What men need to know about the vaccine that helps prevent cancer
Three years ago, New York doctor Abraham Aragones, MD, did two things he never thought he would do: He divorced his wife for 14 years and got the vaccine to protect himself from HPV.
Dr Aragones, then 41, had spent the previous 15 years of his career at Memorial Sloan Kettering Cancer Center promoting vaccination against the human papillomavirus (HPV). It is the endemic virus that is usually spread through skin-to-skin contact during unprotected sex and is linked to several types of head, neck and genital cancers in men. Until the end of his marriage, he did not think he needed to be vaccinated. He had been with the same partner, after all. But with the divorce, he returned to the dating pool and realized that he could easily be one of the 85 percent of all sexually active people who will contract HPV in their lifetime.
Although the vast majority are unaware that they are infected and eventually clear the virus from their bodies within two years, a small percentage do not eliminate it. It is this group that Dr. Aragones is worried about, as they are at risk of developing cancer later. The most recent data indicates that there are approximately 2,100 cases of anal cancer and 900 cases of penile cancer in men in the United States per year, the majority of which are linked to a previous HPV infection.
The most alarming types of HPV-related cancers to public health experts are oropharyngeal or “back of the throat” cancers, which affect the base of the tongue, soft palate and tonsils. There are about 11,800 cases in men per year, and the rates have been steadily increasing amid the rise in connection culture and the spread of HPV.
Still, there is a way to stop it. This vaccine, available in two or three doses depending on your age, can protect people against infection and, therefore, against cancer caused by the virus. Although head and neck cancers tend to have a high survival rate, treatment can be overwhelming. The field is littered with horror stories of brutal radiotherapy treatments or disfiguring surgery to remove the affected part of the mouth or jaw, treatments that make it difficult to eat, swallow or speak.
Unlike Dr. Aragones, however, most adult men don’t get the vaccine, and many don’t even know they can be. This keeps the virus circulating and cancers grow.
Why so many men haven’t heard of this cancer protector
In 2006, the first HPV vaccine was approved for girls and young women ages 9 to 26 in what was widely seen as a public health victory. The vaccine could inoculate them before they become sexually active and are exposed to carcinogenic strains of HPV. This recommendation was extended to boys and young men in 2009, initially to prevent genital warts, but the vaccine was eventually approved to prevent cancer in men as well, as vaccines developed to fight more strains of HPV are being developed. become available. (The target age to receive one is between 11 and 12 years old.)
In 2019, a calmer phase of the HPV vaccine arrived: the CDC announced that people between the ages of 27 and 45 could also benefit from the vaccine and suggested they discuss it with their healthcare providers. Even though older men and women have probably already been exposed to several of the more than 100 strains of HPV, the idea is that the vaccine may still protect some people from subsequent infection with a high-risk strain.
In fact, the announcement was so low-key when the University of Michigan reported on Reddit last April that HPV causes more cases of oral and pharyngeal cancer in Americans than cervical cancer. , the message received over 54,000 upvotes and over 3,000 comments. … And the main comments were that users were unaware that the HPV vaccine was available for men.
What’s more shocking about the history of HPV cancer is that researchers didn’t even make the connection that STIs caused head and neck cancer until 20 years ago. Before that, doctors believed that people who developed them were generally in their 60s and 60s and were generally heavy smokers and drinkers. Then the data started to tell a different story.
“When we looked at the epidemiological studies, we started to notice young runners, vegans, non-smokers, and very sexually active men,” says Thomas E. Carey, head and neck cancer specialist, of the University of Michigan. Medical School, whose laboratory has been studying HPV for 30 years. Link the growing incidence among young people to the American sexual revolution: Cancers appearing in middle-aged men were probably due to HPV contracted decades earlier. Today, 70 percent of oropharyngeal cancers are linked to HPV, and they affect about five times more men than women.
People can get HPV in their genital area during vaginal or anal sex, or in the back of the throat when having unprotected oral sex with an infected person. The connection to oral sex was an eye opener for many who had come of age believing that getting off was safe sex. After actor Michael Douglas blamed his throat cancer in 2013, there was a spike in Google searches on the subject, said Michelle Mizhi Chen, MD, head and neck surgeon at Michigan Medicine. .
One of the reasons many men are unaware of vaccine availability and how HPV is transmitted: unlike women, who tend to visit their gynecologist almost every year and have routine tests for HPV, explains Dr. Aragones, male patients take a more laissez-faire approach. Let’s face it: some guys in their 20s and 30s don’t even see a primary care doctor. Even if they do, the problem may never arise. The CDC doesn’t recommend routine screenings for most guys. (There is no FDA approved test for men.) There is also no therapy they can get to clear the virus – just look at the areas it may inhabit for. make sure there are no cancerous changes.
In women, if an HPV test is positive and the virus has caused cancerous changes in the cervical tissue, that tissue can be removed. Men do not have this option.
Dr Aragones says the low vaccination rates of men are also due in part to what he calls anti-vaccine misinformation campaigns that falsely claim that the HPV vaccine impairs immune function and causes infertility. “What frustrates me is that anti-vaccines use the anti-vaccine sentiment of Covid to turn it into a weapon and undermine confidence in the HPV vaccine,” he says.
What to do if you are not eligible for the HPV vaccine
While condoms and dental dams can lower your risk of oropharyngeal cancer, experts know that it’s just not realistic to expect people to use them all the time. That’s why Dr Chen says public health messages should focus on vaccine awareness. “The only way to really protect yourself is to get the vaccine,” she says.
What happens if you are over 45 and missed the vaccination deadline? The consensus is that the vaccine is less effective as people get older: the older you are, the more you have been exposed to HPV in the past. Doctors suggest that you can still protect your health by staying alert for the signs of head and neck cancer. Not all head and neck cancers come with the same symptoms. The most common to look for are: a sore throat that never seems to go away; unexplained weight loss; persistent ear pain; difficulty or pain in swallowing; a lump in the neck that lasts more than a few weeks; and persistent sores or white or red patches on the tongue, throat, or oral mucosa.
But for the men who still have the chance to get vaccinated? It’s obvious, says Dr Aragones. “It’s a safe and effective way to protect yourself against cancer. Why wouldn’t you do it? “
This story originally appeared in the October 2021 issue of Men’s health.
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