Author: Camilla Cornell, Hamilton Spectator
If Tiffany Bond could have had her 25-year-old son inoculated against the human papilloma virus (HPV), she’d have done it in a heartbeat. After all, Bond knows well the pain HPV virus can cause.
Eight years ago, at age 39, Bond flicked back her long hair and touched a lump in her throat. Her doctor’s diagnosis? Bond had oral pharynx cancer — a type of throat cancer caused by the HPV virus. Worse, the cancer had spread into her lymph nodes. She began a seven-week regimen of radiation and chemotherapy treatments so intense that Bond couldn’t eat a thing. She was fed through tubing in her stomach for months and lost about a third of her body weight.
“I was sick to my stomach every day for seven weeks,” Bond says. “There came a point where I just gave up — I wanted to die. It was horrific for my son to watch.”
The good news, says Joanne Di Nardo, a spokesperson for the Ontario branch of the Canadian Cancer Society: There is an HPV vaccine that is 100 per cent effective against many forms of HPV. The bad news? Although all provincial governments administer the vaccine free to girls, in many provinces boys don’t have the same privilege. Only Alberta, Nova Scotia, British Columbia and P.E.I. (either currently or will soon) offer the vaccine free to boys.
“We really need to do some catching up here in Ontario,” says Di Nardo. “Boys are just as much at risk as girls are when it comes to getting HPV-related cancers.”
Bond sees it as a prevention issue. Most people — like her — don’t even know they’ve been exposed to HPV, she says, so it’s easy to pass back and forth. And yet, points out Eduardo Franco, chair of the department of oncology at McGill University, “about one in 20 of all human cancers are caused by one or more of the different strains of human papillomavirus.”
Cervical cancer in women is the most significant, Franco says, but HPV is also associated with genital and anal cancers in men and women, as well as vulva or vaginal cancer and penile cancer. And oral pharyngeal cancer — diagnosed three times more often in men than in women — is rapidly gaining ground. “We’re seeing an upsurge of pharyngeal and oral cavity cancer because of oral HPV transmission,” confirms Franco.
The vaccine would do double duty, he says, by preventing cancers directly in the vaccinated boys, and also by extending “herd protection” to society generally.
“It would be interrupting the chain of transmission both for men and women,” Franco says, “because even those who aren’t vaccinated will eventually have decreased probability of having sex with someone who has been infected.”
Vaccinating boys against HPV is particularly important in provinces like Ontario, says Franco, because only about 60 per cent of girls are vaccinated, compared to 85 per cent in Quebec.
On the plus side, the cost of the HPV vaccine has dropped in recent years, from about $130 per dose to $100 per dose. And at the beginning of this year, the National Advisory Commission on Immunization recommended that for young people, ages 9 to 14, only two doses are needed over a six-month period, instead of the previously recommended three.
If girls got two doses of the vaccine instead of three and the government reaped the economies of scale associated with bulk buying for both boys and girls, that would make it cost-effective to vaccinate boys, points out Franco.
As it stands now, says Di Nardo, if you want to have “your young men” vaccinated, you’ll pay hundreds of dollars out of pocket. Di Nardo believes that policy is short-sighted and urges people to contact their MPPs about the issue or to visit the CCS’s advocacy site (takeaction.cancer.ca). “If you have a vaccine to prevent cancer, should we not all be getting it?” she asks. “Boys and girls.”