Cunnilingus, Cancer, Michael Douglas and You

Michael Douglas recently outed himself as a dangerously prolific cunnilinguist when he claimed that his epic oral sex prowess, not his years of smoking and drinking, were to blame for his recent battle with stage four throat cancer. We interviewed doctors to set the HPV record straight before Douglas becomes the new poster child for idiot teenage boys and abstinence-only advocates who already think vaginas are super icky.

How many guys get oral cancer from the Human papillomavirus (HPV)?

Every year in the U.S., about 5,600 men contract cancers of the oropharynx (back of throat), but many of these cancers are related to tobacco and alcohol use, not HPV, according to the Centers for Disease Control and Prevention (more on this in a sec). A recent study on the prevalence of oral HPV infection in the U.S. found that HPV infection is the principal cause of a specific form of oropharyngeal squamous cell carcinoma that is increasing in incidence among men in the United States, but acknowledged that little is still known about the epidemiology (the study of disease/its prevention) of oral HPV infection.

Basically: no need to freak out, but a definite need for education.

Which men are most at risk?

Gay and bisexual men (who have sex with other men) are about 17 times more likely to develop anal cancer than men who only have sex with women, according to the CDC. The two doctors interviewed for this piece said they didn’t know of any studies on whether it’s riskier to perform oral sex on men or women.

Did Michael Douglas reeeeallly get throat cancer because he contracted HPV after giving ladies oral pleasure?

According to Dr. David Godin, MD, who specializes in head and neck surgery, HPV-induced squamous cell carcinoma of the oropharynx (the kind Douglas had) has a much better prognosis with treatment than the same tumor caused by smoking, but if you smoke along with an HPV-induced cancer, the prognosis appears to mimic smoking-induced cancer. As stated above, the CDC says the majority of men who get throat cancer do so because of smoking and drinking, not HPV. Therefore, both Godin and Dr. Ida Santana, MD, an internist and pediatrician, said it’s kinda silly for Douglas, a known smoker, to blame his throat cancer completely on oral sex. “I’m curious why he’s playing up this reason instead of smoking,” Santana said. “Why dismiss the smoking part completely?”

I’m a young fellow who doesn’t smoke or drink heavily but loves oral sex. (Good job, me.) What should I do?!?!

It’s easy. GET VACCINATED, ideally before you start having sex.

Most people don’t know that the CDC recommended the HPV vaccine Gardasil for boys in late 2011; even Dr. Godin wasn’t aware that the CDC had taken an official stance. But it’s all there on the CDC‘s website:

CDC recommends the HPV vaccine for all boys ages 11 or 12, and for males through age 21, who have not already received all three doses. The vaccine is also recommended for gay and bisexual men (or any man who has sex with men), and men with compromised immune systems (including HIV) through age 26, if they did not get fully vaccinated when they were younger. The vaccine is safe for all men through age 26, but it is most effective when given at younger ages.

“Both sexes should be vaccinated; otherwise, you’re only treating half the population,” Godin said. Santana said vaccinating both sexes was a “no-brainer.”

So how come boys barely ever get vaccinated?

According to a recent study in Pediatrics, parents are most likely to refrain from vaccinating their teenage daughters if they’re worried about side effects or don’t think it’s necessary. So: if they’re misinformed. Ignorant politicians like Michele Bachmann have spurred national fearmongering by claiming the vaccine is unsafe and encourages promiscuity. Santana said Bachmann’s comments influenced her sister’s decision to hold off on vaccinating her teenage daughter because she “wasn’t having sex yet.” Now she’s 14 and still hasn’t gotten it. Ugh.

If lack of knowledge is an issue for girls, it must be an issue for boys, who weren’t even included in the study. If specialists like Dr. Godin aren’t up to date on the CDC’s recommendations, parents certainly aren’t, either.

Godin recommended practicing safe sex and being honest with sexual partners. too.

Should we be happy, frustrated, or grossed out that Michael Douglas’s mouth is trending?

Both doctors said they hoped Douglas’s “confession” would help convince young men that HPV isn’t just a girl thing; Godin said it could “put a face” on the problem and help foster awareness. “Obviously, we can prevent HPV by vaccinating young men and women,” Santana said, citing Australia’s successful nationwide HPV vaccination campaign. She hopes Douglas’ story will spur similar efforts here in the United States. “But, like other political issues that relate to female sexuality, the puritanical Religious Right will try hard to get in the way.”

As for getting Michael Douglas’s glistening lips out of your brain? Sorry, can’t help you there.

Related: What’s The Protocol When It Comes To Telling Your Partner You Have HPV? The doctors said the guidelines we outlined back in 2011 still stand.