Cancer From Oral Sex Indeed

Actor Michael Douglas said his throat cancer was caused by HPV.
oral sex cabbage.jpg
(Mr. Hepe / Flickr)

Michael Douglas, talking with The Guardian yesterday around his role in the Liberace biopic Behind the Candelabra, gave this background on his survival of advanced-stage throat cancer:

Without wanting to get too specific, this particular cancer is caused by HPV [human papillomavirus], which actually comes about from cunnilingus ... I mean, I did worry if the stress caused by my son's incarceration didn't help trigger it. But yeah, it's a sexually transmitted disease that causes cancer ... And if you have it, cunnilingus is also the best cure for it. It giveth and it taketh.

His comment is making headlines, either because it's news to some that about half of throat cancer is caused by HPV, or just because a celebrity called attention to it. Or because a successful, respected guy like Douglas talked about getting what's often essentially a sexually transmitted cancer. In any case, HPV is predicted to cause more oral and throat cancers than cervical cancers in the U.S by 2020.

SHARK300200.jpgDental damn campaign by Oregon State University Student Health

Meanwhile the HPV vaccine should protect against at least some types of HPV that cause throat cancer, though it's not yet approved for that use. For now, as the U.S. CDC has put it, "The most reliable way to prevent infection with either a high-risk or a low-risk HPV is to avoid any skin-to-skin oral, anal, or genital contact with another person." So, that's all you have to do.

If you insist on doing sexual stuff with your mouth, though, the British National Health Service looked at what sorts of genitals are safest:

... We do know that HPV-related oropharyngeal [mouth and throat] cancer is twice as common in men, and is most common in heterosexual men in their 40s and 50s (as compared to the rates in homosexual men). This indicates that performing cunnilingus is more risky that performing fellatio. This seems counterintuitive [Ed. note, please don't tell me what's intuitive], but the concentration of HPV in the thinner moist skin of the vulva is much higher than the amounts of virus shed from the thicker dry skin of the penis, and this affects how easy it is to pass the virus on. Other research indicates that HPV can be present in semen and passed on at ejaculation.

They also offer this potentially terrifyingly all-inclusive list of symptoms of oral cancer:

  • Red, or red and white, patches on the lining of your mouth or tongue
  • Mouth ulcers that do not heal after three weeks
  • Swelling in your mouth that lasts for more than three weeks
  • Pain when swallowing
  • A tooth, or teeth, that becomes loose for no obvious reason
  • Persistent pain in the neck
  • Hoarse voice
  • Unexplained weight loss
  • Changes in your sense of taste
  • Earache
  • Swollen lymph nodes (glands) in your neck

So, condoms and dental dams for any and all contact? Here's how to make a DIY dental dam out of a condom. And of course there's always the full body condom.

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James Hamblin, MD, is a senior editor at The Atlantic.


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