Genital warts and cervical cancer


  • Putting Dr G On The Spot
  • Sunday, 28 Jan 2018

Dear Dr. G,

Something in my sex life is troubling me a lot and I really hope you can help me.

I am 32 year old and divorced. In my previous relationship, my ex-wife sadly developed cervical cancer and blamed me for genital warts, which caused the cancer. Although I am not 100% convinced; but I have to accept the blame.

Needless to say, my marriage did not survive the storm.

In the last six month, I have met a colleague I really cared for.

We started going out and things are getting intimate. We have started having sex, however, rest assure I did use condom!

Although I am adamant the genital warts were harmless, I am still fearful this will repeat the fate of cancer in my love ones.

I would like to put Dr. G on the spot on the final Sunday of January to clarify the issues related to the role of genital warts in men in causing cervical cancer?

Can the genital warts be eradicated?

Would the use of barrier technique (condom) protect my sexual partners?

What do you think about the vaccination for someone like me, who is already affected by the warts?

Thanks for your response.

Regards

William

Human Papilloma Virus, commonly known as HPV are a groups of viruses that can be spread by direct contacts. The transmission is believed to occur when the skin of the external genitalia, mucous membranes of the vagina, anus and mouth are in close contact. Hence the virus is commonly spread by unprotected vagina, anal and oral sex.

Although not commonly known, HPV is the most common sexually transmitted infection, as about 14 million new infection occurs each year. The prevalence of the virus in healthy hosts are so common, it is estimated more than 90% of men and 80% of women who are sexually active harbour at least one subtype of the virus. In fact, most people get HPV shortly after losing their virginity. HPV infections are naturally more common in someone with mores sexual partners.

The HPV transmitted sexually can be categorised into high and low risk, based on their abilities to transform into malignancy. The low risk HPV, such as subtypes 6 and 11 do not cause cancer, but can be a nuisance resulting in recurrent warts around the genitalia and anus. The high-risk HPV, such as 16 and 18 are responsible for most HPV-induced cancer such as cervical, mouth and anal cancers. Despite the frightening malignant potentials of such viruses, the vast majority of the high-risk HPV infections are dormant for decades, this is believed to be suppressed by host immunity and less frequent repeated infection from sexual promiscuity.

Although HPV is believed to cause more than 90% of the cases of cervical cancers, most people infected by even the high-risk viruses do not develop cervical cancers. The immunity and number of sexual partners are important determinant of the cancer transformations, smoking, early onset of sexual contact and oral contraceptive pills are also believe to influence the disease progression.

The use of the latex condoms the right way every time during sexual contacts can lower the chances of HPV transmission. However, as HPV can transfer due to skin to skin contact, as certain areas not covered by the barrier are susceptible to infection, making condoms not fully protective against HPV. Hence, the barrier protections of the condoms may still be inadequate!

The introduction of the HPV vaccines aims to reduce the risk of infections. The routine vaccination is targeted at sexually naïve boys and girls for the protection of up to nine subtypes of HPV virus is widely available across many countries. Sadly, such programs are mainly for the girls for the prevention of cervical cancer. The applications of the vaccines in non-virgins individuals, especially ones affected by warts, are ongoing studies. Although the benefits of such interventions reducing warts recurrences and cancer inductions for sexual partners may not be as efficacious, the protection is believed to be worthwhile.

January of each year is dedicated to the Cervical Health Awareness Month. Each year, an estimated 12,000 women are diagnosed with cervical cancer, and one-third will die from the cancer. Although this lethal disease caused by a virus following sexual contacts, the finger pointing blame game is often destructive and unhelpful. The Canadian-American psychotherapist Nathaniel Branden once said: “The first step towards change is awareness. The second step is acceptance!” When Dr. G is put on the spot on his view for those who are already affected by this horrible virus is: “The first step towards healthy sex life is knowledge and awareness. The second step is acceptance and protection by vaccination!”  

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Dr George Lee

Dr George Lee

Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Ask Dr G” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at askdrg@thestar.com.my

   

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