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HPV (Human Papilloma Virus)

This is a sexually transmitted virus that is highly contagious and very common. It is easily passed on through genital to genital or oro-genital contact. There are about 30 different sexually transmitted types. Two of these, 6 and 11 cause most genital warts and type 16 and 18 are the most aggressive and potentially cancer causing types.

It is important to note that just having the virus doesn’t necessarily mean that you will develop cancer. We know that most healthy adults usually get rid of the virus by themselves. The problem comes with people who for whatever reason do not clear the virus, i.e. those with weak immune systems, or with additional risk factors, such as smoking or HIV, or with partners who have HPV who keep reinfecting each other.

To discuss further with our doctor, or to learn more about our testing fees, please contact us at samedaydoctor, Canary Wharf.

Symptoms

  • Sometimes fleshy warty growths in the pubic area
  • Once the cells start changing you might get symptoms such as soreness and bleeding, especially after or during sex (anal or vaginal)

Diagnosis

For years there has been an NHS screening program to detect cervical changes in women, (caused by HPV) in order to try prevent these changes from developing into cervical cancer. As someone can have it for many years before changes are detected by smears, guidelines have recently changed and now it is advised to have  an HPV swab at the same time as your smear. It is hoped  that this will increase detection of problems even earlier.

HPV can also cause pre cancerous changes in men or women who have receptive anal sex. Smokers and  HIV positive patients, especially MSM (men who have sex with men) are most at risk. We urge all our patients who have receptive anal sex and feel they might be at risk, to have a rectal HPV swab.

The swab is painless and tests for the 20 most common sexually transmitted types of HPV, including the more aggressive types (16 + 18) that are implicated in most cancers.

Furthermore, If you are diagnosed with any of these high risk types, we can do a smear test (for men and/or women) that can detect any pre cancerous changes. Anal smears for men are not offered on the NHS at the current time. I would definitely recommend regular smears for our HIV positive patients with high risk HPV.

When it comes to throat or oral cancer it is important to see a doctor if you develop any suspicious symptoms, especially persistent pain in the throat or an undiagnosed persistent lump in the mouth or throat (painful or painless), unexplained bleeding, difficulty chewing or swallowing, persistent hoarseness etc. We do not recommend routine testing of the mouth although it can be done.

Treatment

Although it is possible to treat the symptoms of HPV such as warts, the virus is much harder to get rid of. There have been some good success in treating HPV with an immune modulator, Imiquimod. It alerts the body to the presence of the virus and if your immune system is healthy, it attacks the virus from inside. Because this medication can have more serious systemic side effects we would strongly advise treatment under medical supervision only.

For most people with HPV we would recommend more frequent smears to try and detect any changes in the local cells. It can take several years for the infection to cause changes in the local cells, and treatment would only be advised once the cells become abnormal and we would usually refer you for specialist treatment at this point.

Prevention

You can protect yourself from getting HPV infection by getting vaccinated. The Vaccine Gardasil, available at samedaydoctor Canary Wharf, will protect you against four of the most common HPV types 6, 11, 16 and 18 (the latter 2 being the potentially cancer causing strains). This cuts the risk of developing cervical or anal cancer significantly.

If you have the vaccine prior to coming into contact with the virus it should protect you against getting any of the 4 strains. Even if someone already has one of the more aggressive strains it might still be worth vaccinating against the other 3 types the vaccine protects against, as research has shown that having multiple strains can increase the risk for developing cancers.

It is important to note that Gardasil is a preventative vaccine not a therapeutic vaccine, in other words it doesn’t treat the infection.

HPV and oral sex

HPV is a sexually transmitted virus so most people will associate it with disease of the genitals, but as the inner lining and cells of the mouth and throat are very similar to the genital surfaces, it becomes more apparent that these areas are also at risk from the infection.

It has been known for some time that tobacco and alcohol use are risk factors for developing mouth and throat cancers, but recent studies show that HPV may be another risk factor.

As oral sex has become more widely practised the risk of picking up HPV in the mouth has increased.

Without trying to cause even more anxiety when it comes to sex, it is important to realise that oral sex is not always as safe as was thought.

There are other STI’s that can be passed on through oral sex, including:

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