Richard G. Petty, MD

It’s Not Just Kissing

Once upon a time Marilyn Monroe is supposed to have said, “So what’s wrong with sleeping with lots of people? You can’t get cancer from it.”

The quotation may be apocryphal, but the facts are not: we now know full well that there are viruses that can be sexually transmitted that may in turn increase the risk of getting cervical cancer. Hence all the talk about Gardasil, the new vaccine against some of the main culprits: strains of the human papillomavirus (HPV) types 16, 18, 6, and 11. HPV types 16 and 18 cause about 70% of HPV-related cervical cancer cases.

It was only a matter of time before someone put two and two together and asked the question whether the viruses might be involved in cancer if they end up in other parts of our anatomy.

After all the revelations concerning a former President, it seems that over the last ten years there has been a sea-change in attitudes. According to surveys, many young people now regard oral sex as nothing more significant than kissing.

On many levels, that is sad.

Anyone able to see the larger picture will be upset to see that complex matters of human relationships, feelings of self-worth and transcendence are being reduced to a branch of gymnastics. This is not at all a puritanical view: any kind of sexual activity is complex and multi-faceted. And now there is some new evidence to suggest that oral sex with multiple partners can carry a substantial risk of developing cancer of the throat.

According to a study published in the New England Journal of Medicine people who have oral sex with 5 or more partners during their lifetime have a much greater chance of having throat cancer, The researchers suspect that the cause is a well known strain of the human papillomavirus (HPV) that is linked to a number of anogenital cancers.

Dr Maura Gillison and a team of collaborators from the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland conducted the research.

Scientists already knew that HPV was doing something at the molecular level to help trigger a type of throat cancer known as oropharyngeal squamous-cell carcinoma, but consistent epidemiological evidence was still missing.

The researchers recruited 100 patients with newly diagnosed oropharyngeal cancer and 200 control patients without cancer in a hospital-based case controlled study. They used a statistical method called logistic regression to look for links between results from the patients’ blood and saliva samples and lifestyle variables such as their sexual behavior, consumption of alcohol and smoking habits. Getting honest and accurate lifestyle data is always tough, particularly when asking about sex, so this data was collected using an anonymous questionnaire.

The results showed that:

  • Patients who had a lifetime number of 6 or more oral-sex partners were 3.4 times more likely to have oropharyngeal cancer
  • Those who had 26 or more vaginal-sex partners during their lifetime were 3.1 times more likely to have oropharyngeal cancer.
  • The link became stronger as the number of lifetime oral and vaginal sex partners went up.

Oropharyngeal cancer was linked with oral infection with HPV type 16 (HPV-16), with any of the 37 types of HPV, and with having been exposed in the past to HPV. That was determined by measuring for antibodies to the HPV-16 L1 capsid protein. The statistics were impressive. What is known as the odds ratio for these three events were found to be 14.6, 12.3 and 32.2 respectively.

DNA from HPV-16 was found in 72 per cent of tumor specimens and 64 per cent of patients tested positive for presence of one or more cancer-related proteins produced by HPV-16. (These are known as oncoproteins E6, E7, or both).

The results suggested that once the link with HPV is present, there is no added risk from tobacco use and alcohol consumption, usually regarded as the highest risk factors for this type of throat cancer.

The researchers suggest that HPV "drives" the cancer and once the cell is sufficiently disrupted to cause cancer, the impact of tobacco and alcohol is unlikely to contribute any more risk.

The researchers concluded that:

"Oral HPV infection is strongly associated with oropharyngeal cancer among subjects with or without the established risk factors of tobacco and alcohol use."

In an accompanying editorial, Dr Stina Syrjänen from the University of Turku in Finland suggested that this study raises important clinical and public health issues.

For instance:

  • Should heavy smokers and drinkers be screened for HPV-related throat infection?
  • Should throat cancers with a suspected HPV origin be treated differently form those with no HPV link and most likely caused by smoking and drinking?
  • And the question that must be in the minds of many currently focused on the HPV vaccination debate: would HPV vaccination give people protection against some throat and mouth cancers?

About Richard G. Petty, MD
Dr. Richard G. Petty, MD is a world-renowned authority on the brain, and his revolutionary work on human energy systems has been acclaimed around the globe. He is also an accredited specialist in internal and metabolic medicine, endocrinology, psychiatry, acupuncture and homeopathy. He has been an innovator and leader of the human potential movement for over thirty years and is also an active researcher, teacher, writer, professional speaker and broadcaster. He is the author of five books, including the groundbreaking and best selling CD series Healing, Meaning and Purpose. He has taught in over 45 countries and 48 states in the last ten years, but spends as much time as possible on his horse farm in Georgia.


2 Responses to “It’s Not Just Kissing”
  1. Reg Adkins says:

    Dr. Petty,
    That is absolutely astounding,and yet completely plausible. Does the study go so far as to report a causal finding?

  2. Richard Petty says:

    Dear Reg,

    I agree with you: astounding.

    You make an important point. It is actually very difficult to establish causality in medicine, simply because there are so many systems in the body, some of which obey different laws. As an example, we cannot prove that smoking causes lung cancer, though I doubt that you smoke. There is a powerful association between the two, but proving causality is slippery. We have to so many other factors: genetics, epigenetic factors, other environmental influences and so on.

    As in this study, the HPV effect can be exacerbated by smoking.

    It is fair to say that in medicine, with the exception of simple gene problems such as inborn errors of metabolism, there is hardly ever one cause for anything.

    Kind regards,


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