Perspective on HPV and Oral Cancer

Dan Savage is my favorite sex columnist. He is smart, concise, and offers up (usually) solid, well thought-out advice. He answers questions on a wide variety of questions, from the seriously kinky (like this) to relatively more pedestrian sexual issues (like this), and includes a good bit of political discussion as well (like this, from just before the 2000 elections). If you’re not ready to be surprised, don’t read through too many of his columns.

But do read this week’s advice which includes a discussion on HPV and oral sex. I like his perspective on it, particularly his discussion of gender and medical attention at the end.

Cancer Sucks

I’m having a problem. Twice when my girlfriend has given me oral sex, I’ve come in her mouth and then a little urine has come out. She’s understandably mad. The first time it happened was in the morning, so I thought it was just me being full of piss, but the second time I just came a lot and she kept sucking and a little bit of urine came out. Her technique involves a lot of sucking, so could she be creating some vacuum pressure? Or is there just something wrong with me?

Pissing By Accident

Swallowing a little piss may be the least of your girlfriend’s worries, PBA. Researchers at the Johns Hopkins Bloomberg School of Public Health announced last week that oral sex—blowjobs and cunnilingus—may cause throat cancer.

First the bad news—and you better sit down, because it’s really, really bad: If you and your girlfriend have had more than five oral-sex partners in your lives, PBA, you are both 250 percent more likely to develop throat cancer than some sad asshole who’s never had oral sex. Researchers are too polite to point this out, but I’m not: Most Americans eat pussy and swallow cock. According to the National Center for Health Statistics, 90 percent of straight men and 88 percent of straight women report engaging in oral sex. Half of all American teenagers have had oral sex; by age 19, the number rises to 70 percent.

“Researchers believe,” reports New Scientist, “[that] oral sex may transmit human papillomavirus (HPV), the virus implicated in the majority of cervical cancers,” and the virus lodges in the throat, where it can cause cancer. Study subjects infected with HPV were 32 times more likely to develop throat cancer; folks who tested positive for one highly aggressive strain of the virus, HPV-16, were 58 times more likely to develop throat cancer. Smoking, previously believed to be the culprit behind most throat cancers, only triples a person’s risk. (A new slogan for the tobacco industry: “Smoke cigs, not pole.”)

But before we panic—it’s just one study—let’s put throat cancer in perspective. Despite the fact that nearly all Americans engage in oral sex, throat cancer accounts for a tiny percentage of the roughly 1.5 million cases of cancer diagnosed every year. According to the Cancer Facts & Figures report released by the American Cancer Society in 2007, we will see 35,000 cases of oral cancer this year—that’s tongue, mouth, pharynx, and “other oral cavity.” That compares to 271,000 cases of digestive-system cancers, 229,000 cases of respiratory cancers, 220,000 cases of prostate cancer, and 180,000 cases of breast cancer.

And let’s put HPV in perspective, too. While most sexually active adults are exposed to HPV at some point, our immune systems usually “clear” the virus on their own. So not every HPV exposure leads to infection, and not every HPV infection is lifelong. Clearly, men and women need to keep an eye on their throats—and researchers are, according to reports, working on a saliva test for HPV—because when it comes to cancer, early detection saves lives.

So while the news is alarming, and the mainstream media will doubtless go into full hysteria mode, last week’s report in the New England Journal of Medicine shouldn’t be read as, “Eat yourself some pussy, get yourself some throat cancer!” Engaging in oral sex puts you at a greater risk—significantly greater, admittedly—of contracting a virus that, if your body doesn’t clear it, has a very small risk of causing throat cancer. It’s not a certainty; it’s a risk. As with any pleasurable activity, sexual or otherwise, we weigh risks against benefits and make decisions. Smart folks minimize their risks—by, say, using condoms for oral sex (har har)—but most sexually active adults are likely to conclude that the real and immediate pleasures of oral sex are worth risking a distant and unlikely case of throat cancer.

And now for the good news: There’s a vaccine that offers 100 percent protection against the strains of HPV that cause cervical cancer in women and, it now appears, throat cancer in men and women. The HPV vaccine has already been approved for women and is currently being tested in men. You may have already heard of this vaccine thanks to the controversy that surrounds it. The HPV vaccine is most effective when administered before a person becomes sexually active; doctors recommend that girls receive the vaccine at age 11 or 12. Religious conservatives believe that the HPV vaccine undermines abstinence education by making sex less risky. Never mind that studies have shown that abstinence education does not work. The right would rather see 4,000 American women die of cervical cancer every year than call off the fraud that is abstinence education.

And up to now the mainstream media have refrained from calling the right’s opposition to the HPV vaccine what it is—delusional, psychotic, homicidal—because up to now only women’s lives were at stake.

That’s about to change.

Here’s the headline from my morning paper: “HPV Factors in Throat Cancer: Study Could Shift Debate About Vaccine.” You bet it will. Up to now the HPV vaccine—which, again, has proven 100 percent effective against the cancer-causing strains of the virus—could merely prevent 10,000 cases of cervical cancer in American women every year, along with 4,000 deaths. But now the debate could shift—it will shift—because it’s no longer “just” the lives of 4,000 American women that are on the line, but the sex lives of 150 million American men.

“If men got pregnant,” goes the bumper sticker, “abortion would be a sacrament.” Now that straight men can get cancer from eating pussy, the HPV vaccine is going to go from controversial to sacramental faster than you can say, “Suck my dick.”

Getting back to your original question, PBA: Maybe researchers will one day discover that piss cures throat cancer. If that day comes, your girlfriend will thank you for those mouthfuls of piss. She’ll be married to someone else by then, and may only contact you through her lawyer, but still. It could happen. Just in case it doesn’t, PBA, discuss your orgasm-induced urinary incontinence with a doctor.

About Karen Rayne

Dr. Karen Rayne has been supporting parents and families since 2007 when she received her PhD in Educational Psychology. A specialist in child wellbeing, Dr. Rayne has spent much of her career supporting parents, teachers, and other adults who care for children and teenagers.