Learning about HPV

>> Thursday, July 21, 2011

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Dear KnowYourV,

I read a lot about the HPV virus from you & on line. If what I’ve read is true then having sex is what puts us at risk for contracting it. To me that is scary since HPV (human papilloma virus) can cause cervical cancer which to me means that it is an STD, ya know? Cervical cancer is an STD or caused from an STD, right? Supposedly, I’m thinking that’s why we all go to our gynecologist each year to get our pap. Good because from what I’ve read the pap has worked perfectly for many years as a way to screen for cervical cancer and the high risk HPV. I also have heard many people say that HPV is passed to men from women because women carry the virus in their bodies, is that true? I don’t know. But what I’m really worried about is this, I read that HPV can also put women at risk for vulvar cancer which is cancer on the vaginal lips and where the hair grows on top, clitoral cancer, anal cancer, and cancers in the mouth. So I just don’t understand why there isn’t some type of annual screening or blood test to check for other forms of HPV infection that could cause dysplasia and cancer. What do you think or know about all this?



Heather, I’m so glad you brought this up because you are right, it is scary that cervical cancer is a sexually transmitted disease and I don’t know about you, but when I first heard about Farah Faucet having anal cancer a few years ago and then dying from it, I was shocked. It just isn’t a common cancer that we’re used to seeing in women or one we routinely screen for. So what’s was going on? Previously anal cancer was the torment of doctors as it almost exclusively plagued the community of MSM (men who have sex w/men) or heterosexual couples who have unprotected penile-anal intercourse. Of course, now anal dysplasia is recognized as a growing problem affecting women today, and routine screening should be available for all women.

Anal dysplasia in women has no relation to a women’s participation in anal intercourse, as the anal area can be exposed to carcinogens like HPV without anal penetration because HPV is living in the man’s semen. After ejaculation, a portion of the semen always drains out of the vagina & runs posteriorly toward the anus and if it is HRHPV infected can begin the process of anal invasion of the virus that can eventually result in anal dysplasia. Given that, much of the technology and most of the techniques needed to evaluate women for anal lesions, are extensions. This makes it easy to introduce the use of a soft swab to the anal area, which causes no discomfort and adds only a few more minutes to the overall exam but can be a lifesaving step for them because of early detection of those used in the screening of cervical cancer done with their routine pap smears at their annual exam. Early detection has an impact on decreasing incidence of anal carcinoma by initiating early treatment. Unfortunately, screening is being limited to high-risk patients such as those with known HRHPV or high grade lesions.

It has been found that 93% of anal cancers are biopsy positive for HPV. It’s true Heather, that this virus can cause dysplasia and eventually cancer of areas of the mouth and throat. This is why it is important to visit your dentist regularly, so they can thoroughly examine the oral cavity for any of the HPV type lesions. The HPV dyplasias and cancers of the vulva, clitoris, and even the anal area can cause severe itching and purities that are not relieved with creams or tablets. On close inspection (or sometimes to palpation) a lesion or discoloration of the tissue can be seen.

If you should experience this, go immediately to your gynecologist as they may want to do a biopsy to determine etiology of your symptoms. If you and you gynecologist decide to do an anal “pap” it is done by using a moistened Dacron swab. The swab is introduced through the anal verge until it passes through into the rectal vault, it is then gently rotated and swirled to touch all around the walls on its way back out. The sample is best placed in liquid cytology as cells can be separated from contaminants during processing.

Should further testing be needed after this, similar to colposcopy is done for abnormal pap smears, the procedure is called HRA. With this procedure, lidocaine lubricant is used prior to introducing an anoscope to visualize the anal area for hidden lesions. These lesions are biopsied if necessary and any further positive tests would be referred out to a colorecto-surgeon for further care and treatment such as laser or infrared coagulation of lesions.

Heather, the other question you had about transmission of HPV being passed to men by women because we harbor the virus in our bodies sounds pretty far out. Sexually transmitted diseases are passed around from partner to partner, so it is impossible to determine the origin in most cases when they are traced back for centuries, and for our purposes, it is just as likely that a man passes the virus to a woman as it is a woman passing it to a man.

We certainly have so much more to learn about the HPV virus, and for now I recommend that all of you continue to see you doctors and keep up with all your screening exams for peace of mind and bodily health. WaterWorks Feminine Cleansing System has been a blessing to women as it has allowed them a safe way to clean up and wash off semen from the genital area inside and outside. The faster it is cleansed and removed semen, the less likely you will encounter these infections.

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