- Dr Thomas Stuttaford
- The London Times
WORDSWORTH’S early romantic experiences were not confined to admiring daffodils. But the results of these experiences were not as transient as the beauty of the daffodils fluttering in the breeze by a lake. After Cambridge he went on a walking tour of the Continent before living for a time in France, where he fell for a French woman. When he returned to England, he had a nasty dose of chlamydia. The infection spread to his eyes and gave him life-long trouble. The additional lights he needed to follow a church service can still be seen on his pew.
It is not only the eyes that may be damaged by sexually transmitted diseases. There is a suggestion that infection with the human wart virus — HPV (Human Papilloma Virus) — which is the cause of cervical cancer, may also be one of the reasons why oral cancer is becoming more common. Springtime love might have a surprising and unpleasant sequel, for the type of cell involved in cancer of the mouth and the cervix is the same.
Two years ago Professor Saman Warnakulasuriya, of King’s College London, presented findings on oral cancer to the Royal College of Surgeons of Edinburgh. Seventy five per cent of the patients had lifestyles that included well-known risk factors for mouth cancers. In the past it was customary to attribute these to rotten or broken teeth, but either changing circumstances, or greater knowledge, has shown that the great risks for these tumours are smoking and too heavy an alcohol intake. Smoking cannabis represents a greater risk than smoking normal cigarettes. Even after these and other known factors had been excluded, 25 per cent of the patients had no obvious cause for the cancers.
Fifty years ago five men developed mouth cancers for every woman; this has now changed to two to one. In the past ten years in Scotland there has been a 50 per cent increase in the numbers of younger people developing oral cancer, and over the past 40 years a fourfold increase in those under 45 affected by it.
Before the Second World War, and the start of the welfare state, patients with oral cancers usually had them on their lips, and nearly all had appalling teeth. Many also either smoked pipes or were chain smokers of home-rolled cigarettes. Previously the cancer usually developed on the lips as a result of smoking. Now the incidence of lip cancer has fallen, whereas cancer of the tongue in men, and the floor of the mouth in women, has more than made up for this.
Recent research by Dr Elaine M. Smith, from the University of Iowa, and published in the Journal of the National Cancer Institute, supports the involvement of HPV as a causative agent for oral cancers. HPV 16, one of the high-risk types of wart virus for cervical cancer, was the most frequently detected type of HPV found in the mouth and was present almost twice as often in cancer patients as it was in healthy subjects.
The case for the increase in mouth cancers in young people being the result of changing sexual habits, especially oral sex, could account for the changes in age group, differences in the site of the tumors — tongue in men and floor of mouth in women, rather than lips — and for social class differences. Income group is now becoming a more important risk factor, whereas older age is becoming less relevant.