Oral Sex Linked to Rise in Men's Throat Cancer

Studies Show Epidemic That Could Be Stemmed by Cervical Cancer Vaccine Gardasil

For years now, doctors have urged young women to be vaccinated against the human papilloma virus (HPV), which is believed to cause cervical cancer.

But now, growing research in Europe and the United States is implicating HPV in a rising number of cases of head and neck cancers in men, and many doctors are recommending that all boys be vaccinated as well.

Doctors say that changing sexual behaviors -- earlier sex, more partners and especially oral sex -- are contributing to a new epidemic of orpharyngeal squamous cell cancers, those of the throat, tonsils and base of the tongue.

These cancers can be deadly, and are striking men at a younger age and in increasing numbers.

"There's a lag in information," said Dr. John Deeken, a medical oncologist at Georgetown University. "We physicians have done a poor job of advertising the fact that boys and girls should have the vaccine."

"This kind of cancer traditionally affects males who have been smoking and drinking all their life, and now in their mid-60s they are getting head and neck cancer," he said. "However, HPV cancer we are seeing in younger patients who have never smoked."

Two decades ago, about 20 percent of all oral cancers were HPV-related, but today that number is more than 50 percent, according to studies published by the American Association for Cancer Research.

Similarly high rates have also been seen in Europe, where a new Swedish study has shown a strong correlation between oral cancers and oral sex. Oddly, the rising rates have not been seen yet in the Southern Hemisphere in Australia and New Zealand.

Each year, more than 30,000 new cases of cancer of the oral cavity and pharynx are diagnosed, and more than 8,000 people die from oral cancer, according to the Centers for Disease Control and Prevention (CDC).

Cure rates are higher than for smoking-related throat cancers, but still only 50 percent.

Today, men are more likely to get oral cancer than are women, but as the epidemic grows, that could soon change.

"We expect in head and neck cancers that 85 percent are men and 15 percent are women," said Deeken. "But over the coming years that could become equal."

"It's going to take a couple of decades to see the trend turning around," he said. "The epidemiological risk factors are past sexual partners as well as marijuana exposure, not just oral sex."



Human Papilloma Virus Affecting More Men

HPV is the most common sexually-transmitted infection. Those who are infected often have no symptoms and pass it on to their partners through genital contact during vaginal and anal sex. It can also be transmitted during oral sex and, more rarely, during deep kissing through saliva.

There are more than 100 strains of the virus. Some cause genital warts, but others can result in cell changes that decades later can become cancerous. Each strain is identified by a number; oral and cervical cancers are caused by HPV sub-types 16 and 18.

HPV can also cause cancers of the vulva, vagina, penis and anus, and there is some evidence it is associated with esophageal and lung cancers.

The Food and Drug Administration (FDA) approved the use of Gardasil for girls in 2006 and for boys for treatment of genital and anal warts in 2009. The vaccine can be given at any age, though it is most effective given young people before any sexual exposure.

Doctors say it could prevent 10,000 more cases of oral cancer a year.

Several deaths associated with the vaccine led doctors to advise caution in the rush to promote widespread use of the vaccine, and doctors say there is a lack of public awareness of its role in preventing cancer.

"With any new vaccine, you have to err on the side of caution, but every year we know more about it," said Deeken. "But we have to ask the question: What do we do for the spouses and kids of our patients? I don't see any downside to vaccination at this time. My son and daughter will get it."

Because humans are the only reservoir for HPV, "it could be eliminated like smallpox," he said.

The research isn't new, but it has not received wide attention, perhaps because of taboos associated with oral sex.

Oral sex has become more commonplace; people have more sex partners and have sex earlier in life -- all behaviors linked to HPV-related oral cancers, according to a study in the Centers for Disease Control and Prevention's (CDC) Emerging Infectious Diseases report.

A study at the Swedish Karolinska Institutet showed the risk of developing oral HPV infection increased with a rise in lifetime oral or vaginal sex partners. It also cited "open mouth kissing."

The study included 542 American students, and noted similar increases in such cancers in Britain, Finland and The Netherlands.

But Dr. Kevin Cullen, director of University of Maryland's Marlene and Stewart Greenebaum Cancer Center, is not sure only oral sex is to blame.

"It's hard for me to believe sexual behaviors have changed that much in 15 to 20 years," he said. "It may be that as happens, epidemics get enough people infected and an infection begins to take off, and that may have happened with HPV at some point."

A study Cullen did last year found that HPV-related oral cancer in African Americans were less common than whites, perhaps because of negative cultural attitudes about oral sex.

"But it looks like blacks are beginning to catch up with whites," said Cullen.

Scientists also don't know why women tend to develop cervical cancer while men have more throat cancer. "Maybe women are better able to transmit to a man than a man to the oral mucosa of a woman," said Cullen.

Doctors also think that cancer is likely to develop in the first area of exposure ? in women, usually the vagina. The woman may then develop later immunity in the throat.

But with more oral sex, often before vaginal sex, female throat cancers could increase, they say.

Very little HPV was seen until the 1980s. "It was very rare in our archives," said Cullen. "But each year we looked, it was more prevalent. Why, no one is really sure."

And doctors say those numbers have not yet peaked.

"There is increasing evidence that boys as well as girls should be vaccinated," said Cullen. "Men and women are increasingly going to face the burden of cancer, and we have a tool to prevent it."

Why the medical community has not fully embraced vaccination is not clear.

"The lead time for development of oral cancer is in decades, so to do definitive studies would take decades to do," he said. "[The FDA] picked the simpler task of preventing HPV warts in the short time frame."

Resistance has also come from safety concerns, as well as the fear by some groups that vaccination for a sexually transmitted disease will promote sexual behavior.

Cervical cancer just may just be "sexier" than throat cancer, said Dr. Ranit Mishori, a family physician in the Georgetown University School of Medicine.

"We don't think about oral cancer except in smokers," she said. "There is no question HPV is the cause of most oral cancers, but it's partly an awareness issue relating to our kids' sex life, and who wants to talk about oral sex?"

Convincing parents to vaccinate their sons as well as their daughters is a "hard sell," said Mishori.

"Oftentimes it's the moms who take the kids to the doctor, and we tell them we have this great vaccine that can prevent their daughter from getting cervical cancer," she said. "Moms can easily relate."

But it's harder to tell her "to give her son three painful shots so that he won't transmit it to his girlfriend in the future and might not transmit cancer or have oral cancer himself," said Mishori.

As for potential side effects with the vaccine, Mishori said those concerns are "pretty minor compared to the potential."

"It hasn't been around too long, but it's been tested on thousands of women," she said. "The fact that the vaccine prevents cancer is astounding in itself."

Source: http://abcnews.go.com/Health/ReproductiveHealth/hpv-oral-cancers-rise-oral-sex-popular-spread/story?id=11916068&tqkw=&tqshow=

Can Your Sunscreen Cause Skin Cancer?

A dermatologist sheds light on a new study that claims your SPF might be doing more harm than good.

A new study has found that an overwhelming amount of sunscreens on the market contain an ingredient that speeds cancerous cell growth. That's right: sunscreen might cause cancer, the very thing people lather it on to protect themselves from.

But don't go throwing out your white creams, sprays, oils, and lotions just yet. Many doctors and dermatologists aren't convinced that sunscreen should go the way of canola oil and old-school Coppertone.

Dr. Marta Rendon, a board-certified dermatologist and global spokesperson for Procter & Gamble's Head and Shoulders division, tries to assure worried consumers that the results — released last week by the Environmental Working Group, a nonprofit public health organization — come from animal testing only and are the findings of "just one study."

According to that study, nearly half of the 500 most popular sunscreens may actually increase the speed at which malignant cells develop and spread skin cancer such as melanoma.

Why? Because they contain Vitamin A, an ingredient that was added to sunscreen formulations because it's an antioxidant that slows skin aging.

This isn't necessarily new information to Rendon, who acknowledges that some studies suggest "that vitamin A might have some phototoxicity." Still, she says that "it does not necessarily correlate that it'll increase your risk of skin cancer."

To be safe, however, Rendon recommends using sunscreen that blocks both UVA rays — the ones that penetrate the skin more deeply to cause aging issues such as fine lines and wrinkles — and UVB rays, which are the ones that can give you a sunburn and are more responsible for cancer.

"Both forms of ultraviolet light are carcinogenic and increase the risks of skin cancer, but some sunscreens don't target both — most of the new ones are UVA blockers," Rendon says. "You need to block both."

Although in its annual report, the EWG only recommended 39 of the 500 products they examined as safe to use, Rendon says that all FDA-approved sunscreens have undergone rigorous trials to prove their efficacy and hold up against safety standards. (Some brands she recommends? Any with Helioplex, such as Neutrogena's line, or with Mexoryl like La Roche-Posay.)

But regardless of where you stand, she says that by following a few simple rules, you'll be safe in the sun:

Check the product label. Make sure your sunscreen includes zinc oxide or titanium dioxide, which act as physical barriers and keep ultraviolet light out best.

Don't worry about SPF. Sun protection factor is not regulated by the FDA, and as it turns out, sunscreens with a high SPF — like 70, 80, or 100+ — really don't work any better than those half its count. "The difference between SPF 30 and SPF 60 is maybe five percent," Rendon says. "Those with lighter complexion, freckles, or red hair should use SPF 45 to 50 with good UVA and UVB blockage. For normal complexions, SPF 30 is just fine."

Don't under-do it. "A shot glass is the right amount, and reapply every two hours," she says, adding that you can't really ever put on too much.

Remember that sunscreen isn't the only armor against sun damage. "You have to be conscious of sun exposure," Rendon warns. "Wear hats and sun-protective clothing."

Look for European brands. "It's true that Europe has better sunscreens because they process ingredients faster than we do," she admits.

Source: http://health.msn.com/health-topics/skin-and-hair/articlepage.aspx?cp-documentid=100260739>1=31036

Blood Pressure Meds Might Reduce the Spread of Breast Cancer, Study Says

Women taking the widely-prescribed blood pressure medications known as beta-blockers when they are diagnosed with breast cancer appear to have a significantly reduced risk for the cancer spreading, or metastasizing. The new study also reported that these women were much less likely to die from breast cancer than women who did not take the medication.

The research team, based at Queen's Medical Centre in Nottingham, England, says that their study is the first ever to look at the relationship between beta-blockers and the spread of cancer. The study was presented last month at the European Cancer Organisation (ECCO)’s European Breast Cancer Conference in Barcelona, Spain.

The team found that the women who were taking beta-blockers had a 71% reduced risk of dying from breast cancer, and a 57% lower risk of developing a second type of cancer.

Des Powe and his colleagues followed 466 breast cancer patients, 92 of whom were on some sort of blood pressure medication. Of these, about half were taking beta-blockers when they were diagnosed with breast cancer. The team found that the women who were taking beta-blockers had a 71% reduced risk of dying from breast cancer, and a 57% lower risk of developing a second type of cancer. These numbers are in relation to women who were either taking a different kind of blood pressure medication or who weren’t taking any kind of blood pressure medication at all. This suggests that the differences seen were actually due to the action of the beta-blocker itself, rather than to the effect of lower blood pressure.

Powe explains that beta- blocker drugs compete with stress hormones and bind, at a cellular level, to the same target receptors as those hormones. But unlike stress hormones, beta-blocker drugs do not activate cancer cells. In other words, blocking the stress hormones may block the ability of the cancer to spread, because cancer cells depend on the presence of these hormones to do so.

Powe says that more research will be needed to assess proper dosing and potential side effects and whether beta-blockers should be given as a supplement to existing breast cancer treatment. Still, he and his colleagues are encouraged by these early results.

Source: http://www.thedoctorwillseeyounow.com/content/cancer/art2897.html

What's the Fastest Growing Cancer Diagnosis in U.S.?

A full-page ad in a recent Time magazine, paid for by the Light of Light Foundation, recommends that you ask your doctor to check your neck for thyroid nodules — abnormal growths that form a lump in the thyroid gland. In fact, thyroid nodules have become the most common endocrine diagnosis in the United States, with thyroid cancer now being the fastest growing cancer diagnosis in the country.

Few thyroid nodules produce any symptoms, so people will usually only find them by chance. Far more often, they will be detected by your doctor during a routine physical exam or by an imaging study (ultrasound, computed tomography, or magnetic resonance scan) that is looking at some other condition in the head or neck.

The likelihood of a thyroid nodule being cancerous is greater in those who are less than 20 years old or who are older than 70. The risk of this cancer is also higher in individuals who had undergone radiation of the head and neck, once a common treatment for acne.

How worried should you be if a nodule is found on your thyroid? Not very. About 90 percent to 95 percent of thyroid nodules are not cancerous. Also reassuring: Most common types of thyroid cancer are curable and rarely life-threatening. Nonetheless, nodules require further evaluation to determine whether cancer is present.

If a nodule is easily felt, the physician can usually evaluate it in the office under a local anesthetic by using a thin needle to perform an aspiration biopsy. A small needle is inserted into the nodule several times, each time in a different place, so that the cells withdrawn will be a representative sampling. For nodules that are difficult to feel, the biopsy is done using real-time ultrasound images to guide the needle into the lump. A pathologist then examines these cells under a microscope for cancer.

The biopsy of a thyroid nodule may be interpreted as being either benign, malignant, or indeterminate (suspicious). For benign nodules, only an occasional follow-up exam is required. Malignant nodules, however, are most often treated by removing nearly all of the thyroid gland. Removing the thyroid condemns the patient to a lifetime of taking thyroid hormone pills. The major risks of this surgery are the inadvertent removal of the parathyroid glands, which are closely associated with the thyroid, and damage to the laryngeal nerve.

For nodules considered suspicious, thyroid hormone pills may be administered in an attempt to suppress progression of possible cancer; more often, the suspicious nodules are removed surgically.

While some nodules can be felt easily, I have learned that many doctors are not adept at finding thyroid nodules that are located low down in the gland or buried deep in the thyroid tissue. Also, keep in mind that the utility of any fine-needle aspiration depends on the experience of the doctor who carries out the procedure and of the pathologist who examines the cells.


Source: http://health.yahoo.com/experts/healthnews/14182/whats-the-fastest-growing-cancer-diagnosis-in-us/