We’ve known for a long time that the Human Papilloma Virus can cause cervical cancer in women. But increasingly, HPV is causing cancers further up the body, in the throats of people infected with the virus. And the largest group of patients? Middle aged men. Emily Richardson-Lorente has the story of one Virginia man dealing with the consequences.
Fifty-four-year old Keith Hart is a hunter. Bobcats, wild turkeys, deer … whatever he can track in the woods around his house in eastern Virginia. His wife Lori says he’s not just a country boy, he’s a “man’s man.”
LORI HART: Yeah, he is a man's man. (laughing)
Before Keith got sick at 52 …
LORI HART: You got that right!
… he kinda thought of himself that way, too.
KEITH HART: Took care of everything and then come home and could take care of everything around the house. Go and go and go every day, good hard work, just steady. And then now I'm like a little old man trying to play catch up.
So what happened to Keith? HPV did— or rather, an oropharyngeal cancer caused by HPV.
KEITH HART: On the front side of my neck I found a lump. I figured I better get it checked out.
After a biopsy, Keith’s doctor gave him the diagnosis: base-of-tongue cancer, stage 4.
KEITH HART: I could tell he — he felt bad for me, and that kind of scared me.
The doctor then referred him to Mark Jameson, a head and neck surgeon at the University of Virginia. Fifteen years ago, most of the cancer patients his department treated were heavy smokers or drinkers in their 60s or 70s. Now the patients are younger, often otherwise healthy, and their cancers are far more likely to be caused by the sexually transmitted Human Papilloma Virus.
MARK JAMESON, MD: Of the cancers of the tonsil and tongue base that we deal with now, close to 80% of those cancers are HPV related. And while they have a reasonably good prognosis, people go through hell and high water to get treated.
Keith Hart certainly did. After having 42 lymph nodes and a chunk of his tongue removed, he began radiation.
KEITH HART: Which once they got started, was every day for 37 days.
It wasn’t until after the surgery that Keith learned definitively that his cancer was caused by HPV — most likely transmitted through oral sex … which hit his wife Lori particularly hard.
LORI HART: Because I thought, “My god! Did I just kill my husband? Did I just give him cancer?” I blamed myself, I thought I gave it to him. I felt horrible!
Lori HAD had an HPV infection in her 20’s, but that’s not unusual. In fact, the Human Papilloma Virus is so common that more than 80% of us will eventually become infected with it. Some women will end up with an irregular pap smear, like Lori did. Other people will end up with genital warts. But most will clear an HPV infection without ever knowing they had it, who they got it from, or who they might have given it to. But in a fraction of people – like Keith -- an old HPV infection will eventually become cancer.
KEITH HART: I’m only 50% of what I used to be, basically, physically, I’m only 50%.
Eighteen months after his treatment, Keith is still recovering.
KEITH HART: You know I walk out some days and I think that nothing's wrong with me and I start trying to use my body like I used to and then the next day I suffer for a week or two weeks so, one day you feel good, and then you pay for it.
Lingering pain from the surgery and radiation IS a big problem, but one thing that really galls Keith is something much more banal. Food tasted terrible.
KEITH HART: … nasty. You’d get all types of metal taste in your mouth, kind of like putting a penny in your mouth.
Keith’s sense of taste is returning slower than he hoped it would, but he’ll take what he can get.
KEITH HART: Two bites of corn, two bites of lettuce, two bites of anything is great nowadays. But after that, it starts to go bad.
And as if that wasn’t enough to deal with there’s the dry mouth. Keith’s salivary glands just don’t work like they used to.
KEITH HART: My best friend is the mouth spray to keep my mouth moist and keep me swallowing. It's really been antagonizing to fight this dry mouth.
The good news is, of course, that Keith’s cancer is in remission and he’ll continue to feel better with time. But Dr. Jameson says:
JAMESON: I mean, we may have a great survival rate, but we still have folks that die from this disease. And, you know, I think the take-home point is ultimately it's unnecessary.
Unnecessary because there’s a vaccine to prevent just these types of sexually transmitted cancers. It is, however, a childhood vaccine, and here in Virginia, only about one in three kids completes the shots by age 18. Given what Keith has been through, it’s no surprise that he and his wife Lori jumped on the chance to get their 13-year old daughter vaccinated.
LORI HART: I went and got her that vaccination right away. Right away.
KEITH HART: I don't want her to get anything from anybody and I don't want her to get something and give it to somebody. I definitely don't want anybody to follow in my footsteps.
Although the Centers for Disease Control recommends routine HPV vaccination at age 11 or 12, the vaccine can be used for women up to age 26 and men up to age 21. So, if you’re in that age range, or love someone who is, it’s worth noting that the HPV vaccine won’t just prevent them from getting a potentially embarrassing sexually transmitted infection, but may actually save them from a sexually transmitted cancer way down the road.