STD Awareness: Can the HPV Vaccine Prevent Head-and-Neck Cancer?

Photo: Heather Hazzan, Self Magazine

The HPV vaccine Gardasil protects against human papillomavirus, a prolific virus that causes many types of cancer. In fact, although it was initially approved to prevent cervical cancer, the most common HPV-associated cancer is head-and-neck cancer. Last month, Gardasil 9 was finally approved for the prevention of head-and-neck cancer.

That certainly took long enough! We’ve known for a long time that HPV is behind the epidemic of head-and-neck cancers, and we’ve known that the HPV vaccine guards against infection with this virus. With HPV causing more head-and-neck cancers than any other HPV-associated cancer in the United States, this approval was long overdue.

Bearing the Burden of HPV


Gardasil 9 is now approved for the prevention of head-and-neck cancer, shining a light on this epidemic.


Although its routine use in boys and men has been recommended since 2011, the HPV vaccine is still primarily thought of as a “girl’s vaccine,” invaluable for its ability to prevent cervical cancer. For the first few years of its existence, Gardasil was only FDA-approved for girls and women, and since then it has struggled to escape its gendered connotations. While this new FDA approval doesn’t change who is eligible to receive the vaccine, it does shine some awareness on head-and-neck cancer, and gives parents more evidence that this anti-cancer vaccine is important to give to sons, not just to daughters.

Head-and-neck cancers can strike anywhere from the lips to the larynx, or voice box, and up into the sinuses and nasal cavity. According to the Centers for Disease Control and Prevention, an estimated 11,300 U.S. men are diagnosed with head-and-neck cancer every year, compared to 2,200 U.S women. Continue reading

STD Awareness: Winning One War on Cancer

Cancer starts with the uncontrolled division of cells.

The developed world is in the midst of a huge nosedive in genital warts and cervical “precancer” — all thanks to the human papillomavirus (HPV) vaccine. This simple shot trains the immune system to defend itself against HPV, a virus that causes genital warts and several types of cancer. Most sexually active people will be exposed to it in their lifetimes — it’s even been nicknamed the “common cold” of sexually transmitted infections.

Gardasil 9 protects against seven strains of HPV that collectively cause 90% of cervical cancers and anal cancers, plus the two HPV strains that are jointly responsible for 90% of genital warts. Vaccination also reduces the frequency of “precancers,” which are cellular abnormalities that can be treated before progressing into full-fledged cancer — meaning less time, money, and anxiety spent dealing with follow-up procedures and treatments.


The HPV vaccine is an anti-cancer vaccine.


The vaccine is safe and effective — and when we say “effective,” we mean it could lead to the eradication of HPV, and with it the cancers it causes. A recent analysis of 66 million vaccine recipients published in The Lancet points to plummeting rates of genital warts and precancer. Among teenage girls, there was an 83% drop in HPV-16 and HPV-18 infections (the two strains of HPV that together cause 70% of cervical cancers) — and cervical precancers were cut in half.

The most dramatic gains were made in countries that offered the HPV vaccine to both boys and girls. Additionally, there were even decreases in the HPV strains that aren’t covered by the vaccine — evidence of “cross-protection,” the phenomenon in which the immune system recognizes close relatives of the viruses it has been trained to attack. Even people who did not receive the vaccine were less likely to catch the virus, simply because their risk was reduced if their partners were vaccinated. Continue reading

STD Awareness: Searching for an HIV Vaccine

Ever since the dawn of the AIDS era, researchers have worked nonstop to develop an HIV vaccine. In 1984, Margaret Heckler of the U.S. Department of Health and Human Services famously (over)promised that a vaccine would be ready for testing in two years. But it’s taken much, much longer. This Saturday, May 18, is HIV Vaccine Awareness Day, a celebration of the patients, community members, and scientists who are hard at work bringing this vaccine into existence.


Only one vaccine — still in the experimental stage — has shown any effectiveness against HIV.


Hiding from the Immune System

Vaccines are inspired by our own bodies’ ability to fight disease. Usually, when our immune system encounters a threat, it takes note of the viral “antigens,” which are like facial features — a button nose, say, or dramatically arched eyebrows — that make it instantly recognizable. It creates “antibodies,” weapons that can target those antigens like guided missiles. Often, the immune system can remember the distinguishing facial features so it’s ready to attack if the enemy ever returns — giving us immunity, possibly for life.

Vaccines take advantage of our natural ability to create these immune memories by exposing our immune systems to antigens without actually exposing us to infectious viruses. Think of it as a “wanted” poster that helps the immune system recognize “bad guys” before it actually sees them on the street, enabling it to attack and destroy them before they cause disease. Continue reading

STD Awareness: How Common Is Herpes?

Those of you with an eye for weird news might have noticed recent headlines about wild monkeys in Florida suffering from a herpes epidemic.

Two things in that sentence might have tripped you up. One, Florida has wild monkeys? Yup. In the late 1930s, after a Tarzan movie was wrapped, three male and three female rhesus monkeys were released into the Florida wilds, giving rise to an estimated 1,000 monkeys roaming the Sunshine State today.


Both oral herpes and genital herpes are on the decline.


The second thing that might have given you pause: Monkeys can get herpes? Yes again! The Herpesviridae family is huge, with at least 100 members infecting mammals, birds, reptiles, bony fish, amphibians, and oysters — even dinosaurs are thought to have been infected by herpesviruses! The virus has been evolving alongside us since before the dawn of humanity, so it knows us like the back of its hand (metaphorically speaking), allowing it to stow away in our bodies and hide from the immune system.

The “Tarzan” monkeys suffer from a type of herpesvirus called herpes B, which can be deadly in humans, though it’s rare — just try not to find yourself on the receiving end of a monkey bite or scratch. Not so rare in humans are human herpesviruses, of which there are eight types. Types 1 and 2 — aka herpes simplex virus (HSV) 1 and 2 — can both cause genital herpes, one of the most common sexually transmitted diseases (STDs). HSV-1 mostly causes cold sores, but can also infect the genitals to cause genital herpes, while HSV-2 mostly causes genital herpes, but can also infect the facial area to cause cold sores. (A little confusing, I know.) Continue reading

STD Awareness: The Long Road to a Chlamydia Vaccine

Earlier this year, television personality John Oliver was the butt of an elaborate prank orchestrated by actor Russell Crowe. It started with an auctioned jock strap, and ended with Crowe funding the John Oliver Koala Chlamydia Ward at the Australia Zoo. If you want the full story, check out the video below (beware explicit language).

Despite Oliver playing it for laughs, koala chlamydia is very real and very serious. At least half of wild koalas are infected with a chlamydia type that’s related to the human version. As in humans, koalas can transmit these bacteria through sexual contact. And, similar to the havoc it wreaks in our species, in koalas chlamydia can cause blindness, urinary tract infections, and female infertility — and can be passed from mother to infant. Along with other factors, chlamydia is said to be responsible for plummeting koala populations in many parts of Australia. Continue reading

STD Awareness: Can Older Adults Receive the HPV Vaccine?

female-patient-with-female-doctorWhen the human papillomavirus (HPV) vaccines were introduced, a lot of people were excited about protection from a sexually transmitted virus that could cause cancers, including cervical cancer, anal cancer, and head-and-neck cancer. It wasn’t just any old vaccine, it was a shot that could prevent cancer. Cancer!

In fact, a lot of people were disappointed they were too old to take advantage of an anti-cancer vaccine, which was initially approved for people as old as 26. We were given a lot of reasons why people above that age were “too old,” such as the assumption that anyone older than 26 has probably been sexually active for years and would have already contracted the most common strains of HPV.


While getting vaccinated before becoming sexually active is optimal, the HPV vaccine can still benefit people who have already had sex.


But there are compelling reasons to vaccinate people in their late 20s and beyond. In fact, Gardasil 9 was recently approved for people as old as 45. That’s great news for those of us who missed out on the HPV vaccine the first time around. We might never have had any sexual contact, and therefore were never at risk for catching the sexually transmitted virus. We might have found ourselves widowed or divorced after years or decades of monogamy. We might have been sexually active with multiple partners during that time. Whatever our circumstances, those of us who are 45 or younger can now consider HPV vaccination.

HPV and the “Older” Individual

When Cervarix and Gardasil, the first HPV vaccines, were released, they only protected against two cancer-causing HPV strains, HPV-16 and HPV-18, which are responsible for 70 percent of cervical cancers (Gardasil protects against two additional wart-causing HPV strains). A few years ago, Gardasil 9 hit the market, targeting five additional cancer-causing HPV strains — increasing the chances that even sexually active recipients could be protected from HPV strains they hadn’t encountered. Continue reading

STD Awareness: HPV Testing vs. the Pap Test

I love writing about health and medicine, but I hate going to the doctor. I don’t like taking my clothes off for a dermatological exam, I don’t like rolling my sleeve up for a shot, and I don’t like opening my mouth for a dentist. I don’t even like having my blood pressure taken — it gives me the heebie-jeebies, and probably a case of white-coat hypertension too.


For now, pelvic exams are a mainstay — and an important part of cancer prevention.


So when it comes to something even more invasive, like the Pap test to screen for cervical cancer, I’m one of those people pining for a magic wand — a tool that a health care provider can wave over your fully clothed body to detect disease. The Pap test may have transformed a scourge like cervical cancer into one of the most easily detected and treated cancers — and for that I love it — but I still fervently wish for its demise. As long as it’s replaced by something better, of course.

Last month, an article in JAMA inspired a burst of headlines. “HPV test more effective than Pap smear in cancer screening,” said CNN. Or as WebMD put it more succinctly, “HPV Test Beats Pap.” Then, last week, the U.S. Preventive Services Task Force updated their guidelines to recommend that patients 30 and older can forgo the Pap test in favor of HPV testing alone. This news might be welcome to anyone who dislikes regular Pap tests and wishes to avoid stirrups and speculums. Unfortunately, HPV tests aren’t the noninvasive “magic wand” so many of us hope for. From the patient’s perspective, the experience of undergoing an HPV test is no different from the experience of undergoing a Pap test. They both require a pelvic exam — the stuff of stirrups and speculums. Continue reading