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HPV and Males: Moms and Dads, Let’s Talk

By Kathleen Aharoni

Before my son left for his freshman year at college, I, the single mom, pushed myself to have the talk with him. Not that talk. This talk was about HPV (human papillomavirus), and its link to the increasing number of occurrences of head and neck cancer in males.

Yes, this is the same HPV that is a sexually transmitted disease (STD) that can cause cervical, anal and penile cancers and genital warts. What the medical community now knows is that it is also a leading cause of oropharyngeal (mouth and throat) cancers in males, surpassing tobacco-related oral cancer, says Dr. Bruce Brockstein, director of the Kellogg Cancer Center at NorthShore University HealthSystem and a head and neck cancer specialist.

Cervical cancer. Oral cancer. Ding, ding. One of the ways this cancer-causing virus is spread is through oral sex.

Really? I have to talk to my son about oral sex?

What I learned as I squeamishly had this talk, was that I knew nothing about the virus or how to prevent it. The best I could say was that he might want to ask the girls he is sexually intimate with whether they have had the HPV vaccine.

I so wished our family doctor had covered this subject and offered vaccination.

So, let us, the parents, have the talk about HPV with our sons. I have much more information now and no hesitations.

“Take it [HPV] seriously,” says Dr. Heidi Renner, assistant professor of internal medicine and general pediatrics at Loyola University Medical Center. Unlike other STDs, with HPV, “you can end up with cancer,” she emphasizes. Interestingly, she has found in her practice that most mothers don’t need convincing to give their daughters the HPV vaccine. Mothers of both sons and daughters, she says, are more willing to vaccinate their sons because they already are more willing to have (or will have) their daughter(s) inoculated. In families with only boys, Renner is seeing less willingness to vaccinate. This can be for several reasons, she says. “Boys don’t want it. They think it is a girl-thing and doesn’t apply to them,” she explains. “Girls talk about HPV and the vaccine with one another. They see advertisements. Boys don’t talk about these things.

“And, boys hate shots,” she adds.

The Centers for Disease Control’s Advisory Committee on Immunization Practices (ACIP), in December 2011, began to recommend “routine vaccination of males aged 11 or 12 with HP4 [Gardasil] administered in a 3-dose series.” The ACIP also recommends that males aged 13 through 21 who have not been previously vaccinated or who haven’t completed the

3-dose series also receive the vaccination, as well as males 22 through 26.

“Get the vaccine,” says Brockstein. He emphasizes that boys should be vacci­­nated prior to first infection, before the beginning of sexual activity. He says don’t worry about having a conversation about HPV with your child[ren], if that keeps you from vaccinating them—give them the vaccine; discuss it later. Did you discuss tetanus, diphtheria and Hepatitis B with your bab[ies] before inoculating them? Probably not.

When you do decide to discuss HPV with your child, be sure to include that condoms should be worn at all times, even during oral sex. Oral condoms, known as dental dams, are available for vaginal and anal oral sex (rimming). Encourage your children to engage in conversation with their partner(s). Renner suggests that sexual partners ask one another whether they have been screened for STDs, whether they have ever tested positive for one and whether they have received the HPV vaccination.

According to Brockstein, “almost everyone today gets infected with HPV at some point—half of people are infected some time before their early 20s. Usually, it clears itself [up].” For males with HPV-related head/neck cancer, “the cure rate is 80 percent, with radiation and/or chemotherapy,” says Brockstein.

According to the American Society of Clinical Oncology and the National Cancer Institute: “The numbers of HPV oral cancer is increasing in men so rapidly, it will surpass cervical cancer by 2020.”

Help your children master their health. Talk to your family doctor about the HPV vaccination. Renner says, “We won’t get a hold of HPV until both boys and girls are vaccinated.”

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