News from Illinois CancerCare

Oral Sex Linked to Head and Neck Cancer

By: Patrick Gomez, MD Illinois CancerCare

While the information contained in this article is sensitive in nature, it is incredibly important to get out to the residents of Bloomington/Normal. If you personally are involved in a lifestyle that is mentioned in this article, please take time to really read and digest this information. If you are a parent of children who might benefit from this article, please take time to talk to them and share this information. From a medical perspective, oral sex is sex, and generally, as practiced, it is unsafe. Most people don’t realize that sexually transmitted diseases such as herpes, gonorrhea, chlamydia, and human papilloma virus (HPV) can take hold in parts of the oral cavity during sex with infected partners, and that in reverse oral contact can infect the genitals, too. HPV is a particularly scary threat, since it incubates silently in the back of the mouth and is now linked to a dangerous form of throat cancer in both men and women similar to the one that rises in the cervix. Head and neck cancers, which can attack the mouth, nose, sinuses, and throat, have been diseases of people over 50 with a history of heavy smoking and drinking. With the decrease in smoking and use of chewing tobacco, these disfiguring cancers have been on a steady decline. The problem: this triumph of prevention has been clouded by an unexpected increase in oropharyngeal cancer, which develops in the tonsils and the base of the tongue and is apt to show up in those who don’t smoke or drink heavily, and in younger people. Researchers from Johns Hopkins reported in the Journal of Clinical Oncology that between 1973 and 2004 there has been a near doubling of the incidence of these HPV-related oral cancers among people in their 40s. The rise in oropharyngeal cancer is linked to changing sexual practices and, in particular, ones that involve bathing the throat with HPV-infected fluid. Increasingly, scientists are implicating HPV-16, and in some cases 18, the same ones that cause cervical cancer. In a Swedish study conducted in 2006, it was found that of the preserved surgical specimens from excised oropharyngeal cancers going back over 30 years HPV-16 was identified in less than a quarter of specimens removed in the 1970s. By the 1990s, the proportion was 57 percent. After 2000, it was 68 percent. In 2007, a study published in the New England Journal of Medicine found HPV-16 in 72 percent of oropharyngeal cancers in the United States. These findings give cause for alarming medical concern that the increased infection rates are indeed being acquired through unprotected oral sex. The fact that our children might be at growing risk for this deadly cancer is particularly unnerving. Health surveys indicate that well over half of American teens now engage in oral sex. These behaviors are fueled by the adolescents’ belief that oral sex is risk-free play, making it more common and acceptable. A group of researchers determined that more than 80 percent of adolescents whose ages range from 16 to 21 failed to protect themselves with condoms during oral sex. This is an age group well known for diligently using them during vaginal sex. The relative ease and growing frequency of oral sex among those engaging in casual “relationships” is a virtual epidemic in the making. Providing our young people with medical information and stern parental and medical guidance is long overdue. The abstinence message should be foremost and explicit. But it’s not always enough. Our children must be informed that safe sex applies to sex by mouth, too. And, that’s a message for all ages. For more information, you may contact Illinois CancerCare at 309-662-2102 or online at www.illinoiscancercare.com. References available upon request.