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HPV... Testing and treatment
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.
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
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.
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: 75
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: 2306
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: 75
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.
WillyTaylor Posts: 11
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.
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.
WillyTaylor Posts: 11
Oct 17, 2008 6:10 PM GMT
thank you man, i just ordered 2 bottles, i will keep you informed.
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.
May 28, 2009 8:17 PM GMT
I think I should comment here. I have anal cancer and I tested positive for HPV.

The scary thing was, that I complained of problems "down under" and had a biopsy performed on me. It showed cancer cells proliferating. But then just to be sure I had an HPV test done at a different office. These two offices that did the biopsy and the HPV culture test are interconnected so they share medical records. But when I got my HPV positive results that particular office didn't know of my cancer diagnosis. Probably because the data didn't cross the network yet as less than a week had passed.

So I sort of tricked the nurse and asked, "So now what do we do since I'm positive for HPV?" The nurse that gave me the results said, "Well, we watch it." I said, "Oh really? That's all for now?" She said, "Yes." Then I ripped into her and told her, "Well that's really interesting, because I just had a biopsy done last week and I was told I have cancer and now here you are telling me that we should just watch it. That's really unbelievable! Had I gone through your office alone I would have trusted you to 'watch' it and in the meantime I have a cancer growing in my body!!!" She looked at my with shame and guilt and realized how stupid of an answer she gave me.

I guess my point of the story is watch for any lesions or growths. Get them biopsied as soon as possible. Had I had my tests performed in reverse I would have not been treated for stage 1 cancer. I am very fortunate. It could have metastasized and gone to other organs and then I'd really be up a shits creek.
May 28, 2009 8:27 PM GMT
jack8 saidalso it is important to remember - talking about HPV virus that causes genital warts - that you can remove genital warts by surgery, freezing, laser, acid or cream but genital warts can reappear again and again because genital warts appears when your immune system is weak!

HPV is the virus that causes genital warts. People can be infected with HPV and never show any symptoms. Others will develop genital warts. These warts can stay the same size, grow, or go away on their own. It largely depends on the infected person's immune system. A healthy immune system means your body may be able to suppress the virus and not show symptoms.

Even after the warts go away, the person will always remain infected with HPV. That person can spread the virus even without showing symptoms.

so you must build up your immune system because your body can get rid of genital warts by itself if your immune system will be strong! so eat more healthy food, more vitamins and more sport activities! (No smoking, no beer/ale, no booze, no drugs, no junk food, no fast food garbage, no sugary sweet soda's. Get on a good, balanced, healthy diet including plenty of boiled or steamed vegetables.
Drink P L E N T Y O F W A T E R , fruit juices & fat free milk. Snack on lots of RAW fruit & veggies. Get up one hour early every morning & take a BRISK 30 minute walk - then - do the same thing again in the evening after dinner. Make sure you eat a good, balanced breakfast daily. You get your energy for the day from your breakfast meal. Get 8 hours sleep each night. Flip your mattress over so it will level out to give you a good night's rest. Slack off too much coffee & tea) also you must use herbal treatment!

in that case Wartrol is a good (probably the best) product that gets rid of genital warts comparatively fast and makes you feel more confident knowing that they wont reappear again! It works by stimulating your immune system to fight the HPV virus that causes the warts. of course it is better if you use full course (5 months - if I remember correctly).

It worked and still works for me!
http://www.wartrol.com/?aid=749165


You are, by no means, fit to comment here. All that you said is poppycock. The only thing that you said that is true is that even if a person freezes warts off that they still have HPV. But freezing off warts won't make the possibility of cancer go away. That is just ridiculous. I never had anal warts before and I still got anal cancer. And a person can still spread HPV without any visible warts. After all, who is going to sleep with someone if you find that your bed partner has wart on his genitalia?

I actually had a small lesion that was the cancer itself. It's called a squamous cell sarcoma. It was not a wart and even doctors sometimes will mistake this carcinoma for a hemorrhoid and misdiagnose a person. The only way to do it right is through a biopsy.
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!
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.
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




Sonicbelve 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!
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.
Sonicbelve 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: 755
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: 137
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.
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
Jun 05, 2009 11:46 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 very ignorant answer. Most people who wind up with anal cancer are in their 60's. They're older and therefore they're more susceptible to a cancer taking hold of their bodies.

I was told that because I was treated for stage 4 lymphoma just a year prior that this caused the HPV to mutate into cancer. It's a very logical and sound argument. The level of chemo I received over a 5 month period to treat stage 4 cancer was enough to fill a 20 gallon fish tank if not more.

Farah Fawcett has it, she was pretty much healthy. Her anal cancer metastasized to her liver and she's having continual problems with her battle for her life. As far I as know she was rather healthy before having anal cancer.
GuerrillaSodo... Posts: 2946
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.
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."
GwgTrunks Posts: 994
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.
GuerrillaSodo... Posts: 2946
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.
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 males 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
Jun 07, 2009 9:55 PM GMT
GwgTrunks said
Any way, not HPV. It's a condition some guys have called pearly papules.



Interesting post, thanks for what you said.

On a humorous note the name of your condition gives a new meaning to the "clutch the pearls" phrase.
bluey2223 Posts: 2
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.
rightasrain Posts: 39
Oct 30, 2009 5:01 AM GMT
i treat it every day in our practice.... i've done hundreds of HRAs (high resolution anoscopies). certified by ASCCP. contact me off the thread if interested. lots of missing or incorrect information on here.