vaccine

Why oral cancer threatens men

Source: www.scientificamerican.com
Author: Claudia Wallis, Scientific American November 2018 Issue

Back in 2006, when the vaccine for human papillomavirus (HPV) was introduced, I rushed to get my teenage daughters immunized. Here, amazingly, was a vaccine that could actually prevent cancer. By blocking HPV infection, it protects girls from the leading cause of cervical malignancies. I didn’t give much thought to my son, and neither did the medical establishment. It wasn’t until 2011 that health authorities recommended the vaccine for boys.

In hindsight, that delay was a mistake, though perfectly understandable: the vaccine was developed with cervical cancer in mind and initially tested only in girls. Today, however, we see a rising tide of cancers in the back of the throat caused by HPV, especially in men, who are three to five times more vulnerable than women. This surge of oropharyngeal cancers, occurring in many developed nations, took doctors by surprise. Oral cancers were expected to decline as a result of the drop in smoking that began in the 1960s.

Smoking-related oropharyngeal cancers are, in fact, down. But making up the difference, particularly in men, are those related to HPV, which have more than doubled over the past two decades. With cervical cancer waning (thanks to screening and prevention), this oral disease is now the leading HPV-related cancer in the U.S. Nearly 19,000 cases were reported in 2015, according to a recent report by the Centers for Disease Control and Prevention. Roughly nine out of 10 involve a nasty strain called HPV-16.

Researchers link the rise of these cancers to changing sexual practices, perhaps dating back to the 1970s. “People have more partners than they had in the past, and they initiate oral sex at an earlier age than previous generations did,” says Gypsyamber D’Souza, associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. Greater exposure to oral sex means that the nearly ubiquitous virus gets transferred from the genitals to the mouth.

Studies suggest that most women develop protective antibodies to HPV after having a few sexual partners, but for men, it may take more than 10 partners. A likely reason for the difference, says oncologist Maura Gillison of the University of Texas MD Anderson Cancer Center, is that “in women, the infection is vaginal-mucosal; in men, it’s entirely on the skin,” where it is much less likely to trigger an antibody response. Males can get an active infection again and again, and it lingers longer than in women, making them the “Typhoid Marys of HPV,” as Gillison puts it. The path from infection to cancer may take decades and is not well understood.

Fortunately, the HPV vaccine should prevent these oral cancers, just as it protects against cervical cancer (as well as virus-related cancers of the vulva, labia, penis and anus). After lagging for years, U.S. rates of vaccination of boys are catching up with that of girls. New CDC data show that in 2017, 68.6 percent of girls and 62.6 percent of boys, ages 13 to 17, had received at least one dose of the vaccine—up from 65.1 and 56 percent, respectively, in 2016. If the trend continues, HPV-related cancers will ultimately become a scourge of the past in the U.S.

The tough question is what to do in the meantime for the large number of people, especially at-risk men, who have never been immunized. The CDC recommends the vaccine for children as young as nine and up to age 21 for boys and 26 for girls. Merck, which makes the only HPV vaccine now used in the U.S., is seeking approval to make it available up to age 45, but the $130-a-dose vaccine is less cost-effective in older populations. “It’s best given before people are sexually active,” explains Lauri Markowitz, team lead and associate director of science for HPV at the CDC. “The vaccine is not therapeutic; it’s prophylactic.” A vaccine advisory committee meeting this fall will weigh whether to revise current recommendations. One possibility, she says, is raising the upper age for boys to 26, matching that for girls.

D’Souza, Gillison and others are investigating ways to identify and screen people who may be at an especially high risk for oral HPV cancers—a significant challenge. There is no Pap-smear equivalent for this devastating disease, no reliable way to spot precancerous or early-stage lesions. And research by and her colleague Carole Fakhry shows that even if you focus on a high-risk group such as men in their 50s—8 percent of whom are infected with one of the noxious HPV strains—only 0.7 percent will go on to develop the cancer. There’s little point in terrifying people about the small odds of a bad cancer, D’Souza says, so “we’re working on understanding which tests would be useful.”

October, 2018|Oral Cancer News|

As HPV-related cancer rates climb, experts scrutinize barriers to HPV vaccination

Source: www.cancertherapyadvisor.com
Author: Bryant Furlow

Oropharyngeal squamous cell carcinomas (SCCs) are now the most commonly diagnosed human papillomavirus (HPV)-associated cancers in the United States, with 15,479 men and 3438 women diagnosed in 2015, according to an analysis by the Centers for Disease Control and Prevention (CDC).1

Between 1999 and 2015, cervical cancer and vaginal squamous cell carcinoma (SCC) rates declined, by 1.6% and 0.6% per year, respectively. But rates for vulvar SCC increased by 1.3% annually during the same period. Anal SCC rates also climbed by approximately 2% a year among men and 3% among women.1

Rates of oropharyngeal SCC — cancers of the throat and tongue — climbed as well, particularly among men (2.7% a year vs 0.8% in women).

All told, more than 43,000 Americans were newly diagnosed with HPV-related cancers in 2015, the analysis showed, up from 30,115 in 1999.1 Most people diagnosed with HPV-associated malignancies are older than 49 years.1 Most women diagnosed with cervical cancer are older than 30 years.1

“We don’t actually know what caused the increase in HPV infections but we know now that we have a safe and effective vaccine that can prevent infections,” said Lois Ramondetta, MD, professor of gynecologic oncology and reproductive medicine at the University of Texas MD Anderson Cancer Center, Houston.

“We’re seeing people who were infected decades ago developing these cancers,” Dr Ramondetta said. “We’ll see rates continue to rise over the coming years because the vaccine wasn’t available before 2006.”

HPV vaccination rates are improving, Dr Ramondetta noted.

Overall, approximately half of adolescents in the United States have completed the HPV vaccine dose-series — well shy of the 2020 herd immunity goal of 80%.

“That’s the overall up-to-date vaccination rates for adolescents aged 13 to 17,” Dr Ramondetta explained. “That’s definitely not where we want it to go but it is 5% higher than last year. If you look at the one-completed-dose vaccine initiation rate, that’s 65.5%.”

HPV vaccination rates are improving more rapidly among boys than girls.

“For some reason, safety is not as big a concern for boys and their parents,” Dr Ramondetta said. “It shouldn’t be a concern at all. This vaccine has been studied more than just about any other vaccine. But if you ask parents why girls are not vaccinating, safety seems to be a concern for some.”

There appears to be less stigma among parents about sons becoming sexually active than there is about the sexual activity of daughters, said Debbie Saslow, PhD, senior director of HPV-related and women’s cancers at the American Cancer Society in Atlanta, Georgia.

Vaccination rates vary geographically, both between countries and within the US. Only a handful of states require that public school students receive the HPV vaccine. Vast expanses of the rural US have few or no pediatricians and limited access to the vaccine.

Australia introduced HPV vaccines at the same time as the US, nearly a decade ago, but Australia achieved 80% vaccination rates in just a year, Dr Saslow said. That was largely because the Australian government paid for the vaccines and they were administered in schools. As a result, this year, Australia changed cervical cancer screening recommendations to reflect the reduced risk: at age 25, women start undergoing HPV testing (rather than pap tests) every 5 years.

That will eventually happen in the US as well, Dr Saslow predicted.

“It’s going to happen but the question is when,” she said. “What will happen is we’ll start screening later, at age 25 and maybe eventually 30, and screening will get away from Pap testing, because Pap tests are not as effective in vaccinated people: they’ll detect a bunch of cervical changes unrelated to cancer. It will all be false positives. We’ll need to go to strictly HPV-based testing” or potentially some new type of screening test, according to Dr Saslow.

In the US, there appear to be socioeconomic or class barriers at play regarding HPV vaccination. Completion rates tend to be higher among more affluent groups, meaning that those who get the first vaccine are more likely to complete the series.

But there’s also a “reverse disparity” in initiating HPV vaccination at all Dr Saslow noted. “Poor and minority kids have higher rates of [the] first dose. Providers might be doing their own risk-based recommendations to parents, which they should not be doing, saying these kids are at higher risk.”

In high-socioeconomic-status urban and suburban communities, vaccine hesitance and prevalent “anti-vax” conspiracy theories may be barriers to vaccination. In rural areas, religious conservativism about sex and sexually transmitted disease — as well as the political climate — are likely factors, Dr Ramondetta added. Rates of HPV vaccination are worse than those for, say, polio or measles, suggesting that hesitance is related to the sexual nature of HPV transmission.

“There’s still a stigma about HPV infection, which is crazy, since most people are exposed,” said Dr Ramondetta. “Normalizing HPV is important — it’s just an aspect of the human condition, like flu.”

“There is ample evidence of the efficacy, safety and durability of this vaccine,” Dr Ramondetta said. “We need to find new ways to educate the public. We can talk to one another all we want in journals but meanwhile, social media is filled with [misinformation] … We need to take a larger role in social media, flooding it with accurate information.”

“Most parents just need reassurance,” she added. “Their motivation is to keep their kids safe.”

Doctors should recommend HPV vaccination every time they see adolescent patients and their parents, Dr Saslow emphasized. And, oncologists need to reach out to family physicians and pediatricians, she said.

References
1. Van Dyne EA, Henley SJ, Saraiya M, Thomas CC, Markowitz LE, Benard VB. Trends in human papillomavirus-associated cancers — United States, 1999-2015. MMWR Morb Mortal Wkly Rep. 2018;67(33);918–924.

October, 2018|Oral Cancer News|

HPV vaccine expanded for people ages 27 to 45

Source: www.nytimes.com
Authors: Denise Grady and Jan Hoffman

About 14 million women and men become infected with the human papillomavirus each year in the United States, according to the Centers for Disease Control and Prevention. CreditCreditKeith Bedford/The Boston Globe, via Getty Images

The HPV vaccine, which prevents cervical cancer and other malignancies, is now approved for men and women from 27 to 45-years-old, the Food and Drug Administration said on Friday.

The vaccine is Gardasil 9, made by Merck, and had been previously approved for minors and people up to age 26.

It works against the human papillomavirus, HPV, which can also cause genital warts and cancers of the vulva, anus, penis and parts of the throat. The virus has many strains. It is sexually transmitted, and most adults encounter at least one strain at some point in their lives. The vaccine protects against nine strains, including those most likely to cause cancers and genital warts.

“Today’s approval represents an important opportunity to help prevent HPV-related diseases and cancers in a broader age range,” Dr. Peter Marks, director of the F.D.A.’s Center for Biologics Evaluation and Research, said in a statement.

The approval was based on a study in women ages 27 to 45, showing that an earlier version of the vaccine was highly effective in preventing persistent HPV infection, genital warts, vulvar and vaginal precancers, cervical precancers and cervical cancers related to the virus types covered by the vaccine.

The vaccine’s effectiveness in men ages 27 to 45 is inferred from the data in women, from its efficacy in younger men and from evidence that it created immunity in a study of men 27 to 45-years-old.

The most common side effects of the vaccine include soreness at the injection site, swelling, redness and headaches.

If a person has already been exposed to a particular strain of HPV, the vaccine will not work against that strain. For that reason, vaccination has been strongly recommended for young people before they become sexually active.

But even someone who has already been exposed to a few strains — but not to all nine in the vaccine — can still gain protection against the strains they have not encountered.

“This is great,” Dr. Lois M. Ramondetta, a professor of gynecologic oncology at MD Anderson Cancer Center in Houston, said in an interview. “It’s a prevention vaccine. The best time to get it is before you turn 13 and have any intimate activity at all. But, that said, it protects against nine types of HPV, so if you have one of the types, you still can be protected from other HPV types.”

She added: “There is a whole generation of people we were missing who didn’t know about it. Doctors weren’t good at talking about it.”

She and Dr. William Schaffner, an infectious disease expert at Vanderbilt University, said people over 26 began asking doctors about the vaccine. Some were leaving marriages or monogamous relationships, expected to begin dating and realized they might be exposed to the virus.

“They want to feel protected to some extent,” Dr. Ramondetta said. “Now they have the opportunity.”

Younger people need two shots, but the older ones will need three, spaced a few months apart.

Dr. Ramondetta noted that tumors affecting part of the throat — called oropharyngeal cancers — caused by HPV are rising, particularly in men. The vaccine is believed to help prevent them.

Dr. Schaffner said a panel that advises the Centers for Disease Control and Prevention has already been discussing the data on using the vaccine in older people, and is expected to make a recommendation about it. The recommendation could be universal, meaning that everyone in that age range should receive it, or it could be “permissive,” meaning that the decision is up to doctors and patients.

Once that group, the Advisory Committee on Immunization Practices, recommends a vaccine, insurers generally cover it.

October, 2018|Oral Cancer News|

Oral sex and ‘deep kissing’ linked to increase in HPV-positive head and neck cancer

Source: www.sbs.com.au
Author: Amelia Dunn

Jake Simpson was 22 when he started to get painful toothaches. Trips back and forth to the dentist couldn’t seem to fix the growing lump at the back of his mouth It came as a total surprise to Jake, his partner Carly, and their newborn son Noah, when oncologists in Brisbane told him he had stage four head and neck cancer, and would need to start treatment immediately.

“We didn’t know what any of it meant. He was so young and healthy, we couldn’t believe it,” Carly said.

Despite rigorous treatment and surgery that removed more than two-thirds of his tongue, Jake’s cancer was too aggressive and spread to his lungs. He died within eight months of his diagnosis.

These cancers, known as oropharyngeal cancers in the back of the tongue and tonsils, are on the rise in young men, and are caused by the sexually transmitted disease HPV – human papillomavirus. While doctors believe it is most commonly passed on through oral sex, some argue it’s now as easy as ‘deep kissing’.

“Jake wasn’t tested for HPV because it was too aggressive from the day one, but that age bracket that he fell in, more than likely, the cause was HPV,” Carly said.

HPV has been dubbed the ‘common cold’ of STDs. Over 80 per cent of Australian adults will get HPV at one point in their lives, and most will clear it without even knowing.

But two particular strains, P16 and P18 are closely linked with cancer, not just in the cervix like widely known, but increasingly in the head and neck.

Two strains of HPV, P16 and P18 are closely linked with cancer, not just in the cervix like widely known, but increasingly in the head and neck.
Source: The Feed

Researchers across the US, UK and Australia say changing sexual practices over the last 50 years, and an increase in sexual partners has prompted the rising incidence rate of this cancer.

Oncologist Brett Hughes has witnessed the significant shift in the patient demographic, who says nearly 80 per cent of his patients now have HPV positive cancers.

“We now see an age group of people who generally live very healthy lifestyles; that don’t necessarily have to have drunk or smoke and the other risk factors that we’d normally associate with cancers in the mouth or throat.”

The cancer is also eight times more likely to present in men. Dr Hughes said oropharyngeal cancers are now the most common HPV related cancer in Australia, trumping cervical cancer, and are continuing to rise.

“It’s predicted for Australia and it may even be as late as in the 2030s that we might see the peak incidence which is a little bit scary considering how common this cancer is becoming.”

While this cancer is increasing, many take comfort in Australia’s strong vaccination program to fight HPV related cancers.

The Gardasil vaccine, developed by Australian of the year Professor Ian Frazer, was first administered to Australian girls in 2007, and then to boys in 2013 after it became clear HPV was affecting them as well. But Professor Frazer said people need to be given the vaccine before they’re sexually active.

“All the vaccines that we currently use are vaccines to prevent infection. A vaccine to cure an infection is a different beast all together,” he said.

Without a therapeutic vaccine, sexually active adults who missed out on the vaccine at school are still at risk of contracting persisting HPV, with Prof Frazer insisting “the big challenge now is to get something for oropharyngeal cancer.”

Right now, there is no vaccine for adults and no way of testing or preventing HPV positive oropharyngeal cancers. But there are people out there trying to change that.

After Jake Simpson passed away in 2016, he donated $20,000 for research into early intervention for these cancers.

His family chose a saliva research program currently underway at the Institute of Health and Biomedical Innovation in Brisbane lead by Professor Chamindie Punyadeera. The lab work is aimed at creating a simple and easy test everyone can do to monitor their HPV status at the dentist or GP.

“What we want to do is early intervention and detection,” she said.

“If you detect early, 80 per cent of patients survive. If you detect late, 20 per cent of them survive.”

But as the technology is still five years away from public use, and a therapeutic vaccine is perhaps even further away, Carly and Professor Punyadeera agree young people just need to be aware that this cancer exists, and is on the rise.

“Young boys think it’s a women’s cancer type. It’s not at all,” Prof Punyadeera said.

“It’s really sad and we all need to be aware of HPV associated head and neck cancers.”

October, 2018|Oral Cancer News|

Italy Is Living Through What Happens When Politicians Embrace Anti-Vaxxers

Source: Huffingtonpost.com
Author: Nick Robins-Early

Italy’s Five Star movement, which was founded by a man who once called HIV a hoax, campaigned against mandatory vaccinations ahead of the country’s elections in March — and won. Last month, party leaders pushed through a law that ended compulsory immunizations for children attending public school.

The new law has made Italy the darling of the global anti-vaxxer movement. But now the country is struggling to stop a measles outbreak that has already infected thousands of people, and Europe is recording its highest number of cases in a decade — an inevitable and foreseeable result of anti-vaccine policies and rhetoric, experts say.

“Europe now is a good example of what happens when coverage of vaccinations is in decline,” said Vytenis Andriukaitis, the European Commissioner for Health and Food Safety.

The efforts of Five Star and its far-right coalition partner, the League, have particularly complicated the global campaign to combat measles, an extremely contagious virus that often spreads among children and can result in severe complications, including pneumonia and encephalitis. The World Health Organization in 2012 set the goal for Europe to eliminate the disease by 2015. Instead, an estimated 41,000 people across the continent have been infected in the first six months of this year.

Even a slight dip in a population’s vaccination rate can have disastrous effects: Countries need at least a 95 percent coverage rate to be measles-free. So when fewer people get vaccinated, kids get sick.

“We’ve got this terrible self-inflicted wound where you’re reversing public health gains in Europe and the U.S.,” said Peter Hotez, dean for the National School of Tropical Medicine at Baylor College of Medicine.

Five Star and the League have sometimes framed their efforts to do away with compulsory immunizations as a way for parents to make their own health decisions, rather than limiting vaccinations in the country. And Luigi Di Maio, Five Star’s current party leader, has recently tried to tamp down on outright anti-vaccine conspiracies.

But the rhetoric and proposals of other prominent party figures and their allies are much more radical. One top Five Star official, Paola Taverna, last month backed hazardous “measles parties” where children gather to infect each other and build up immunity. League party leader Matteo Salvini described mandatory vaccinations as “useless and in many cases dangerous” in June. Some party candidates and top officials went further, falsely claiming vaccines cause autism and referring to state-funded vaccination as “free genocide.”

These politicians’ rhetoric is in line with anti-vaccine groups that couch conspiracies and opposition to vaccinations in appeals to personal choice and pseudoscience. “They use these phony terms that really have no meaning … like medical freedom and vaccine choice,” Hotez said. “What these [anti-vaccine] groups are really doing is depriving children of fundamental rights.”

In a little over three months in office, Five Star and the League have furthered the goals of a small but vocal anti-vaccine community.

Just a year ago, Italy looked like it was on a path to solving its measles outbreak. The country’s previous government passed a law that required children to receive 10 vaccinations in order to attend state-run schools.

The law received the backing from infectious disease experts from the World Health Organization and Italian doctors, but was fiercely opposed by Europe’s well-organized anti-vaccine movement.

“It’s quantitatively a very small group, but qualitatively they are noisy and very, very aggressive,” said Walter Ricciardi, president of the Italian National Institute of Health.

Anti-vaccine protesters attacked government deputies outside of the Italian parliament. They held rallies in the streets of Rome. A group of 130 families wrote to Italy’s president claiming they would seek asylum in Austria to avoid the vaccinations. At one of Health Minister Beatrice Lorenzin’s events promoting her book, activists screamed accusations that she was killing children.

Prominent international anti-vaxxer organizations, a network made up of activists and even some disgraced doctors, latched on to Italy as a symbol of resistance, and posts on anti-vaxx forums lauded the demonstrations. The League and Five Star parties capitalized on the unrest and criticized the law as government overreach.

“The law was good and it was working, then the major leaders of the two parties made unscientific comments on vaccines,” Ricciardi said.

Stopping the outbreak became less important to Five Star and the League than appealing to the anti-establishment sentiment that ushered the parties into power, critics allege.

“They wanted the votes of anti-vaxxers and people that consider the law of compulsory vaccination a violation of personal freedom,” said Stefano Zona, a doctor of infectious diseases and member of IoVaccino, an Italian nonprofit that seeks to correct misinformation around vaccines.

“They are feeding the anti-vaxxer movement,” he said.

The U.S. has also had several major measles outbreaks in recent years, in part driven by anti-vaccine activists and linked to lower vaccination rates in some communities. And American politicians aren’t much more restrained than their Italian counterparts in fueling vaccine skepticism. President Donald Trump questioned the safety of vaccines during a 2015 Republican presidential debate and spent years promoting anti-vaxxer conspiracies.

September, 2018|Oral Cancer News|

The UK will give boys cancer-preventing HPV vaccine

Source: www.care2.com
Author: Steve Williams

The UK has announced that, after a great deal of pressure, it will be making the HPV vaccine available to teenage boys, potentially protecting them from a number of cancers.

The vaccine is routinely offered to teenage girls in schools. It has shown an impressive safety record while at the same time driving down cervical, oral and throat cancer rates by protecting young women from sexually transmitted HPV.

Campaigners have long said that teenage boys should also be provided the vaccine, because evidence has shown the HPV vaccine can reduce rates of oral, throat, penile and anal cancers. Unfortunately, Public Health England has taken some convincing on this issue, with a cash-strapped National Health Service having to make sure that every investment more than pays its way.

Now, the government says it believes the cost is far outweighed by the public health benefit.

Dr. Mary Ramsay, Head of Immunisations at Public Health England, is quoted as saying, “This extended programme offers us the opportunity to make HPV related diseases a thing of the past and build on the success of the girls’ programme, which has already reduced the prevalence of HPV 16 and 18, the main cancer-causing types, by over 80 percent.”

This change of course comes after the Joint Committee on Vaccination and Immunisation said earlier this month that, after careful review, it believed the HPV vaccination program should be extended to boys, as it found “gender-neutral vaccination is highly likely to be cost effective”.

HPV VACCINE’S SAFETY RECORD IS OVERWHELMING
While there have been some scare stories in the media relating to supposed side-effects from HPV vaccine, it’s important to note that the actual safety record for HPV vaccination is overwhelmingly good.

In fact, a meta-analysis of studies involving over 70,000 women demonstrated that of the 14 deaths per 10,000 that occurred around the time of vaccination, not a single one could be directly linked to the vaccine.

Like every live vaccine, there is the potential for some side effects. HPV vaccine’s side-effects are, for the most part, mild. If a person does have an adverse reaction, it is likely to manifest in localized swelling, a rash, or feelings of fatigue or nausea — all of which will subside on their own within a day or two.

Again, like any medication, there is the potential for more serious side-effects. However, for the HPV vaccine the chances of this happening are incredibly low. The NHS puts it at less than one out of every million cases for reactions like anaphylaxis.

Ah, but aren’t there studies linking HPV to various conditions like fibromyalgia? There have been such small-scale studies. None have found a convincing link, and their size and quality pale in comparison to the data we have to support that, for most women, the vaccine is safe and effective.

It may well be that for a tiny minority of people, the vaccine could present a risk, but that possibility is neither confirmed nor does it outweigh the manifest benefit. The HPV vaccine is thought to save thousands of lives per year globally by preventing cervical cancer deaths.

In short, the weight of not just national but global evidence points to the HPV vaccine saving lives and doing so safely.

WHY THIS MOVE WILL PROTECT GIRLS AS WELL AS BOYS
The fact that the vaccine will protect boys from cancer is, for many, motivation enough to say that the vaccine should be provided to teenage boys.

However, in addition to that, protecting boys from HPV has a knock-on effect for girls. That’s because it cuts down the circulating HPV strains that cause cancer for young women. This means that those young woman who cannot have the vaccine due to their medical history or current conditions will benefit from herd immunity.

It’s estimated that HPV16 and HPV18 circulation has already gone down by 80 percent in the UK as a result of the vaccination program.

In this way, not only are we seeking to eradicate the incredibly common HPV strains, we are also helping to cut our children’s cancer risk. The UK is among the first group of nations to offer the HPV vaccine to both girls and boys, and it is hoped that other nations will follow.

The rise of HPV-related cancers in men

Source: www.tmc.edu
Author: Alexandra Becker

Scott Courville admired his full beard and round belly in the mirror: He was ready for the upcoming holiday season. It was November 2015 and Courville, who plays Santa Claus in Lafayette, Louisiana, was too excited about his favorite time of year to worry much about the pain developing in his jaw.

By February, though, the ache had worsened and was accompanied by new symptoms: white spots on his right tonsil, difficulty swallowing and lumps in his throat. He finally made his way to a walk-in clinic where he was diagnosed with tonsillitis and prescribed antibiotics.

“They sent me home and said, ‘In two weeks everything should clear up,’” Courville recalled.

But his symptoms only worsened. Courville made an appointment with a local ear, nose and throat (ENT) specialist who also diagnosed Courville with tonsillitis. The doctor prescribed more antibiotics and steroids, but two weeks later there were no improvements. Courville was referred to a dentist—“In case they see something we don’t”—but that, too, was a dead end.

Courville’s dentist insisted he return to his ENT, where he ultimately had a CT scan that revealed a mass in his throat. That was June 6, 2016. Two days later, Courville underwent a biopsy. When he awoke from the surgery, his doctor was standing over him.

Courville always gets choked up retelling this part of his story.

“The hardest part for me is always remembering when the doctor said, ‘I’m sorry, but you’ve got cancer.’”

Courville was referred to The University of Texas MD Anderson Cancer Center, where doctors confirmed that he had squamous cell carcinoma of the right tonsil. But there was more: Courville learned that his cancer had been caused by the human papillomavirus—HPV.

11 million men
Courville’s story is becoming increasingly common, with the annual incidence of HPV-related cancers of the throat, tonsils and the base of the tongue in men in the United States now outnumbering cases of cervical cancer in women, according to the U.S. Centers for Disease Control and Prevention (CDC). A 2017 research paper authored by scientists at Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, among others, found the overall prevalence of oral HPV in men in the U.S. to be upwards of 11 million—much higher than previously believed.

“This has implications, because pretty much everyone is exposed to HPV,” said Andrew Sikora, M.D., Ph.D., one of the authors of the paper and vice chair for research and co-director of the Head and Neck Cancer Program at Baylor College of Medicine. “When we’re talking about the prevalence of oral HPV infection, we’re talking about that infection persisting inside the tonsils or on the base of the tongue of these men, and I think that’s what sets you up for cancer later in life—it may happen decades after you were exposed to HPV.”

That lag time, coupled with an absence of symptoms, is part of the reason HPV-related oropharyngeal cancers, also referred to as head and neck cancers, are increasing.

“What makes this cancer interesting is that it’s one of the only cancers in the body that we’re actually seeing more cases of year over year,” explained Ron J. Karni, M.D., who serves as chief of the division of Head and Neck Surgical Oncology at McGovern Medical School at UTHealth and Memorial Hermann-Texas Medical Center. “In the U.S., we can expect a certain number of breast cancer cases and lung cancer cases every year, but this is actually starting to look a bit like an epidemic in that we are seeing more every year. It’s alarming.”

Holy grail
HPV is the most common sexually transmitted disease in the U.S., with an estimated 79 million individuals infected. According to the CDC, HPV is so common that most people who are sexually active will get the virus at some point in their lives if they do not get the HPV vaccine.

The virus is spread through vaginal, anal and oral sexual activity, and often exhibits no signs or symptoms. In many cases, HPV is cleared by the immune system and does not cause health problems, but it can also persist and show up decades later alongside conditions such as genital warts and cancer—including cervical cancer, anal cancer and oropharyngeal cancers. For reasons not well understood, oropharyngeal cancers predominately affect men.

Currently, there is no annual screening test for men to determine whether they have the virus. Women, on the other hand, are advised to get regular pap smears.

The Papanicolaou test, commonly known as the pap smear, involves collecting cells from inside a woman’s cervix to detect pre-cancerous changes. It is performed during a woman’s annual exam and has been widely credited for detecting early signs of HPV-related cervical cancer and saving countless lives. No such screening test has been successfully developed for oropharyngeal cancer—another reason cited for its steady rise.

“We’re at a huge disadvantage,” said Sikora, who, in addition to his research, treats patients at the Michael E. DeBakey VA Medical Center in Houston. “The pap smear, in terms of global health impact, is probably one of the best, most cost-effective things ever invented in terms of just the sheer number of women who have not had cancers because of it. We have nothing like that for men.”

Sikora explained that anatomy is, in part, to blame. Whereas the cervix is easily sampled, the tonsils are full of “nooks and crannies,” he said, and scientists have yet to develop a reliable technique for obtaining a representative sample of cells inside the throat, tonsils and back of the tongue.

“It’s sort of a holy grail for researchers in the field,” Sikora said. “It would be a game-changer in terms of prevention and early detection of cancer.”

Scientists at MD Anderson, where Courville was treated, may be closing in on some answers. Researchers, including Erich M. Sturgis, M.D., MPH, the Christopher & Susan Damico Chair in Viral Associated Malignancies, are currently conducting a clinical trial for an antibody test that could be used to screen for HPV-related throat cancer.

The HOUSTON study, an acronym for “HPV-related Oropharyngeal and Uncommon Cancers Screening Trial of Men,” is looking to recruit 5,000 men ages 50 to 64 years to provide blood and saliva samples for serologic HPV testing and oral HPV testing, respectively. If a subject is found to have a positive antibody test, he will be asked to participate in a second phase of the study, which includes an intensive screening program run through MD Anderson’s oral pre-cancer clinic.

“A researcher at Arizona State University, Dr. Karen Anderson, developed a serologic test that predicts extremely well the risk for HPV-related oropharyngeal cancer,” Sturgis explained. “We have been able to show that serum antibodies to HPV early proteins, which are rare in the general population, are markers for oropharyngeal cancer. Specifically, we found that those who had antibodies to certain HPV antigens have a greater than 450-fold higher risk of oropharyngeal cancer compared with those who do not have the antibodies.”

The hope is that this study will reveal that serological HPV antibody testing is an effective screening tool for HPV-related cancer in men: the equivalent to a pap smear.

A lump in the neck
If and when HPV-related cancer does develop, men often notice a pain in their jaw or throat, trouble swallowing, change or loss of voice that lasts more than a week or two, a sore spot on the tongue and, most often, a lump in the neck.

“There’s often a very small, primary tumor, which is the tumor that is in the tongue or in the tonsil, and it travels early to the lymph nodes,” Sikora explained. “Depending on what your neck looks like, lymph nodes can get pretty big before they become noticeable. But a lump in the neck is by far the most common symptom, and unfortunately it’s often detected much later than we would like.”

Even more troubling, many individuals who have these symptoms are commonly misdiagnosed and handed antibiotics, as in Courville’s case.

“The most important message I can convey is that if you have a lump in your neck, go see an ear, nose and throat doctor,” Karni said, emphasizing the importance of an informed diagnosis and specialized care.

Treatment for oropharyngeal cancers varies depending on the case and often involves a multidisciplinary team of clinicians, as well as some form of combined modality therapy such as radiation and chemotherapy. In the future, Sturgis sees novel therapies, including immunotherapy options, changing the landscape of treatment protocols.

Karni hopes UTHealth’s dedicated HPV-related throat cancer program will carry patients through the entire arc of treatment by offering minimally invasive robotic surgery for qualifying cases, as well as annual community-wide screening clinics, rehabilitation therapists, and numerous other specialists.

“We want to think about cancer the way Target thinks about shopping or the way the best airlines think about flying,” Karni said. “We designed a program that is patient-centered. We asked, ‘What does the patient need on their fourth week of radiation? What do they need on their third month post-radiation? How can we get that into one clinic space?’ It’s a large team and it’s all centered around this one disease.”

47th in the nation
In 2006, an HPV vaccine named Gardasil hit the market. It was originally intended to prevent HPV in females and, ultimately, HPV-related cervical cancer. But as scientists learned more about HPV—first that males could be carriers and later that it causes cancer in men, as well—public health professionals and clinicians unanimously recommended the vaccine to everyone. The CDC recommends all young women through the age of 26 and all young men through age 21 receive two doses for the vaccine to be effective.

And it is. A recent report published in May by Cochrane, a global independent network of clinical researchers and health care professionals, concluded that the HPV vaccine protects against cervical cancer in young women, especially when they are vaccinated between the ages of 15 and 26.

Which begs the question: Will the vaccine protect young men against the development of oropharyngeal cancers?

“There is a lot more data on cervical cancer in women and the vaccine than there is on head and neck cancer in men and the vaccine, but what data exists suggests that it is going to be a very effective intervention,” Sikora said.

Yet despite scientific evidence that prophylactic HPV vaccination of children and young adults will drastically reduce HPV-related cancers, vaccination rates in the U.S. remain alarmingly low—and Texas ranks 47th. Even more, several generations did not have the vaccine available to them and are currently at risk for HPV-related cancer.

As Karni said, it is alarming.

“Because the median age of oropharynx cancer related to HPV is about 55 and, in some studies, 60, and because the vaccine does not seem to work in individuals who have already been exposed, the benefits of vaccination on HPV-related cancer will not be realized for several decades,” Sturgis said. “Even if we vaccinate 100 percent of our boys and girls tomorrow, we have a whole generation or two who are at risk for this cancer and cannot do anything about it.”

Courville endured six rounds of chemotherapy and 33 daily rounds of radiation to treat his cancer. He lost a year of his life, 100 pounds, his taste buds and salivary glands, and can no longer grow his full beard— but his therapy was successful. He has now made it his life’s mission to inform the public about the importance of the vaccine as well as ongoing advocacy and research surrounding HPV-related cancers.

“If you can educate the public and educate the parents, they will vaccinate their kids,” Courville said. “And if we can vaccinate this generation, we could eliminate these types of cancers.”

History of the Anti-Vaccine Movement – When Did the Anti-Vaccine Movement Really Start?

February 8th, 2018
By: Vincent Iannelli, MD
Source: https://www.verywellfamily.com

It is likely a surprise to many people that there has always been an anti-vaccine movement. It isn’t something new that was created by Jenny McCarthy and Bob Sears.

18th Century Anti-Vaccine Movement

In fact, the anti-vaccine movement essentially predates the first vaccine.

Edward Jenner’s first experiments with a smallpox vaccine began in 1796.

Even before that, variolation as a technique to prevent smallpox was practiced for centuries in many parts of the world, including Africa, China, India, and the Ottoman Empire.

In fact, Onesimus, his African slave, taught Cotton Mather about the technique in 1706.

Lady Mary Wortley Montagu introduced inoculation to England, having learned about the practice in Turkey. As she encouraged others to inoculate and protect their children against smallpox, including the Royal Family, there was much debate. It is said that “Pro-inoculators tended to write in the cool and factual tones encouraged by the Royal Society, with frequent appeals to reason, the modern progress of science and the courtesy subsisting among gentlemen. Anti-inoculators purposely wrote like demagogues, using heated tones and lurid scare stories to promote paranoia.”

Were those the first vaccine debates?

19th Century Anti-Vaccine Movement

Eventually, Edward Jenner’s smallpox vaccine replaced variolation.

Even though this was much safer than the previous practice and smallpox was still a big killer, there were still those who objected.

Much of the resistance may have come because getting the smallpox vaccine in the UK in the 19th century was compulsory—you had to vaccinate your children or you would be fined, and the fines were cumulative.

The Anti-Vaccination League was created shortly after the passage of the Vaccination Act of 1853.

Another group, the Anti-Compulsory Vaccination League, was founded after the passage of the Vaccination Act of 1867, which raised the age requirements for getting the smallpox vaccine from 3 months to 14 years old.

There were anti-vaccination leagues in the United States, too.

That they actually called them “anti-vaccine” is one of the only big differences between these groups and the modern anti-vaccine movement.

Anti-vaccine groups in the 19th Century typically:

  • said that vaccines would make you sick
  • blamed medical despotism, “a hard, materialistic, infidel thing” for creating the vaccination acts
  • warned about poisonous chemicals in vaccines, namely carbolic acid in the smallpox vaccine
  • said that Jenner’s smallpox vaccine didn’t work
  • pushed alternative medical practices, including herbalists, homeopaths, and hydropaths, etc.
  • used their own literature to scare people away from vaccines

They even had some celebrities join the anti-vaccine movement, including George Barnard Shaw, who also believed in homeopathy and eugenics.

20th Century Anti-Vaccine Movement

Anti-vaccine groups didn’t change much in the 19th and early 20th Century.

That’s perhaps not too surprising, as after Jenner’s smallpox vaccine, it would be almost 100 years before another vaccine was developed—Louis Pasteur’s vaccine against rabies in 1885.

And it was more than 50 years before the American Academy of Pediatricsformally approved the use of a pertussis vaccine (1943).

Over the next few decades, the other vital vaccines that we know today were developed, including the DPT vaccine, polio vaccines, and MMR, etc.

Of course, the anti-vaccine movement was alive and well during this time, using all of the same tactics.

In 1973, John Wilson and M. Kulenkampff reported on 50 children seen over 11 years at the Hospital for Sick Children in London. He reported on a clustering of neurological complications in the first 24 hours of the kids getting their DPT shot, even though his team didn’t actually see the children for months or years later.

In 1974, they reported the findings of 36 of these children in the Archives of Diseases in Childhood.

As with a later report by Wakefield, media coverage of this small study led to fear of vaccines and lower immunization rates. John Wilson even appeared on “This Week,” a prime-time TV show in the UK. The consequences were not unexpected. In addition to a large outbreak in England, with at least 100,000 cases and 36 deaths, there were pertussis outbreaks and deaths in Japan, Sweden, and Wales after this study. Pertussis deaths in the UK were likely underreported, though, and some experts think that the actual number of childhood deaths was closer to 600.

While many people think that Lea Thompson’s “DPT: Vaccine Roulette” in 1982 helped create the modern anti-vaccine movement, it should be clear that others had a hand.

This was also the time that Dr. Robert Mendelsohn, a self-proclaimed “medical heretic” and one of the first anti-vaccine pediatricians, became infamous for writing “The Medical Time Bomb of Immunization Against Disease” and making the rounds on the talk shows of the day. Mendelsohn also was against adding fluoride to water and “coronary bypass surgery, licensing of nutritionists, and screening examinations to detect breast cancer.”

Lea Thompson’s show did prompt Barbara Loe Fisher and a few other parents to form the group Dissatisfied Parents Together (DPT). And from there we got her book, “A Shot in the Dark,” that had such a great influence on Dr. Bob Sears, and the eventual formation of the National Vaccine Information Center.

And since excerpts of “DPT: Vaccine Roulette” even ran nationally on the Today Show, it likely influenced a lot more people.

Next came accusations that the DPT vaccine caused SIDS. And that the hepatitis B vaccine causes SIDS. Barbara Loe Fisher was in the middle of many of these accusations, even testifying before Congress.

And while she was certainly not the first anti-vaccine celebrity, this was the time (1990) when Lisa Bonet of The Cosby Show fame went on The Donahue Show and said that vaccines could “introduce alien microorganisms into our children’s blood and the long-term effects which could be trivial or they could be quite hazardous – and they could just be allergies or asthma or sleep disorders or they could be cancer, leukemia, multiple sclerosis, sudden infant death syndrome. It’s very scary and it’s very serious, and I think because I felt wrong doing it…that’s why I didn’t do it. You know we have to think twice. You know why are our kids getting these diseases?”

A few years later, in 1994, the first deaf Miss America was crowned, with her mother blaming the DPT vaccine for her child’s deafness. Like many other vaccine-injury stories, Heather Whitestone’s story wasn’t what it seemed. Her pediatrician quickly came forward and set the record straight—she was deaf because of a life-threatening case of Hib meningitis and the subsequent treatment with an ototoxic antibiotic. It took several days for the media to run the corrected story, though.

Born in 1973, it would be another 15 years before the first Hib vaccine was approved and began to be routinely given to children. The DPT vaccine, which has never been shown to cause hearing problems, had nothing to do with Heather Whitestone’s deafness. It certainly didn’t stop anti-vaccine groups from using her initial story and the media coverage to scare parents about vaccines, though.

This is about the same time that Katie Couric did a segment on the NBC News show Now with Tom Brokaw and Katie Couric about DPT “hot lots.”

But of course, things didn’t really get moving in the modern anti-vaccine movement until the 1998 press conference for Andrew Wakefield’s study, when he said that “that is my feeling, that the risk of this particular syndrome developing is related to the combined vaccine, the MMR, rather than the single vaccines.”

ABC’s 20/20 even got in on the anti-vaccine misinformation, raising “serious new questions about a vaccine most children are forced to get” in their 1999 episode “Who’s Calling the Shots?”

The media didn’t take as big an interest in the fact that:

  • a series of lawsuits in England which were brought against the manufacturers of the DPT vaccines claiming they caused children to develop seizures and brain damage all found that the DPT vaccines did not cause vaccine injuries
  • a 1991 IOM report which concluded that the evidence doesn’t indicate a causal relationship between DPT and SIDS and there was insufficient evidence to suggest a causal relationship between DPT and chronic neurological damage and many other disorders
  • many cases of alleged vaccine encephalopathy secondary to the DPT vaccine were in fact caused by Dravet syndrome

It should even be considered “media malpractice” that they didn’t correct all of the misinformation in the Vaccine Roulette piece.

21st Century Anti-Vaccine Movement

The anti-vaccine groups in the 21st Century aren’t that much different from their 19th Century counterparts. They still:

  • say that vaccines will make you sick
  • blame Big Pharma
  • warn about poisonous chemicals and toxins in vaccines, although they continue to shift which chemicals they worry about, moving from thimerosal to formaldehyde and aluminum, etc.
  • say that Jenner’s smallpox vaccine didn’t work and neither do any of the other ones
  • push alternative medical practices, including herbalists, homeopaths, chiropractic, naturopaths, and other holistic providers
  • use their own literature to scare people away from vaccines

One difference is that instead of a few people writing pamphlets with their anti-vaccine ideas, like they did in Boston in 1721, now anyone can reach a lot more people by starting their own website or blog, posting in message boards, writing a book, or getting on TV, etc.

Another is that even more than the late 20th Century, we saw a great rise in the media scaring parents about vaccines in the last 10 or 15 years, including:

  • Jenny McCarthy on Larry King Live
  • Holly Pete on Larry King Live
  • Jenny McCarthy on Oprah in 2007
  • Jenny McCarthy in Time magazine in 2009
  • Matt Lauer interviewing Andrew Wakefield on Dateline in 2009
  • Katie Couric and HPV in 2013
  • Barbara Loe Fisher discussing “Forced Vaccinations” on Lou Dobbs in 2009
  • Matt Lauer and his hour-long Dateline episode, A Dose of Controversy, with Andrew Wakefield himself
  • Robert DeNiro on the Today Show in 2016

This is also the time when we saw the rise of the celebrity anti-vaccine spokesperson and the pandering pediatricians.

And we should have seen them coming. We were less than a week into the year 2000 when Cindy Crawford appeared on Good Morning America with her celebrity pediatrician, Dr. Jay Gordon.

But what’s really different today? Although the great majority of people still vaccinate their kids, clusters of intentionally unvaccinated children are certainly on the rise. And it is these clusters of unvaccinated kids and adults that are leading to a rise in outbreaks of vaccine-preventable diseases that are getting harder to control.

One thing that may be different now is that more people have grasped on to the Natural is the new Medicine movement. From amber necklaces and essential oils to sports magnets and homeopathic “medicines” on pharmacy shelves, these things go hand in hand with the modern anti-vaccine movement.

In addition to pandering pediatricians who push non-standard, parent-selected, delayed protection vaccine schedules, we now have more and more chiropractors, naturopaths, holistic pediatricians, and integrative pediatricians who might advise a parent to skip vaccines altogether. And with Dr. Oz on TV pushing a lot of these types of holistic remedies on TV every day, it probably does seem like an OK thing to do.

Big natural remedy websites that also push everything from organic food to medical conspiracy theories also provide a lot of fodder for anti-vaccine folks. Many others push fear about chemicals, so it isn’t surprising that it would be easy to scare parents about vaccines.

But still, it is important to keep in mind that these things have not become mainstream, it is just that the anti-vaccine movement has become a big business. From selling vitamins, supplements, e-books, e-courses, and holistic treatments to pushing for new laws ensuring that kids can stay intentionally unvaccinated and unprotected, they are the very vocal minority.

Of course, that doesn’t make them right.

Get Educated. Get Vaccinated. Stop the Outbreaks.

May, 2018|Oral Cancer News|

Restaging raises hope against HPV oral cancer

Source: atlantajewishtimes.timesofisrael.com
Author: Cady Schulman

Jason Mendelsohn was diagnosed with Stage 4 tonsil cancer from HPV in 2014 after finding just one bump on his neck. He survived thanks to a variety of treatments, including a radical tonsillectomy and neck dissection to remove 42 lymph nodes, seven weeks of chemotherapy, radiation and a feeding tube.

But if Mendelsohn’s cancer had been discovered today, just four years later, it would have been classified as Stage 1. That’s because HPV-related oral cancers now have a high survival rate through a better response to treatment, said Meryl Kaufman, a speech pathologist specializing in head and neck cancer management who worked for Emory University’s department of head and neck surgery for 10 years.

“Cancer staging is taking into account the HPV-related cancers,” said Kaufman, who now owns her own practice. “It was kind of all lumped together. The survival rates for people who have HPV-related cancers are much higher than the typical head and neck cancers associated with smoking and drinking.”

For Mendelsohn, finding out that patients with HPV-related cancers likely face easier treatments and higher success rates made him extremely happy.

“If I was diagnosed and I heard Stage 1 instead of Stage 4, while it’s still cancer, it would make me feel like I could beat it,” said Mendelsohn, who made a video for his children a month after his diagnosis with advice for their lives after he was gone. “When I hear Stage 4 to Stage 1, I think people have hope they can beat it. My hope is that it will give people hope that they can beat this.”

As a cancer survivor, the Florida resident wants to give hope to other patients. He talks to people throughout the world every month and is creating a worldwide survivor patient network to connect cancer survivors with patients.

“While cancer is scary, Stage 1 is a lot less scary than Stage 4,” Mendelsohn said. “Stage 4 was overwhelming. When I was looking for information, there was nothing out there that made me feel like I was going to be OK. What I’m trying to do is give people hope and let them know that it’s all temporary.”

Another way Mendelsohn is trying to reach those affected by cancer is through his website, supermanhpv.com. He shares his story, news articles featuring him and oral cancer caused by HPV, and information for survivors, patients and caregivers.

The site also features Mendelsohn’s blog, putting himself out there so people can see that someone who, just four years ago, was diagnosed with Sage 4 cancer is now a Peloton-riding, travel-loving cancer advocate.

“People see me and say (they) can’t believe (I) had cancer three to four years ago,” Mendelsohn said. “I was in bed 18 hours a day for a month. I was choking on my saliva for a month. I was consuming five Ensures a day and two Gatorades a day through a feeding tube in my stomach. If people going through that can see me working out, going on the bourbon tour in Louisville. I’ve been on an Alaskan cruise. I’ve been to the Caribbean. I’ve been to the Grand Canyon.”

Mendelsohn, who started his campaign to raise awareness of HPV and oral cancer by raising money for the Ride to Conquer Cancer in Washington, now serves on the board of the Head and Neck Cancer Alliance. The organization’s goal is to advance prevention, detection, treatment and rehabilitation of oral, head and neck cancers through public awareness, research, advocacy and survivorship.

“I feel like it’s gone from me raising money for a bike ride to me on two boards helping create awareness and raise inspiration and creating a survivor patient network,” Mendelsohn said. “Now it’s not about me and my three doctors. Now it’s about helping people with diagnosis globally. There are great doctors. I think we’re going to do great things.”

One way to help prevent children from getting cancer caused by HPV when they grow up is the Gardasil vaccine, which protects against HPV Strain 16, which causes oral cancer. Mendelsohn said 62 percent of college freshmen and three-quarters of adults by age 30 have HPV.

But he doesn’t tell people to get the vaccine. Instead, he advises parents to talk to their kids’ doctors about the benefits and risks.

“I talk about the importance of oral cancer screenings when they’re at the dentist,” he said. “And if you feel a bump on your neck, go to your ENT. I had no symptoms and just a bump on my neck, but I was diagnosed with Stage 4. I’ve had so many tell me that they didn’t know the vaccine is for boys. They thought it was just for girls.”

Kaufman said that the HPV vaccine is recommended for use in boys and girls and that it’s important for the vaccine to be given before someone becomes sexually active. The vaccine won’t work if a person has already been exposed to HPV, as most sexually active adults have been, she said.

Men are much more likely to get head and neck cancer from HPV.

“Usually your body fights off the virus itself, but in some people it turns into cancer,” Kaufman said. There hasn’t been specific research that the HPV vaccine will protect you from head and neck cancer, she said, “but if you’re protected against the strains of HPV that cause the cancer, you’re probably less likely to get head and neck cancer.”

Treatment for this cancer isn’t easy, Kaufman said. Radiation to the head and neck can affect salivary glands, which can cause long-term dental and swallowing issues. Treatment can affect the skin, taste and the ability to swallow.

“A lot of people have tubes placed,” she said. “It’s not easy. It depends on how well you respond to the treatment.”

While getting the vaccine can help protect against various cancers, awareness about head and neck cancer is the key. And knowing the signs and symptoms — such as sores in the mouth, a change in voice, pain with swallowing and a lump in the neck — is important.

“If one of those things lasts longer than two weeks, you should go to your doctor,” Kaufman said. “This can affect nonsmokers and nondrinkers. It’s not something that people expect. The more commonplace it becomes and the less stigma, the better.”

Doctors paying for sons to have cancer jab

Source: www.bbc.com
Author: Anna Collinson, Reporter, Victoria Derbyshire programme

Doctors and health professionals are regularly paying hundreds of pounds for their teenage sons to receive a vaccination against cancer that girls already receive for free on the NHS, the Victoria Derbyshire programme has been told. Is boys’ health being put at risk?

“Had the HPV vaccine been available when I was a boy, I believe I would not have developed throat cancer more than 30 years later,” said Jamie Rae, 53.

“I’m basing this on the overwhelming majority of research I have seen over the years and countless experts I have spoken to.

“That’s why I’m desperate for boys to be able to receive it.”

HPV is the name given to a large group of viruses. It is very common and can be caught through any kind of sexual contact with another person who already has it. Doctors say 90% of HPV infections go away by themselves – but sometimes infections can lead to a variety of serious problems. For boys, this includes cancer of the anus, penis, mouth and throat.

Since 2008, girls aged 12 to 18 across the UK have been offered HPV vaccinations as part of the NHS childhood vaccination programme. It is currently not offered to boys of the same age, but it can be done privately, costing several hundred pounds.

Mr Rae founded the Throat Cancer Foundation after the treatment he received in 2010. He said at the time there was little information on HPV and he did not want anyone to go through his experience.

“I had radiotherapy for 35 days except weekends. I felt extreme burning in my neck and mouth and I was covered in sores. The pain was excruciating,” he explained. “It’s a lengthy recovery time. You have to teach yourself to swallow again and you get a dry mouth all the time.”

His foundation is part of HPV Action – which represents more than 50 groups and charities that are calling for both genders to receive the vaccination on the NHS.

‘Indefensible’
Mr Rae said the current disparity between boys and girls was “appalling”.

“Lots of doctors are having their boys vaccinated because they can afford it, as are those who are better informed,” he said. “But what about those who can’t afford it? Cases of throat cancer are soaring. It’s indefensible.

“Every day that goes past where boys are not being vaccinated condemns them to a whole host of diseases that we could prevent.”

HPV Action says around a dozen countries including Australia, Canada and the US are already vaccinating boys or are planning to do so in the near future. The government’s vaccination advisory committee is currently reviewing whether boys should receive the HPV vaccination.

A spokesperson for the Department of Health and Social Cares says it will carefully consider its advice once they’ve received it. Campaigners hope there will be a decision this year, possibly as soon as June. A debate is taking place on Wednesday at Westminster Hall about the issue.

The argument for vaccinating boys against HPV:

  • About 15% of UK girls eligible for vaccination are currently not receiving both doses, a figure which is much higher in some areas
  • Most older women in the UK have not had the HPV vaccination
  • Men may have sex with women from other countries with no vaccination programme
  • Men who have sex with men are not protected by the girls’ programme
  • The cost of treating HPV-related diseases is high – treating anogenital warts alone in the UK is estimated to cost £58m a year, while the additional cost of vaccinating boys has been estimated at about £20m a year

Source: HPV Action