KISSING AND JUST HAVING ORAL SEX IS NO LONGER SAFE

A Silent Epidemic of Cancer Is Spreading Among Men

by Maggie FoxShare

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Jason Mendelsohn had been married for close to 20 years and was happily raising three kids when he noticed the painless lump on his neck while shaving three years ago.  Within days, he had been diagnosed with a deadly form of cancer caused by a virus that he probably caught while in college, decades before

Mendelsohn, now 48, is the classic victim of head and neck cancer caused by HPV, the human papillomavirus. A new study out this week shows there’s a silent epidemic of HPV-related cancers among men

A team at the University of Florida, Baylor College of Medicine and elsewhere found that 11.5 percent of U.S. men were actively infected with oral HPV between 2011 and 2014, and 3 percent of women were. That adds up to 11 million men and 3 million women, the researchers report in the Annals of Internal Medicine

It’s a sexually transmitted infection and the more sex partners someone had, the bigger their risk. But the study found smoking also increased the danger of a high-risk infection, and, perhaps surprising to some, that men and women alike who smoked marijuana were far more likely to develop a cancer-causing strain of HPV

Jason Mendelsohn of Orlando was diagnosed with HPV-related oral cancer. He'd been married for 21 years and had three kids and may have been infected with the virus when he was in college. Studio T Photography

The predicted probability of high-risk oral HPV infection was greatest among black participants, those who smoked more than 20 cigarettes daily, current marijuana users, and those who reported 16 or more lifetime vaginal or oral sex partners,” the researchers wrote

Most people get over these infections and never even know they had them. HPV doesn’t cause any symptoms at first. But in some people, it stays in the infected tissues and causes DNA damage that, years later, causes a tumor to grow

Rising rates of oral cancer

HPV is the single biggest cause of cervical cancer and certain types of head and neck cancers called oropharyngeal cancers, according to the Centers for Disease Control and Prevention. Between 2008 and 2012, close to 39,000 people were diagnosed with a cancer caused by HPV every year in the U.S., 59 percent of them women and 41 percent men, the University of Florida team reported

But while the Pap smear and, more lately, HPV tests have reduced rates of cervical cancer, rates of oral cancer are growing

I had zero symptoms, except I found a bump on my neck

There are now more of these HPV-related throat cancers in men than there are cervical cancers in women,” said Dr. Erich Sturgis, professor of head and neck surgery at the MD Anderson Cancer Center at the University of Texas

Frighteningly, the cancers don’t cause any symptoms until they have spread. There is no way to screen people for them — unlike a Pap smear for cervical cancer, there’s not a good test for oral HPV. The only way to prevent infection is the HPV vaccine but once someone’s already infected — and that’s most people over age 26 — the vaccine doesn’t help

That leaves several generations of Americans vulnerable to these head and neck cancers with no way of knowing if one is silently growing

Related: Spike in Cancer Linked to Oral Sex

Mendelsohn was one of them

I had zero symptoms, except I found a bump on my neck,” Mendelsohn said

And the ironic thing is that I literally shave probably every day and never saw or felt the bump before

It was stage 4 oropharyngeal cancer

Treatment for head and neck cancer can be grueling and Mendelsohn said his was no exception.  "It was brutal. I had a radical tonsillectomy,” Mendelsohn, who is recovered now, said.  “I had 42 lymph nodes removed from my neck, followed by seven weeks of chemo, radiation and a feeding tube.”  The radiation treatment was the worst." "You have your head strapped down to a table and you can’t move and you can’t swallow your own saliva, so it’s like being waterboarded,” Mendelsohn said

 It’s horrible,” agreed Sturgis".

.That’s ever more reason why we want to get kids vaccinated so they don’t develop these".

Related: HPV Raises Head and Neck Cancer Risk 7-Fold

Now an advocate for men with head and neck cancer, Mendelsohn notes that he was not promiscuous and did not engage in what most people would see as risky sexual behavior

“I’d been married 21 years. I’ve got three kids. They believe I got the virus in college when I was 18 or 19 and it showed up decades later,” he said.  "This is not people who were promiscuous or who cheated on their spouses. This is normal — like you grow up, you date in college — just normal, everyday dating and having girlfriends,” he added.  “Most people will tell you it’s just oral sex with a woman who has HPV

It’s likely spread by all types of oral sex, said Sturgis, who was not involved in the research.  This not people who were promiscuous or who cheated on their spouse

While 11 percent of men had oral HPV in the study published this week, Sturgis notes that's only over a three year period. Over decades, that adds up to millions more.  “You can imagine over time quite a bit of the population will be exposed to oral HPV. Eighty percent of the population will have a genital HPV infection at some point in their life,” he said

And a significant number go on to develop cancer

Each year, about 11,600 people in the United States are diagnosed with cancers of the oropharynx that may be caused by HPV,” the CDC says

Dentists on the front lines

It’s not clear why the numbers are going up so much, but Sturgis says fear of HIV and of pregnancy may have made oral sex more common and more acceptable starting in the 1980s

Related: Two-thirds of Americans Infected with HPV

If someone has an oral infection, in theory they can spread it by deep kissing,” he said. Unlike HIV, which is spread by blood and semen, HPV is spread in the fluids of the mucosal membranes — which line the mouth, throat and genital tracts

The highest viral loads tend to be in the cervix,” Sturgis said. “Men performing oral sex on women probably tend to get exposed to the highest amount of virus."  There are so few specialists in the head and neck region.  But there are almost 200,000 dentists across the country

MD Anderson and other groups are working to encourage HPV vaccination, but they are also trying to fill the gap for people too old to be vaccinated who are at high risk

We are working with the American Dental Association. We are working with them both on trying to increase vaccination rates and on reducing smoking rates,” Sturgis said

There are so few specialists in the head and neck region. But there are almost 200,000 dentists across the country. And dentists see adolescents. If we could get dentists to at least ask parents whether their kids are vaccinated, just by asking we are going to help improve knowledge about the problem and at least get more of our kids vaccinated

The risk hit the headlines 2013 when actor Michael Douglas announced that he was being treated for throat cancer and said he believed it was caused by HPV

Two FDA-approved vaccines — Cervarix and Gardasil — prevent infection with HPV strains 16 and 18, which are most likely to cause cancer. A new form of Gardasil, approved earlier this year, adds five new high-risk HPV strains to its coverage, for even more cancer protection

Both boys and girls are supposed to get two doses of the vaccine, starting at age 11 or 12.  But the CDC says only 60 percent of parents are getting their kids vaccinated

Mendelsohn says his kids are vaccinated. "They are," he said. "I know they're fully vaccinated with HPV vaccine."

Program Initiatives Supported by CDC HIV/AIDS for New Hampshire

CDC FUNDING TO NEW HAMSHIRE 2016

HIV/AIDS                               $784,295

STD'S                                      $269,723

TB                                            $168,209

VIRAL HEPATITIS               $73,6802

CDC funds the New Hampshire State health department to implement cost-effective and scalable programs and policies that will have the greatest impact on HIV prevention in the state’s most affected communities and regions. Funding supports evidence-based disease monitoring, service delivery, staff development, and routine program evaluation. CDC funds the New Hampshire State education department to assess health-risk behaviors that contribute to the leading causes of death and disability among youth and adults

STD – In New Hampshire, CDC funds the state health department to reduce STDs through science-based prevention and control services that are high impact, scalable, cost effective, and sustainable

TB – In New Hampshire, CDC funds the State health department for TB prevention and control activities. These funds also support the identification and evaluation of persons exposed to TB, as well as laboratory services

 
Viral Hepatitis – In New Hampshire, CDC supports projects to improve the delivery of primary and secondary viral hepatitis prevention services in health-care settings and public health programs that serve at-risk adults and adolescents

Sexually Transmitted Diseases (STDs) Syphilis – Primary and secondary (P&S) syphilis (the stages in which syphilis is most infectious) remains a  health problem, primarily among men who have sex with men, but congenital transmission of syphilis from infected mothers to their unborn children persists in many areas of the country.  In New Hampshire, the rate of primary and secondary syphilis was 1.4 per 100,000 in 2011 and 3 per 100,000 in 2015. New Hampshire now ranks 37th in rates of P and S syphilis among 50 states.  There was 1 case of congenital syphilis from 2011 through 2015

Chlamydia and Gonorrhea – Untreated STDs are a common cause of pelvic inflammatory disease, infertility and chronic pelvic pain. In addition, they can increase the spread of HIV, and cause cancer. Pregnant women and newborns are particularly vulnerable. In 2015

New Hampshire: Ranked 50th among 50 states in chlamydial infections (233.3 per 100,000 persons) and ranked 50th among 50 states in gonorrheal infections (18.5 per 100,000 persons).  Reported rates of chlamydia among women (311.2 cases per 100,000) that were 2 times greater than those among men (153.5 cases per 100,000)

Cancer Awareness In New Hampshire

Out of 50 states, statistics now show that New Hampshire is currently the number 1 state with the highest rate of Breast Cancer diagnoses, and is the 11th state out of 51 states, for the amount of people receiving overall cancer diagnoses

NH Cancer diagnoses per 100K: 464.2
NH Breast cancer diagnoses per 100K: 144.9 - the highest
NH Cancer deaths per 100K: 159.8 - 20th lowest
NH Lung cancer deaths per 100K: 60.9 24th highest
NH Adults who currently smoke: 15.9% 7th highest

Cancer is the second leading cause of death in this country.  This remains to continue happening while it currently is costing 16 billion dollars alone in healthcare, just to still treat the sexually transmitted diseases throughout this entire country.  The USA has 20 million or more, of what could very well be,  an unnecessary 20 million new cases of STD's alone each and every year that the USA now has. This is an extreme amount of money that is well needed towards cancer and many other medical research and studies.  That are working diligently to finally produce a cure that will save many lives.  Instead, these funds are only paid towards a majority of what is just simply unwarranted reckless human behavior

Lauryn Schroeder

Los Angeles Times Reports

 How San Diego Hepatitis A outbreak became the worst the U.S. has seen in decades

© AP Photo/Gregory Bull In this Sept. 28, 2017 file photo a man passes behind a sign warning of an upcoming street cleaning in San Diego

Health officials say a deadly California outbreak of hepatitis A may take a year or more to abate. Experts say San Diego took all the right steps in addressing what is now one of the largest hepatitis A outbreaks the country has seen in decades, but variables unique to the city’s situation contributed to the outbreak

At least 481 people have been infected and 17 have died of the infection since November in San Diego. Another 88 cases have been identified in Santa Cruz and Los Angeles counties, where hepatitis A outbreaks have been declared

Officials throughout the state are now scrambling to vaccinate homeless populations, which are considered the most at risk. Doctors say people who have already been infected could travel and unknowingly spread it elsewhere

Dr. Janet Haas, president-elect of the Assn. for Professionals in Infection Control and Epidemiology, said the outbreak is unusual for the U.S. because the spread of the liver infection has been blamed on a lack of basic hygiene and sanitation, not contaminated food

This means public health officials can’t solely rely on previous containment methods

“It’s not like there’s never been a hepatitis A outbreak before…. We know what’s worked in the past. Usually that contains it and the story ends,” Haas said. “But sometimes it doesn’t work, or circumstances are different and you have to ramp it up.”
In San Diego, where nearly 85% of all confirmed cases are located, cleaning crews are hitting the streets, attacking them with high-pressure water mixed with bleach in an effort to sanitize any surfaces contaminated with feces, blood or other bodily fluids.
A private company was hired in September to deliver portable hand-washing stations in locations where homeless residents tend to congregate

Despite these efforts, the disease is spreading and many are asking what could have been done and what will effectively prevent future transmission

According to Dr. Monique Foster of the Centers for Disease Control and Prevention’s division of viral hepatitis — in San Diego this last week for a national infectious disease conference — there is no national standard that outlines how every public agency should respond

“You can't have a checklist that says ‘do x, y and z,’ because no outbreak is the same,” Foster said following an impromptu session at the conference about San Diego’s outbreak. "The type of illness, the group of people it’s affecting and how it’s being spread are all factors that will impact how a government should respond and when the public should be notified." For example, San Diego’s problem looks similar to a hepatitis A outbreak in Michigan, where state health officials have confirmed at least 341 cases since August 2016. Of those, 268 people have been hospitalized and 14 died

But Michigan and San Diego have different resources, Foster said. The underlying populations being affected are different and the laws in both areas are different

“This is why the CDC assists. We connect them with people who have answers, but we don’t come in and take over,” Foster said. “The local governments and local health departments are the first in line because they know their needs better than we do.”  The California Code of Regulations outlines reporting procedures for hepatitis A cases among a specific class of people, including daycare workers, healthcare facilities and food handlers who are more likely to spread the liver disease to other people

County health officials have been hesitant to release any additional information about where the cases are specifically concentrated, citing state and federal health privacy laws.
“This information is gathered from confidential medical interviews and documents,” Eric McDonald, director of the county’s epidemiology and immunization services branch, said after presenting with Foster at the infectious disease conference. “The public’s need to know has to override the confidentiality of the infected individuals.”  According to Dr. Oscar Alleyne, senior public health advisor to the National Assn. of County and City Health Officials, the Control of Communicable Diseases Manual is often referred to as the “bible” among health officials

The American Public Health Assn. lists the book, which is now in its 20th edition, as a “must-have sourcebook on identifying and controlling infectious diseases.”  Alleyne said it’s the closest thing to a guidebook public officials have and has been an industry standard reference for more than 100 years

According to the manual, prevention is key for hepatitis A, since the vaccine provides lifelong immunity. Data show since being added in 2006 to the recommended list of vaccinations for young children, the number of hepatitis A cases in the United States has decreased by 95%. Officials are instructed to control patients confirmed to have hepatitis A and quickly vaccinate those in immediate contact with infected individuals to increase the likelihood that the vaccine will be effective

County epidemiologists identified the rash of hepatitis A cases in early March, and dated the infection to the previous November. From the outset, the priorities have been vaccination and education, in line with manual instructions

It’s easier said than done.  “The normal method for preventing other people from getting sick gets thrown out the door when the community it’s infecting lives outside,” Alleyne said. “You have to know where they went, who they came in contact with…. The likelihood of being able to capture everyone on that list is small.”  In the event of an outbreak, public health officials should first determine how hepatitis is being spread, vaccinate the at-risk community and make special efforts to improve sanitary and hygienic practices to eliminate fecal contamination, the manual says

By early summer the official focus shifted to sanitation — hand washing and street cleaning

According to Dr. Jeffrey Engel, executive director of the Council of State and Territorial Epidemiologists, that might not be enough. “I can tell you that washing the doorknobs is not going to do it."  Engel said. “This is more about human behavior than anything else.”  Hepatitis A is more commonly transmitted through contaminated food. In 2003, 935 people in multiple states were infected by eating contaminated green onions at a restaurant. It was the largest outbreak since 1998, according to the Centers for Disease Control and Prevention. No one died

Lauryn Schroeder writes for the San Diego Union-Tribune