Archive for the ‘health and wellness’ Category

If You Are a Man Age 45 or Younger PLEASE READ THIS: It Might Just Save Your Life

October 23, 2021

Andrew Siegel MD  10/23/2021

Why Are More Young Men Not Getting HPV Vaccinated?

HPV (human papilloma virus) is the most common sexually transmitted infection in the United States. Most men and women are not aware that they are infected and their immune system fights off the infection; however, some do not clear the infection, and it is this population that runs the risk of cancer many years, even decades, following the initial infection. There are numerous HPV-related cancers and oral HPV-related cancers in men in particular have surged in the last few years. A safe and effective vaccine is available to prevent HPV-related infections and HPV-related cancers. How is it that many men don’t know about the link between HPV and cancer and why aren’t more younger men getting the vaccination against HPV?

If actor Michael Douglas had the availability of this vaccine, he would not have developed a debilitating case of stage IV tongue cancer that required chemotherapy and radiation to cure the disease.

FACTS

  • HPV is the most common sexually transmitted infection (STI)–it is sometimes referred to as “the common cold of STIs”
  • 90% of the sexually-active adult population will have an HPV infection at some point in their lifetime
  • A misconception is that HPV only poses risks to females
  • HPV STIs are extremely common in males
  • HPV can give rise to penile, anal, and oral cancers
  • There has been a recent surge in male HPV-related mouth, tongue, soft palate, tonsil and throat cancers due to HPV contracted from oral sex
  • 70% of oral cancers are linked to HPV
  • In the United States, HPV causes more cases of oral cancer than cervical cancer per year
  • Although treatment of these oral cancers is often successful, it may involve disfiguring surgery and chemo-radiation, all of which have side effects affecting speech, swallowing and eating
  • HPV vaccination (Gardasil) is a public health triumph since it can prevent both STI and HPV-associated cancer
  • Gardasil is best given before sexually activity (recommended age 11-12), but can be given to adults age 9-45
  • Gardasil is given in a series: Age 9-14: 2 vaccinations six months apart; Age 15-45: 3 vaccinations, the second two months after the first, the third four months after the second
Whispyhistory, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons

It is a no-brainer that the youth of America should be vaccinated against HPV to prevent the most common sexually-transmitted infection and even more importantly, sexually-transmitted cancers.  Although HPV vaccination rates among teens have improved, we could do better.  As of 2020, about 61% of girls and 56% of boys were up to date on HPV vaccination. That means that 39% of girls and 44% of boys are still at risk.

Most adult men are not getting HPV vaccinated. Many do not know the relation between HPV and cancer and do not realize that a vaccination is available and approved for them.

Why are these vaccination numbers not better?  What are the barriers to getting vaccinated?

Clearly, lack of knowledge and education is a formidable barrier. The link between HPV and cancer is not widely known.  In general, females are more HPV-knowledgeable than males because of the strong association of HPV with cervical cancer. 

Then there are the anti-vaxxer disinformation campaigns, vaccine hesitancy and worries and fears concerning side effects. The truth of the matter is that the HPV vaccine has been proven both safe and effective. Misunderstandings about how vaccines are made or how they work, distrust of the medical establishment and even fear of needles drive vaccination numbers down.

Another factor is the extent to which health care providers educate young men and their parents as well as endorse the vaccine.  Clearly, physicians, physician assistants, and nurse practitioners are often trusted sources of information and education and have meaningful leverage in breaking barriers and promoting vaccination. Although most children visit pediatricians on a regular basis and most women seen gynecologists on a regular basis, many young healthy men do not see a medical doctor for well care and thus lose the opportunity to be educated about HPV, its relationship with cancer, and the availability of a vaccine.

A major and unique constraint to HPV vaccination is that HPV infections and the development of HPV-related cancers are SEXUALLY transmitted, and vaccination will require a discussion between parents and child of sex that many parents, especially those that are strongly religious, might not feel comfortable pursuing, particularly since this involves the vaccination of young children.

An additional barrier to parents getting their children vaccinated is the thought that immunization against a sexually-transmitted infection might promote promiscuity and when sexual activity is initiated might possibly result in less use of condoms that may give rise to other STIs and pregnancy.

Finally, there is the cost barrier.  Gardasil costs about $240/dose and uninsured and under-insured patients may be unable to afford it. For those with health insurance, Gardasil is usually well covered.  

Bottom Line:  Gardasil is safe and effective in preventing genital, anal and oral HPV infections as well as a multitude of cancers that may develop many years after an HPV infection. It is best to be immunized prior to the onset of sexual activity, but the vaccination may be given up to age 45. Even if one has had a prior HPV infection, the vaccination confers protection against numerous other subtypes of HPV. Oral HPV-related cancers are surging, but are safely and effectively preventable through the vaccine, and it is a no-brainer that Gardasil is not just for children and men up to age 45-years-old should avail themselves of this opportunity for protection. The vaccine is readily available for administration at any pharmacy and covered by most insurances.

Wishing you the best of health,

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro AreaInside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.  He is the co-founder of PelvicRx and Private Gym.  His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families. 

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Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

PROSTATE CANCER 20/20 is now available at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

Video on THE KEGEL FIX