Thursday, June 6, 2013

Michael Douglas Blames His Throat Cancer on Oral Sex

Hollywood star Michael Douglas says oral sex caused his recent bout with throat cancer. 

"Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus," Douglas, 68, told the British newspaper The Guardian. He added that he has had real success beating back the tumor with chemotherapy and, "with this kind of cancer, 95 percent of the time it doesn‘t come back."
Douglas is also a longtime smoker, and was at one time a heavy drinker -- both behaviors are risk factors for throat cancer. But experts say it‘s not farfetched to think oral sex may have been a contributing factor.
"This is no surprise to anybody who studies infectious diseases," said Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center, New York City said. "There is a big increase in HPV-related cancers, and one of the main ones, if not the main one, is throat cancer."
Douglas was diagnosed with cancer in 2010 and underwent two months of chemotherapy and radiation. He remains cancer-free, but has checkups often to catch any recurrence, he told the paper.
Seigel said most adults are at risk of contracting HPV, and 80 percent of people will test positive for HPV infection within five years of becoming sexually active. The virus is also thought to cause the vast majority of cervical cancers, which is why U.S. health authorities have recommended that boys and girls get inoculated with the HPV vaccine.
Another expert agreed that HPV contracted through oral sex can trigger throat cancer.
"We are living through an HPV epidemic," said Dr. Dennis Kraus, director of the Center for Head and Neck Oncology at North Shore- LIJ Cancer Institute in Lake Success, N.Y. "We used to think of throat and neck cancer as a disease of smokers and drinkers," he said, but the demographics have changed and it‘s increasingly become a sexually contracted disease.
The good news is that there is an 80 percent treatment response rate for this type of cancer, Siegel noted.
"It‘s much more responsive than any other throat cancer. If the cancer is due to smoking or alcohol, the ballgame is over practically. This is very responsive, which is why I‘m not surprised to see that he‘s cured," Siegel said.
If a woman has HPV, then having oral sex is also a risk for infection, Siegel said. "It‘s most likely transmitted from females to males," Kraus noted.
Douglas also told The Guardian that oral sex was a cure for his cancer, something Siegel considers humorous. "Saying that oral sex is also the ‘cure‘ is a joke," Seigel said. "He is trying to tell you about courage in the face of illness."
Although the evidence for preventing throat cancer by getting vaccinated for HPV isn‘t clear, Siegel believes that every boy 15 and older should get vaccinated before he becomes sexually active.
Kraus agreed that both boys and girls should be vaccinated against HPV, but he added that there‘s not enough data to know how much vaccination might help when it comes to throat cancer. "This is a cancer associated with HPV," he said. "The question is whether vaccination will change the face of this disease -- that‘s not clear."
More information
For more information on throat cancer, visit the U.S. National Library of Medicine.
Health News Copyright © 2013 HealthDay. All rights reserved.

Angelina Jolie‘s Double Mastectomy Fueling National Debate

Tim P. Whitby/Getty Images(NEW YORK) -- Angelina Jolie says she has no regrets about going public with her very private decision to have a preemptive double-mastectomy to slash her risk of developing breast cancer.

"I‘m very happy to see the discussion about women‘s health expanded.  That means the world to me," Jolie told ABC‘s Good Morning America on Sunday as she walked the red carpet with boyfriend Brad Pitt at the London premiere of his new film, World War Z.

This was the actress‘ first public appearance since penning a New York Times essay explaining how she had both breasts removed after being diagnosed with a rare mutation of the BRCA gene that put her risk of developing breast cancer at nearly 90 percent.

In revealing her medical choices to the world, experts say she instantly created global awareness for genetic screening and preemptive medical procedures.

Dr. Michael Cowher, a breast cancer surgeon with the Cleveland Clinic, said the hospital‘s breast services clinic has not been tracking exact statistics but there has been a noticeable increase in patient inquiries about BRCA screening.

"Personally, I haven‘t had a new patient who hasn‘t asked about genetic testing in the past few weeks since Jolie‘s announcement," he said.

Dr. Laura Corio, an OB-GYN at Mt. Sinai in New York City, agreed.

"We‘ve been offering genetic testing for a while but now patients are asking for it more often and when they do, they seem more informed about their choices," she noted.

While the experts generally agree that Jolie has handled herself admirably and has provided valuable information to the public, they worry there is also a downside to her revelations.

According to the American Cancer Society, a case like Jolie‘s is relatively rare.  Only about 5 percent of breast cancer cases can be linked to a faulty BRCA gene.

"Not every woman needs to be tested and not every woman who tests positive for a BRCA gene should have a double mastectomy," said Dr. Otis Brawley, chief medical officer for the American Cancer Society.  "My concern is that not everyone reading what she wrote will understand this."

According to Brawley, only women with a strong family history of breast cancer where close relatives on both sides of the family have been diagnosed with the disease at a young age are good candidates for genetic testing.  Jolie lost her mother and her aunt to breast cancer.

"I think we need to do a careful job explaining who should and who shouldn‘t be tested," Cowher said.  "I‘ve had several patients who have asked to be tested and who have not met criteria, to their dismay."

Dr. Sandhya Pruthi, a consultant in the breast diagnostic and high risk breast clinic at the Mayo Clinic in Rochester, Minn., said that even a woman who undergoes genetic testing might not get the answers she is looking for.

"If they don‘t test positive this might lead to a false reassurance that they have nothing to worry about when they could be positive for some other genetic mutation we don‘t know about yet," she said.  "Or testing positive for a mutation with unknown significance can create even more uncertainty and anxiety."

Pruthi said women who do test positive for a high-risk BRCA gene might be able to lobby for better health insurance coverage for mammograms and other surveillance tests, but might also have a harder time getting life insurance.

Testing is costly and, in many cases, not covered by insurance, even for women in the high-risk category.  Women interested in testing should speak with a genetic counselor, Brawley advised.

And if they do test positive for a dangerous genetic mutation, they might want to weigh the risks of surgery against other possible preemptive alternatives such as more aggressive screening or medication.

"Mastectomy isn‘t the only option and is certainly not the right option for everyone," Brawley said.