HPV... Testing and treatment

  • Posted by a hidden member.
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    Oct 15, 2008 2:19 PM GMT
    Recently I have taken an interest in HPV and the testing/treatment of gay men with or without HIV. It is getting some mainstream attention lately, but being in the midwest (as opposed to SF or NY where there is a large population of gay men and HIV + men requiring screening) I am looking for someone here who performs these tests and if positive will treat (or at least do an anoscopy to look for) suspicious cells. The screening is being likened to a female "pap" smear, but done anally for gay men. I am interested to know if anyone has been tested by anal pap and if so have you then had an anoscopy or other followup treatment.

    I am thinking about being tested, but don't have a resource here in the midwest. I know of a colorectal surgeon who has just started doing anal paps, but he is inexperienced (not placing blame) and trying to learn about HPV prevention and treatment also. He is willing to work with me, but admits to having learned what he knows from a conference in SF.

    I know talking about our "butts" is not a comfortable topic unless it seems we are talking about who we just bottomed or topped for, but I am hoping that I can count on you guys for some real information on the subject of HPV. Guys, you have come through before don't let me down now.
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    Oct 15, 2008 4:34 PM GMT
    Well... not directly responsive, but here's a disturbing story in this morning's news: It seems that a fairly high percentage of oral cancers (not just cervical cancers) are caused by HPV. And the cancers can develop many years after the infection.

    Hopefully, they'll approve the vaccine for boys soon, but that won't help the current generation much. Maybe not the best sales angle for parents though: "buy this vaccination just in case your boy becomes a cock sucker... "

    http://www.oregonlive.com/health/oregonian/index.ssf?/base/news/1223951122174350.xml&coll=7
  • Posted by a hidden member.
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    Oct 16, 2008 2:16 AM GMT
    Thank you for your input. The article is very disturbing, but this is what HPV does. It is attracted to certain mucosa (i.e. that of the buccal, colo/anal, cervical and even penile types) and will, as you said, eventually cause cancers at these sites.

    Thanks for the information and the post. The point is to get the information out there.
  • Posted by a hidden member.
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    Oct 16, 2008 4:15 PM GMT
    Come on guys...

    I need your help with this one. Again, I know that this is uncomfortable to talk about at first, but so was HIV. Not talking about it doesn't make it go away it just feeds the ignorance.
  • ScotXY

    Posts: 117

    Oct 16, 2008 4:47 PM GMT
    I talked to my dr about HPV and to know if u have or dont have it.

    He has been my dr for little over 3 yrs and has been apart of my recovery from my physical abuse of my ex. We talked about me getting tested for everythign full spectrum. Since not only my ex cheat on me but other things.

    So I have full clean bill of health and can still count my sexual partners on my hands.

    I asked him about checking for HPV. He stated there are specific signs he could not see any leaning towards him willing to do that test for me.

    He stated that insurance does not cover testing for HPV in men. Further the test itself is costly over 400$ labs. He said also that he would be able to see change in blood and examinations on me to know if something was asku.

    Now what he did suggest for those who have unsafe sex with ex's and want to know if u are clean is to go thru several tests. Most insurances pay for.

    I have under gone the below testing thru out this year quartlery basis now after 3 years after my ex. I have clean bill of health.

    But he said most gay or straight men who are sexually active should have tests done regular pending on how many partners and unsafe sex.

    Hep A - Vaccination Avail - Ins Paid
    Hep B - Vaccination Avail - Ins Paid
    Hep C
    HCV AB w/Rflx to Riba
    Panel083824
    RPR
    Venipuncture
    N gonorrhoeae DNA Prob w/Rflx
    Chlamydia/Gonococcus - done via Nucleic Acid Ampplification (NAA) Rectal Swab (Similar to pap smear for women)

    Now I did find this.

    WebMD - Men
    http://www.webmd.com/sexual-conditions/hpv-genital-warts/hpv-virus-men

    CDC
    http://www.cdc.gov/STD/HPV/STDFact-HPV.htm

    Also -
    http://www.hpvselftest.com/

    From - Web MD
    WebMDMale HPV: The Symptoms

    The types of high-risk HPV that can cause cancer rarely present any symptoms in men or in women. Genital warts are the first symptom you may see with low-risk HPV strains that cause warts but not cancer.
    Tests for HPV Virus in Men

    To diagnose genital warts in men, the doctor will visually check a man's genital area to see if warts are present. Some doctors will apply a vinegar solution to help identify warts that aren't raised and visible. But the test is not foolproof. Sometimes normal skin is mistakenly identified as a wart.

    There is no routine test for men to check for high-risk HPV strains that can cause cancer. However, some doctors are urging anal Pap tests for gay and bisexual men, who are at higher risk of anal cancer caused by HPV. In an anal Pap test, the doctor collects cells from the anus, and then has them checked for abnormalities in a lab.
    Treatments for HPV

    There is no treatment for asymptomatic HPV infection. Instead, doctors treat the health problems that are caused by the HPV virus.

  • EricLA

    Posts: 3461

    Oct 16, 2008 5:12 PM GMT
    There's a new concern I think even MORE relevant to the M4M population -- a report on ABCNews.com yesterday says that the new worry is that HPV can cause oral cancer, too. So, oral sex can lead to oral cancer:

    http://abcnews.go.com/GMA/OnCall/story?id=6034244&page=1
  • ScotXY

    Posts: 117

    Oct 16, 2008 5:20 PM GMT
    EricLA saidThere's a new concern I think even MORE relevant to the M4M population -- a report on ABCNews.com yesterday says that the new worry is that HPV can cause oral cancer, too. So, oral sex can lead to oral cancer:

    http://abcnews.go.com/GMA/OnCall/story?id=6034244&page=1


    Although no proof exists yet, there is a chance that HPV can be transmitted mouth to mouth.

    Thats direct quote from the article.
    That is whats is called speculation. As always you have to think. Know your partner. Any unsafe sex practices take you to the next level of possible infections for large spectrum of STD and other things. You are exchanging fluids and well its a dick semen seminal fluid and urine bile all and all.

    Be smart know your partner and take it smarter. If unsure cover it.

    Let them not speculate but provide us facts of what they know and take care of us in mean time be smart about your sexual activities and take care of yourself.
  • Posted by a hidden member.
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    Oct 16, 2008 10:37 PM GMT
    Im looking at this product called valacore, its got some good reviews at the hpvforum.


    Im gonna pull the trigger.
  • Posted by a hidden member.
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    Oct 17, 2008 10:19 AM GMT
    I don't really know anything about this valacore product. It seems to be an over the counter remedy that claims to (if you read carefully) "diminish symptoms". This is not a cure for your or any type of HPV, this is symptomatic relief.

    Besides, I am not looking to cure HPV. I think that curing this virus is a long way off. The only way to not be infected is to not be exposed (or before you are exposed be vaccinated - see Guardasil -- at the present time only approved for use in women, but studies in men are currently underway) and many studies say that protection (i.e using condoms) is only about 70% effective in preventing transmission. The HPV virus is not spread via bodily fluids. IT is mostly spread by skin to skin contact from the infected party.

    Here is the issue... I am not even sure that I have the virus. I am looking for a physician who has experience in the field of testing, diagnosing subclinical anal HPV, monitoring and/or treating the strains that can cause cancer if they are present.

    One last thing to understand is that of the many HPV strains (I think it is around 40 identified to date) only a few of them are oncogenic. Furthermore, the ones that cause warts seem not to be the ones that lead to cancers.

    Thanks for the information on Valacore and good luck with this product. I hope some of the information that I have presented can be useful in return.
  • Posted by a hidden member.
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    Oct 17, 2008 6:10 PM GMT
    thank you man, i just ordered 2 bottles, i will keep you informed.
  • Posted by a hidden member.
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    May 28, 2009 3:02 PM GMT
    According to the CDC 50% of all sexually active people have HPV.

    And while HPV has been linked to cervical and rectal cancers, and may well be linked with oral cancers, I wouldn't worry. Fact is, millions of people have HPV that never turns into cancer.

    What this should bring to mind is the necessity of getting regular check ups with your doctor. Cancer is never easy, but regular checks ups means catching it before it becomes serious.
  • Posted by a hidden member.
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    Jun 01, 2009 11:57 AM GMT
    rawr saideven if you have it, your immune system will keep the fucker in check. this is why they dont really test for it.. since most people who sleep around probably have it and don't know it, and those with weakened systems will display visual symptoms.

    i read an article that said that 100% of hiv poz men have hpv as well, and something like 70% of all americans have it. lols


    Ok that's it! I'm staying a virgin for life!
  • Posted by a hidden member.
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    Jun 01, 2009 1:59 PM GMT
    rawr saideven if you have it, your immune system will keep the fucker in check. this is why they dont really test for it.. since most people who sleep around probably have it and don't know it, and those with weakened systems will display visual symptoms.

    i read an article that said that 100% of hiv poz men have hpv as well, and something like 70% of all americans have it. lols


    A lot of what I'm saying is going to be redundant.
    Certain HPV strains (high risk strains) cause cervical cancer in women.
    Males with high risk strains may develop squamous cell carcinoma of the rectum or penis.
    Strains that cause venereal warts are low risk and do not cause cancer.icon_eek.gif
    Males and females that never had warts can develop cancer from a silent HPV infection.
    Women are screened for cervical cancer with a cervical pap test and a DNA test for HPV.
    Most men with HPV will never develop health problems from it. Finding out if you have HPV is not as important as finding out if you have the diseases that it can cause
    Males who don't have sex with males are not screened for HPV
    Males who have sex with males can have a rectal pap for early detection of squamous cancer. The FDA has not approved the HPV part of the test in males. This makes it unlikely that an insurance company will pay for the test since it is considered experimental.

    HPV can not be cured..Veneral warts can be removed, but as mentioned above the viruses causing the warts are not going to cause cancer.

    I'm suspicious of the product valacore. It is not a medication but a supplement. Since it is called a supplement, it escapes the scrutiny of the FDA.. I can't find any well controlled studies verifying its efficacy. All I could find were anecdotal stories by people claiming how well it worked.

    The vaccine for HPV (Gardisil) has not been approved for use in males.

    The following link has allready been mentioned
    http://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm




  • Belvedude

    Posts: 14

    Jun 01, 2009 2:21 PM GMT
    So pretty much everyone has it according to my doctor. According to her around 70% of the population does have it and mot don't know it! And I'd like to correct the information above that the virus can cause cancer There are two specific ones I believe called ANSI 1 and ANSI 2 and once of those can cause cancer. Get screened if you have any suspicions!
  • Posted by a hidden member.
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    Jun 01, 2009 3:00 PM GMT
    The following is taken from the National Cancer Institute Web page
    http://www.cancer.gov/cancertopics/factsheet/Risk/HPV

    There seems to be a lot of different HPV types that are high risk for cancer.
    HPVs include types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, and 73 These high-risk types of HPV cause growths on the cervix that are usually flat and nearly invisible, as compared with the external warts caused by low-risk types HPV–6 and HPV–11. HPV types 16 and 18 together cause about 70 percent of cervical cancers . It is important to note, however, that the great majority of high-risk HPV infections go away on their own and do not cause cancer...The article did not discuss HPV infections in males

    Oral HPV increases the risk for oral cancer
    Alcohol and cigarette smoking are best known risk factors for squamous cancers of the head and neck
    However the risks from oral HPV infection and alcohol/cigarettes are not additive.
  • Belvedude

    Posts: 14

    Jun 03, 2009 11:58 PM GMT
    Also too just so you all know according to my doctor gardasil will be available for men in the next two years or so!
  • TexanMan82

    Posts: 893

    Jun 04, 2009 2:10 PM GMT
    Sedative said
    rawr saideven if you have it, your immune system will keep the fucker in check. this is why they dont really test for it.. since most people who sleep around probably have it and don't know it, and those with weakened systems will display visual symptoms.

    i read an article that said that 100% of hiv poz men have hpv as well, and something like 70% of all americans have it. lols


    Ok that's it! I'm staying a virgin for life!


    No shit. I don't think I ever want to have sex
  • twentyfourhou...

    Posts: 243

    Jun 04, 2009 2:42 PM GMT
    Very interesting topic.
    I bet many if not most men on this site at one point or another have been exposed to this potential cause of anal/colon cancer. Even those who claim to be 100% top - all it takes is one episode of unprotected (or protected for that matter) anal penetration encounter, are at increase risk.

    I suspect, it will be many more years before any official guidelines are put out for screening of anal/colon cancer in MSM by the CDC or equivalent (including the use of the HPV vaccine in MSM).
    Assuming it would follow a similar path as for cervical/uterine cancer screening in women due to HPV, it would likely involve a combination of HPV smear screening and visual examination - anoscopy, colonoscopy.
    It would be interesting to see if HPV anal (external and internal spincter)smear screening would be effective at detecting precancerous or cancerous lesion higher up in the rectal vault or in the distal colon for that matter. Perhaps the best of both worlds would be visual inspection (?every 3-5 years) via anoscopy/colonoscopy AND HPV DNA smear testing during the procedure of either suspicious or normal looking mucousa.
    I would encourage each individual to research this matterial, get a basic understanding AND present this informaiton to the health care provider. I know for a fact, that if one depends on the provider to bring this up, most will not.
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    Jun 04, 2009 11:16 PM GMT


    Looks like the question is already in mainstream medical and legal circles:


    http://voices.washingtonpost.com/checkup/2009/06/will_men_get_gardasil.html
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    Jun 06, 2009 1:05 AM GMT
    Sonicbelve saidAlso too just so you all know according to my doctor gardasil will be available for men in the next two years or so!


    Men can still get the Gardasil vaccination any time they want. Myself and two of my friends have gotten the vaccine. Insurance will not cover any part of it and it cost me close to $400.00 when it was all over. It's three shots staggered over the course of 6 months just like the Hep B vac, but unlike the HepB, it hurts like hell for a couple days after.
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    Jun 06, 2009 1:32 AM GMT
    GuerrillaSodomite said
    Men can still get the Gardasil vaccination any time they want. Myself and two of my friends have gotten the vaccine. Insurance will not cover any part of it and it cost me close to $400.00 when it was all over.


    Very interesting. I've heard of "off-label" use of drugs (using drugs to treat things they haven't been approved for or in a way that hasn't been approved) before, but not vaccines. I suspect that not all doctors would be willing to give men the vaccine.

    rawr saidi read an article that said that 100% of hiv poz men have hpv as well, and something like 70% of all americans have it. lols


    From a CDC brochure on HPV:
    "Approximately 20 million Americans 15 to 49 years of age (approximately 15% of the population) are currently infected with HPV. About half of those who are infected with HPV are sexually active adolescents and young adults 15 to 24 years of age."
  • Posted by a hidden member.
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    Jun 06, 2009 1:39 AM GMT
    I thought I had HPV a while back, so the first STI screening Ihad I made sure to have the doctor check. I've had these little bumps (they kinda look like pimples) on the underside of my glans for as long as I could remember.

    Any way, not HPV. It's a condition some guys have called pearly papules.

    Anyway, if something seems odd, get it checked out! If it's nothing, you'll feel better.
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    Jun 06, 2009 1:46 AM GMT
    madtown said
    GuerrillaSodomite said
    Men can still get the Gardasil vaccination any time they want. Myself and two of my friends have gotten the vaccine. Insurance will not cover any part of it and it cost me close to $400.00 when it was all over.


    Very interesting. I've heard of "off-label" use of drugs (using drugs to treat things they haven't been approved for or in a way that hasn't been approved) before, but not vaccines. I suspect that not all doctors would be willing to give men the vaccine.


    I'm not sure what legal loophole they go through, but I doubt they could get away with it if it was going to get them in trouble. I first heard about it from my HIV doctor in Seattle who was suggesting it for most of his patients. When I moved here to Chicago, I asked my new doctor about it. I think he might have actually used the term "off-label", but said that a lot of his patients had been requesting it and he saw no problem with it. He said there wasn't a large pool of data available from which to draw scientifically proven conclusions of it's efficacy in male patients, but it probably couldn't hurt either.
  • Posted by a hidden member.
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    Jun 06, 2009 10:44 AM GMT
    madtown said
    I've heard of "off-label" use of drugs (using drugs to treat things they haven't been approved for or in a way that hasn't been approved) before, but not vaccines. I suspect that not all doctors would be willing to give men the vaccine.



    A licensed physician is not restricted from using a medication, including vaccines for off-label indications. A pharmaceutical manufacturer is not permitted to market a medication's off-label indication. Neurontin (Gabapentin) is only approved for seizures. I don't think any physician uses it for this purpose since it does not work well. However there are thousands of prescriptions written for it's off label indications: mood stabilizer for bipolar disease, migraines, chronic pain syndromes, neuralgias from shingles and diabetes mellitus, painful muscle spasms from multiple sclerosis, painful distal symmetrical polyneuropathy in AIDS patients, and on and on. When Neurontin was going through clinical trials no on tested it for these other diseases. When the patent expired on Neurontin and a generic became available, Pfizer's replacement Lyrica had clinical trials for some of these other indications. Pfizer can now market Lyrica for these indications but not Neurontin. You pay far more for the patented Lyrica than the generic Neurontin. When Gardisil went through clinical trials, no on thought about testing it on males so there is no approved indication for males. In December 2008, Merck asked the FDA for permission to market the vaccine in the United States for males between ages 9 to 26. In the UK HPV vaccines are already licensed for males aged 9 to 15 and for females aged 9 to 26.
    If it works for males in the UK, there should be no reason it doesn't work for American made malesicon_lol.gif Your family physician will not lose his license or get cited for immunizing males with Gardisil. He still may be reluctant however. Gardisil would be easier to obtain from a physician familiar and more sensitive to Gay issues
  • Posted by a hidden member.
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    Oct 30, 2009 4:44 AM GMT
    You can get Gardasil now as a male. Three shots of $120 each, not covered by insurance, in the US. This made news a few weeks ago. I asked the University doc if I should get one, and he recommended it even though I've had plenty of sex.