Men may hear a surprising question when they call to set up an annual physical. More and more doctors and nurses are encouraging men to get a pap smear.
Once viewed as only a test for women, tests for Human Papillomavirus (HPV) are commonplace in the doctor’s office and doctors become more aware of the disease’s ability to attack both men and women.
We sat down with Dr. Roberto Ortiz, HIV Specialist at the Orlando Immunology Center to get an inside look at the effects of HPV and its link to rectal cancer in men.
What exactly is HPV?
There are more than 40 types of the Human Papillomavirus that can infect the genital areas of males and females. It’s similar to the STD, herpes. Some types cause warts and other diseases. But because it’s a progressive disease, others may have no symptoms.
How is HPV transmitted?
It’s generally a sexually transmitted disease. The most common strand has an affinity for the anal transitional zone in men and the cervix in women.
Can safe sex help prevent it?
Everybody as an adult will be exposed to it. But antibodies in our bodies help us fight it. Prevention of symptomatic strains includes avoiding direct contact with lesions or warts. There is still a chance that you can contract HPV even if you use protection. There is a vaccine for men and women that should be administered before becoming sexually active.
What does HPV do to cause anal cancer?
A mix of different strains of HPV can cause rectal or cervical cancer. HPV induces cervical displasia, an abnormal, organized growth in rectum or cervix. It’s similar to cancer caused by sun exposure. The difference is that while skin cancer is visible, your rectum or cervix may show no symptoms. Only if you’re in advanced stages, it will cause bleeding.
Are gay men more at risk for anal cancer than straight men because of sexual activity?
HPV and anal cancer are more prevalent in HIV-positive gay men because their immune system isn’t equipped to fight it. But straight men are at risk as well. If a female sexual partner has cervical cancer, the HPV may reach the male’s rectum, where the thinnest layer of skin is located.
Why are “Bottoms” more at risk?
Anyone can get an initial infection. Women and “bottoms” are more likely to get the strand that can lead to cancer because their intraepithelial tissue, the thin layer of skin found inside the anal canal, is coming in direct contact. However, anal cancer is more prevalent in those aged 60 and older.
Are there treatments/cures for anal cancer?
You can’t prevent cancer, but if you have a pap test that is positive, follow up with a High Resolution Anascopy wherein the doctor puts a scope into the anal cavity to determine if there is displasia. If there is, the doctor will do a biopsy. Treatments include surgery, chemotherapy and radiation, just like any other cancer.
What are some symptoms that someone may have HPV?
You may see warts around genitals and in advanced cases, rectal bleeding.
What procedure is involved in order to check men for it?
To screen men, we insert a 1 inch swab into the rectum. However, if cancer is found in men, it can be more difficult to treat. Cervical cancer in women can be cut out, since it’s possible to remove the uterus.
How can men help prevent HPV/anal cancer?
Anyone who is sexually active should be checked regularly; at least every 1–3 years. Anyone with warts should be checked for cervix displasia. Ideally, the best prevention is to be vaccinated before becoming sexually active, generally between the ages of 9 and 20. We hope to make it a requirement to have all kids receive the vaccine to prevent the strain of HPV that produces displasia. Right now, the vaccine is not covered by insurance for most adults and can be expensive. It has to be done by a pediatrician to be covered. If you already have HPV, treat it. The virus will never go away but can be treated. Avoid the drama. Get tested.
