Revelations by Hollywood actor Michael Douglas that the cancerous tumour lodged at the base of his tongue was apparently linked to oral sex, and subsequent denials by his publicist, have sparked a fervent debate in the medical fraternity.
“It is scientifically known that Human Papilloma Virus (HPV) type 16 can cause oral cancer. It’s lodged in the vagina or the cervix of a woman. The most obvious route for transmission of HPV in the mouth can be through oral sex,” said Dr Mehul Bhanushali, surgical oncologist at Jaslok Hospital.
A few years back, doctors at LH Hiranandani Hospital in Powai treated a man in his 30s for a squamous carcinoma tumour in his tonsils which they suspected to be related to infection through HPV 16.
“The patient didn’t smoke, drink or chew tobacco. Hence, we suspected that oral sex might have led to his acquiring the cancer in his throat. However, as the mode of treatment for all oral cancers is the same, we did not investigate further,” said Dr Wasim Phoplunkar, radiation oncologist at LH Hiranandani Hospital.
Also, doctors in the city have yet not taken to prescribing HPV-DNA testing on cancerous tumours in the mouth and throat to precisely zero in on the cause. In other words, in the absence of large scale HPV-DNA testing of tumours, reliable data of HPV-related oral cancer in India is not yet available.
What you must know
A 2006 study by New England Journal of Medicine said a high number of oral sex partners (six or more) in a lifetime was associated with oropharyngeal cancers which occur in the mouth, at the base of the tongue or at the back of the mouth and throat.
Bhanushali says, “HPV 16 is a sexually transmitted infection. Multiple sex partners greatly increase the risk of acquiring it, especially as cervical cancer caused due to HPV is the topmost killer in India. However, there is no reason to be alarmed if a person does not indulge in sex with multiple people.”
Contrary to notion that HPV can cause oral cancer in men only, doctors warn otherwise.
“HPV 16 once lodged in the oral cavity is difficult to eliminate. The tumour manifests over several years and is only diagnosed in the third or fourth stage. Also, kissing may spread the virus to a woman’s oral cavity. Further, HPV 16 can be lodged in a man’s penis and a woman may acquire it if she is giving a man oral sex,” says Bhanushali.
“However, the occurrence of such tumours is extremely rare; they may be one in a population of one lakh.”
Hold your horses
Maintain proper hygiene before and after having sex.
Use condoms correctly and consistently to reduce transmission of HPV between sexual partners.
Avoid indulging in sex with multiple people.
Women should get the first pap smear done a few weeks after sexual activity starts. Later, they should get it done annually for three years. If the results are negative, then they should repeat pap smear tests once in every five years.