Oral Cancer and Throat Cancer: The Truth by Violet Blue

Skin Flutes, Carcinoma and Chasing the Unicorn:
Oral Sex Will Give You Cancer, and Other Mythological Sex Beasts
by Violet Blue. Originally published in the San Francisco Chronicle Thursday, May 17, 2007

Cancer is no laughing matter. Neither is a good blow job — though an enthusiastic rendering of one’s favorite tune on a skin flute should certainly leave giver and receiver with big, giddy grins. Same goes for cunnilingus. So why are recent headlines telling us we could all get cancer from giving head?

No, it’s not a story from The Onion; scary headlines over the past week based on this oral cancer and HPV study screamed at us, “Study Suggests Oral Sex Can Lead to Cancer,” “Oral Sex Can Spread Throat Cancer,” “Oral Sex Linked to Throat Cancer” and “Cancer Threat From Oral Sex” (among many other articles). Even Time magazine, a bastion of sex-positivity and even-handed reporting on human sexuality, jumped on the fellatio-fatality bandwagon with “Oral Sex Can Add to HPV Cancer Risk.” It’s like sucking a cock or munching a carpet is suddenly the “Jackass” of sex acts. The skimmable Time article leaves out pertinent details and doesn’t explain HPV, or much else:

“The study, which appears in this week’s New England Journal of Medicine (NEJM), shows that men and women who reported having six or more oral-sex partners during their lifetime had a nearly ninefold increased risk of developing cancer of the tonsils or at the base of the tongue. Of the 300 study participants, those infected with HPV were also 32 times more likely to develop this type of oral cancer than those who did not have the virus. These findings dwarf the increased risk of developing this so-called oropharyngeal cancer associated with the two major risk factors: smoking (3 times greater) or drinking (2.5 times greater). HPV infection drives cancerous growth, as it is widely understood to do in the cervix. But unlike cervical cancer, this type of oral cancer is more prevalent in men.”

Even if Time did explain to us that men are not at risk for cervical cancer (phew!), the overall message is that we’re all going to choke on a meatsicle and die. What the quoted study was referring to was a link between HPV and oral cancer. But the message being repeated all over Google News like a game of sex-hysteria telephone is that the sex act itself — fellatio, cunnilingus, rimming — is the cause of cancer.

Is it, and is there really a link? Not very likely, explains Women’s Community Clinic Manager Yvonne Piper (who also is training staff, switchboard coordinator, and resources coordinator at San Francisco Sex Information and off-site sex educator for the Center for Sex and Culture): “This new research states that oral sex may not be the actual cause of oropharyngeal cancer. The study states that ‘[o]ral-genital contact was strongly associated with oropharyngeal cancer, but we cannot rule out transmission through direct mouth-to-mouth contact or other means.'”

Direct mouth-to-mouth contact … as in kissing? Oropharyngeal cancer may be caused by kissing! Does this mean that we should all stop kissing, too? This study is posing just a link — a correlation — between HPV and oropharyngeal cancer. If we checked everybody’s throats, we may very well find HPV, since we’ve learned that up to 80 percent of people have genital HPV, and I’m willing to bet that a fair number of those people have engaged in oral sex.

HPV, short for human papilloma virus, is the virus associated with genital warts. What not many people know is that you can have HPV and never have a genital wart. In fact, most people who have HPV do not know they have it, because it usually causes no symptoms. HPV is extremely common and is considered highly contagious. Piper is unconvinced by headlines and mainstream media articles telling us not to put anything in our mouths unless we totally know where it’s been for the past 30 years. She elaborated on the correlation between cervical cancer and HPV that is least talked about:

“The CDC states that ‘[a]t least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percent of women will have acquired genital HPV infection.’ So until a study proving 80 percent of us contract oral cancer by age 50, I’m sort of unconvinced. Huge numbers of women get HPV, either in the form of genital warts or cervical dysplasia, and with annual Pap smears, the chances of these infections becoming cancerous is quite low. The majority of people who contract HPV can clear the infection on their own in a couple of years with proper treatments and continuation of regular Pap smears. Most women who develop cervical cancer have not had regular Pap smears. The media has left out this part in its barrage of HPV vaccine and test advertisements: The best prevention is still regular screening. The vaccine will not prevent all types of HPV and cervical cancer, so being vaccinated is not a ‘get out of Paps free’ pass. A shot won’t vaccinate you against monitoring your health and deciding when it’s worthwhile to take risks (like having unprotected sex) or not.”

Risk is something that needs to be assessed by the individual, and with knowledge about the dangers of lifestyle hazards, we can engage in responsible risk assessment. But meanwhile, not knowing the risks can be dangerous, and a culture of shame and fear around oral sex can cause people to take risks that they are unaware of. Piper explains how to assess those risks, amid the scary, scary headlines that obfuscate some pretty serious nuggets of truth:

“A lot of the fun things in life might be harmful. Most people are probably going to continue enjoying oral sex, just like before this news. Many of us enjoy activities that are potentially harmful, like drinking, smoking various things, riding motorcycles and eating delicious junk food. But for those of us who feel that eliminating these behaviors altogether makes for a safe, albeit not terribly worthwhile or fun, life, [we] might want to practice these behaviors in a slightly altered fashion or balance our vices with other behaviors that help improve our overall health.

“Here are some strategies to employ until further research concludes any oral sex and cancer links:

* Using condoms or dental dams for oral sex
* Reducing your other risks for this type of cancer, like practicing proper oral hygiene — bacterial oral infections may increase your likelihood of catching a viral oral infection — or reducing smoking and alcohol consumption
* If you’re female and under 26, ask your health care provider if the HPV vaccine is appropriate for you. In San Francisco, you can get the vaccine at the DPH Adult Immunization and Travel Clinic.
* Talk to your partners about their STD histories. There’s much more common bugs you could catch from oral sex — like genital herpes — that are far more prevalent than HPV-associated oropharyngeal cancer. Talking about it isn’t necessarily going to prevent transmission, but it can make you and your partners more aware of risks that you are taking and help inform your decisions.”

So a girl still wonders — will a trip to Blow Buddies (blowbuddies.com) kill me (even if I was the right gender to get in the door)? Piper responds:

“So to answer your question, ‘Will a trip to Blow Buddies kill me?,’ I would answer: Perhaps. Perhaps on your way to Blow Buddies, you will get into a horrific car accident and die. Perhaps you will perform a blow job on someone with HPV, contract oropharyngeal cancer 20 years down the line and subsequently die. But are you so afraid of the horrific car accident that you will stay home? Probably not. It’s much more likely that you will safely make the trip and have a great time sucking cock while you’re there, dying at a (hopefully) much later date of a cause besides HPV-related cancer. Everything we do has some level of risk attached to it, and we choose for ourselves which risks we think are worth taking. If you are concerned about the data contained in this study, maybe you want to modify your oral sex habits. And if the link between HPV and oral cancers is proven in the future to be so direct, then it’s pretty likely that the HPV vaccine will be approved for more people than just young women.”

So it seems that just as it pays to know your risks and use safer-sex barriers, it might pay just as well to use similarly effective barriers when reading the news.