HPV and oral sex: Is Michael Douglas correct?

HPV and oral sex: Is Michael Douglas correct?

I’ve invented a new medical term.

The Michael Douglas Factor: When a celebrity, even one with good intentions, uses his or her own condition to disseminate incomplete, misleading, or incorrect medical information.

I could have called this phenomenon “The Gilda Radner Factor,” in recollection of efforts by Radner’s husband Gene Wilder to encourage women to ask their doctors for the CA 125 blood test –which, to this day, is not considered a good screening test for ovarian cancer–after Radner’s death in 1989. But, likely, more people are now familiar with Douglas and also, his recent comments about oral sex, cancer and human papillomavirus may have more pernicious consequences than Wilder’s advice to the public did.

In an interview earlier this week with the Guardian of London, Douglas attributed his oral cancer not to smoking and drinking alcohol, but to HPV which, he explained, “comes about by cunnilingus” (oral sex performed on women). Douglas subsequently clarified these comments to say that he was only speaking “generally,” but, because of his celebrity, the impression will stick for many: oral sex performed on women=HPV=cancer.

There’s no question HPV can cause oral cancer, and that HPV affects both men and women, but the truth is the vast majority of disease caused by HPV is borne by women, who contract HPV most often from men, and then develop genital warts, anal cancer, and cervical cancer. All those millions of Pap smears women undergo every year are screening for cervical cancer and pre-cancerous changes caused by HPV, most often transmitted by a male partner.

So thanks, Michael Douglas, for bringing public awareness to HPV. Young women and men should be vaccinated and everyone who is sexually active should be aware that oral sex can transmit sexually transmitted diseases.

But no thanks for misleading statements about how HPV “comes about.” We already have centuries of mythology about the dangers to society of female sexuality–such as that offered during the 2012 election season by Rush Limbaugh.

What we need, Mr. Douglas, is information. Not TMI.

Suzanne Koven is an internal medicine physician and a Boston Globe columnist.  She blogs at In Practice at Boston.com, where this article originally appeared. She is the author of Say Hello To A Better Body: Weight Loss and Fitness For Women Over 50

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  • Suzi Q 38

    He is a jerk anyway.

  • Cyndee Malowitz

    Last week I had some male patients ask me to examine the inside of their mouth. Now it makes sense.

  • Steven Reznick

    I have had two adult women develop oral cancer with their only risk factor being engaging in oral sex. They did not smoke and certainly did not drink to excess. It seems to be the most common cause of head and neck tumors in our area in low risk individuals. It is a risk factor for the development of oral cancer and any publicity makes the public more aware and able to act on physical changes earlier in the course of a disease. When we are counseling individuals about STD’s we remind them that when you are intimate with an individual you are intimate with their partners entire sexual past history. Michael Douglas downplaying the role of tobacco on oral cancer is wrong. Encouraging sexually active adults to be screened for HPV and encouraging parents to vaccinate their kids against HPV is neither inflammatory or wrong, It is good public heatlh.

  • Bill98

    ” We already have centuries of mythology about the dangers to society of female sexuality”. “What we need, Mr. Douglas, is information. Not TMI.”

    There is nothing in the article that supports either of these statements. Correctly noting that HPV can cause cancer is hardly declaring the “dangers to society of female sexuality”. I don’t recall hearing Mr. Douglas declare women’s sexuality evil, nor did he advise anyone to stop having sex. This statement seems to convey a certain political agenda on the part of Dr. Koven, and that has no place in this discussion.

    As for the “TMI”, where, exactly, did this occur? I suppose that he must have engaged in oral sex, or else he would not blame HPV for his cancer. Is this “too much information”? Hardly. How can you talk about a disease, which can be caused by sexual activity, without mentioning that activity?

    Finally, as to the equation: “oral sex performed on women=HPV=cancer”. The author is right that the results are not certain, but, it IS correct for the public to understand that “oral sex performed on women=higher risk of HPV infection=Higher risk for cancer”. Why does she seem so bothered by this? Having sex, with men or women, carries risks. That’s just the truth, and sharing that truth is what responsible, caring people should do.

    • Mary Corwin

      Oh come on, everybody was grossed out when Douglas announced his oral sex thing. Plus, it kind of sounded to anyone like oral sex with women leads to mutilation and disease.

      • Bill98

        I don’t see how this topic could be discussed without some mention of the sexual activities involved, but I do understand that some folks are not comfortable with such topics. That may be fine for the general public, but it is troubling in the extreme for a doctor to express such sentiments, as the author did here. How can a patient hope to openly discuss sexual topics if their doctor finds them to be “icky”?

        • Mary Corwin

          I meant that it may be preferable to confine these issues to discussion with your physician as opposed to public declarations. The “general public” probably did not want such visuals associated with a beloved star except, of course, a guy on another website whose commentary read, “Death by Catherine Zeta Jones. Yes, please.”

  • Filo Bedo

    Well I gained nothing from this post.

    • http://www.twitter.com/alicearobertson Alice Robertson

      Except that the author uses illness as a way to condemn conservatives.

  • querywoman

    HPV, cold sores, etc.! That’s a topic full of stereotype and tales! A pharmacist told me once you could have got HPV from an elderly aunt kissing you!

    • querywoman

      I think I got my own cold sores from my daddy rather than an elderly aunt. Herpes is such a touchy word. Strange denial. I used to get some nasty sores around my mouth in my early 20s. They responded to Zovirax my derm prescribed.
      That derm used to call them, “water blisters!” I knew what they were.
      Once my mama had some kind of breast biopsy. When her surgeon popped out to talk to me, he had a lovely herpes simplex sore near his own lips. I know one when I see it.
      I told Mama later, “I hope he didn’t kiss you.” She laughed.

    • Becky05

      Cold sores are caused by a herpes virus or HSV, not HPV. Different viruses.

      • querywoman

        Aren’t HPV and HSV similar? Has any isolated the really bad virus that causes cancer? I’ll google, but I’m not a doctor. I thought oral sex led to a lot of the spread to the genitals, but none of us know how common oral sex ever was! Of course, herpes is very common! I have had chicken pox.

  • SBornfeld

    I had assumed that Douglas had an HPV-related cancer purely on the basis of his excellent response to treatment. I have heard no specific explanation for why the prognosis for HPV-related oropharyngeal tumors is significantly better than for equally-staged oropharyngeal tumors in which smoking and alcohol were the only risk factors.
    I agree that Michael Douglas has not generally been a reliable source of medical information–that’s what our physicians are for.

    Obviously this is a relatively new issue, and the CDC recommendations for who should get HPV vaccine has evolved, as knowledge about these diseases has developed.
    Of course, the first recommendation was for young girls to get vaccinated before they become sexually active, since the focus was primarily on cervical cancer–and so our pediatrician recommended vaccination for our daughter, who was about 11 when Gardasil came on the market.
    Gay men already know they are at risk for HPV-related disease. In my book, if Michael Douglas can get straight men to get vaccinated, it will be good for men AND women.

  • traumadoc

    i see a new product on the horizon—a facial condom???

    • Mary Corwin

      There kinda is one already-the dental dam.

  • http://www.twitter.com/alicearobertson Alice Robertson

    And does this liberal minded doctor feel this way about some of the PR about Angelina Jolie’s supposed bravery? Being a mom with a child with cancer doesn’t make either my child or I brave. You face cancer because you have to (yes, some people do it better than others), but bravery isn’t defined by trying to save your own life. So, yeah, I will await your update and more political incorrectness.

  • FarmerJack

    Rush was still correct on his comment. Sorry you didn’t like it.

  • http://www.facebook.com/chinmay.singh.315 Chinmay Singh

    Do we know if Gardasil has any financial relationship with the actor?

  • Noneofthemcanevertalk

    It’s true. I also got oral cancer from HPV as well as a close friend. Neither of us had HPV before we started going down on women. Now we regret it sort of like Michael here enough to share our story, so quit assuming the guy is getting paid to tell the truth. Do not do this unless your woman is HPV free. These diseases are going to proliferate rapidly as time goes on and the only way to avoid a horrible cancer is to try to live a pure life with a pure woman. Sorry folks, but you need to take a stand and don’t let a woman convince you otherwise unless you want cancer like me and my buddy or Michael Douglas…If you want to get HPV in your throat, go for it, no one else cares. But at least you’ve been warned. make the woman get tested and base your decisions from there…

  • AKMaineIac

    Even if I thought that, knew it, out of respect for my wife I would have carried that information to my grave. “You pays your money and you takes your chances.” He should have at least said neither one of them can be positive where it came from… clearly they both have it now.

  • disqus_cTYPCkCVDM

    Oral male HPV cancer rates appear to be increasing steadily and the association with HPV is well documented

    Reason ?

    Either
    increasing rates of oral sex, more aggressive high risk strains of HPV,
    appallingly poor education (we are obsessed with condoms and unhealthy
    ‘normal sex’), ineffectual or misunderstood ‘treatment’ with colposcopic
    excision procedures and probably a whole host more. I suspect the
    knowledge of HPV and oral cancer in the lesbian community is probably
    also close to appalling, so the amazingly courageous commentary from
    Michael Douglas should be congratulated. Catherine ZJ is the only person
    who should be at all distressed with his comments and it must be
    assumed that he has her full support.

    The last time our peer
    group had a CME meeting with a local STD Physician I wanted to request a
    summary of the commonest diseases associated with oral sex but my
    request was felt to be a bit too unpalatable.

    It is time to bring
    cunnilingus out of the shadows and to provide some genuine adult
    education, so congratulations to MD and CZJ.