and anal cancers. It is given in three shots over six months. [See vaccine recommendations below.]

Condoms (if used with every sex act, from start to finish) may lower your chances of passing HPV to a partner or developing HPV-related diseases. But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against HPV.

Because HPV is so common and usually invisible, the only sure way to prevent it is not to have sexual contact. Even people with only one lifetime sex partner can get HPV, if their partner was infected with HPV.

I heard about a new HPV vaccine – can it help me?

If you are 26 or younger, there is an HPV vaccine that can help protect you against the types of HPV that most commonly cause problems in men. The HPV vaccine (Gardasil) works by preventing four common HPV types, two that cause most genital warts and two that cause cancers, including anal cancer. It protects against new HPV infections; it does not cure existing HPV infections or disease (like genital warts). It is most effective when given before a person’s first sexual contact (i.e., when s/he may be exposed to HPV).

CDC recommends the HPV vaccine for all boys ages 11 or 12, and for males through age 21, who have not already received all three doses. The vaccine is also recommended for gay and bisexual men (or any man who has sex with men), and men with compromised immune systems (including HIV) through age 26, if they did not get fully vaccinated when they were younger. The vaccine is safe for all men through age 26, but it is most effective when given at younger ages.

The HPV vaccine is very safe and effective, with no serious side effects. The most common side effect is soreness in the arm. Studies show that the vaccine can protect men against genital warts and anal cancers. It is likely that this vaccine also protects men from other HPV-related cancers, like cancers of the penis and oropharynx (back of throat, including base of tongue and tonsils), but there are no vaccine studies that have evaluated these outcomes.

I just found out that my partner has HPV ...

What does it mean for my health?

Partners usually share HPV. If you have been with your partner for a long time, you probably have HPV already. Most sexually active adults will have HPV at some time in their lives. Although HPV is common, the health problems caused by HPV are much less common.

Condoms may lower your chances of getting HPV or developing HPV-related diseases, if used with every sex act, from start to finish. You may want to consider talking to your doctor about being vaccinated against HPV if you are 26 years or younger. But not having sex is the only sure way to avoid HPV.

If your partner has genital warts, you should avoid having sex until the warts are gone or removed. You can check for any abnormalities on your penis, such as genital warts. Also, you may want to get checked by a health care provider for genital warts and other sexually transmitted disease (STDs).

What does it mean for our relationship?

A person can have HPV for many years before it is found or causes health problems. So there is no way to know if your partner gave you HPV, or if you gave HPV to your partner. HPV should not be seen as a sign that you or your partner is having sex outside of your relationship.

I just found out I have genital warts ...

What does it mean for me and my partner?

Having genital warts may be hard to cope with, but they are not a threat to your health. People with genital warts can still lead normal, healthy lives.

Because genital warts may be easily passed on to sex partners, you should inform them about having genital warts and avoid sexual activity until the warts are gone or removed. There are ways to protect your partner (see above).

You and your partner may benefit from getting screened for other STDs.

If used with every sex act, male latex condoms may lower your chances of passing genital warts. But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against HPV.

It is important that sex partners discuss their health and risk for STIs. However, it is not clear if there is any health benefit to informing future sex partners about a past diagnosis of genital warts because it is not known how long a person remains contagious after warts are gone.

For More Information

STD information

http://www.cdc.gov/std/

HPV Information

http://www.cdc.gov/hpv/

Gay and Bisexual Men’s Health

http://www.cdc.gov/msmhealth/

CDC-INFO Contact Center 1-800-CDC-INFO (1-800-232-4636) TTY: (888) 232-6348
Email: www.cdc.gov/info

CDC National Prevention Information Network (NPIN)

http://npin.cdc.gov/ disease/stds

P.O. Box 6003
Rockville, MD 20849-6003 E-mail: npin-info@cdc.gov

American Sexual Health Association (ASHA)

http://www.ashastd.org/

P. O. Box 13827
Research Triangle Park, NC 27709-3827 1-800-783-9877