Why no PHE acknowledgement of the epidemic of HPV induced HNCs, and introduction of a vaccination programme

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I am going to apologise in advance here for any upset that I may unintentionally cause, but some of my comments will veer towards sexism!

Most people will recognise what a tremendous success there has been world wide in screening, treating and now vaccinating young women again HPV. The results are spectacular and encouraging. The corresponding fall in morbidity from cervical cancer is dramatic.

At the very same time, we have an equally catastrophic and rapidly growing epidemic of HPV induced head and neck cancers, chiefly but not entirely in males. it's the same disease; it could be prevented! It seems extraordinary that those charities and research groups invested in cancer of men, give so little publicity and drive towards addressing this problem. My personal view is that women would not stand for it!!! 

Public Health England has been challenged on the evidence base for the introduction of a vaccination programme for young men; one can only presume, (and watch the evidence from more enlightened countries elsewhere), that their head in the sand attitude will not change un til the evidence is unarguable; (many would say it already!!!)

Men need to shout; you are getting a preventable cancer and no one is doing anything!

  • There was a very interesting interview about this on Radio 4 on Woman's Hour last Friday morning. You should be able to find it on the iPlayer if you'd like to hear it.

    They were saying that boys should be inoculated just like girls are - and that the NHS or PHE or NICE or whoever, hadn't seen the cost/benefit figures as being worthwhile but that opinion seems to be changing. I also think that if ALL kids were offered it, it might stop the parents who withdraw their daughters from the programme because they think it encourages promiscuity - yep, there are people that short sighted.

    HPV inoculation of girls is well established in the UK but really struggling in some other countries - notably Japan where there was bad publicity and claims some young girls were left in wheelchairs that led to the update of the jabs being around 15% (so not enough to make a difference). 

    I have a friend in Holland who has had both cervical and anal cancer from HPV and it's hard to go through that knowing that an injection as a teenager could have saved her both. Everybody should be getting this injection - I totally agree that men and women (I'm one of the latter) should kick up a stink about this. There are not many preventable cancers - so let's stop flip flopping about HPV and get the needles into maximum numbers of young people. 

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • thanks Barbara, I will certainly hunt the iPlayer replay. As you say, it's extraordinary that we have such a strong evidence base to prevent a complete group of cancers and its not a public health policy. To illustrate the scale of the HPV head and neck cancer epidemic, I dealt with 3 patients with tonsillar cancer during a 35 year GP career. My practice now has had 7 new cases in the last 2 years, (this in a small rural practice) and is by some margin their commonest new malignancy at present. (I apologise that these figures are anecdotal and non scientific etc, but they serve merely as an illustration of the dramatic increase in prevalence).

  • When you look at the money spent persuading the public to stop smoking, drink less and take more exercise, you do wonder that they can't find the money for giving teen-aged boys an injection.

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • FormerMember
    FormerMember in reply to barbaral

    My Dad recently had treatment for cancer of the tongue. We have not heard this mentioned. Should there be tests? How can we raise awareness?

  • FormerMember
    FormerMember

    Is it too sensitive to mention oral sex as the driver of this? Michael Douglas said It caused his. Not enough awareness. Could be the aids of this decade. Oral sex was not done when I was young. Cunnilingus in the days before women shaved was I believe not only rare but not something many men would try. Would like to see a medical opinion on this.

  • FormerMember
    FormerMember in reply to FormerMember

    I do think the oral sex side of this is important. As I see it, it's just another aspect of what consenting adults get up to, and nothing to be ashamed of.

    When I was diagnosed with mouth cancer I wondered if HPV might be the cause, but was told it wasn't. All the same, the chance of HPV causing mouth cancer in men or women really needs to be taken seriously.

    As I understand it, the vaccination against HPV is targetted at specific types of the virus, and that may complicate things in terms of preventing oral cancer.

    From what I read, (sorry I can't find the link, it was a few years ago), most doctors with sons pay to get them vaccintated against HPV. That, surely, says something about the need to make this a national policy.

    Tom.

  • FormerMember
    FormerMember

    I had no idea about hpv positive mouth cancer until my husband was diagnosed with tongue cancer in August and I joined this forum for support ( and I’m a nurse ) !! 

    I asked some of the new students who said on a health promotion module it’s inky the risks to females that are taught ! This is quite worrying and needs hi lighting xx 

  • FormerMember
    FormerMember in reply to FormerMember

    I was told in no uncertain terms in the hospital in France where I was treated that the HPV 16 cancer of my tonsil and tongue was a sexually transmitted disease. I have never smoked and I dont drink, and I have NEVER been sexually promiscuous However my ex-husband was. Not only did I get a cervical cancer but also this tonsil and tongue cancer. I am in touch with my ex and as yet he remains clear.

    Sometimes it seems that life is a little unfair...but sexual promiscuity and oral sex are the main drivers.

  • FormerMember
    FormerMember

    I think you are right to be cross about this for men, but as a woman who was a teenager a long time before vaccination, there's another thought.

    My cancer is vocal cords and my consultant asked me whether I smoked or drank.  I'm a lifelong non-smoker, and drink little, just the odd glass of wine with a meal.  He then asked me about the cervical history and, 30 plus years ago, I'd had an operation for a pre-cancerous cervical condition.  He believes that the virus which causes this stays in the body and can recur - as it seems to have done with me - somewhere else.  

    Rather scary, and not something I'd heard anywhere else.  Has anyone else come across this ?

  • FormerMember
    FormerMember in reply to FormerMember

    AnnaKV01

    Exactly what I was told......I had an operation for precancerous cervical lesion, mine was 35 years ago. Apparently with some people the virus is lodged in the body...a bit like the chicken pox virus, and they are all herpes types, to reoccur somewhere else. A lot of people do shed the virus...but there are some who do not.

    Like you I have never smoked and dont drink.