WEBVTT - HPV and You 0:00:01.480 --> 0:00:05.360 Welcome to Stuff you should know, a production of iHeartRadio. 0:00:11.160 --> 0:00:13.399 Hey, and welcome to the podcast. I'm Josh, and there's 0:00:13.520 --> 0:00:16.079 Chuck and Jerry's here too, and this is stuff you 0:00:16.160 --> 0:00:16.599 should know. 0:00:18.360 --> 0:00:18.439 Now. 0:00:18.440 --> 0:00:19.439 I've got an intro for this. 0:00:19.560 --> 0:00:21.200 Chuck, you're ready, Yeah, let's hear it. 0:00:22.800 --> 0:00:25.920 Dearly beloved, we are gathered here today to talk about 0:00:25.920 --> 0:00:30.880 this thing called human papioma virus. What do you think. 0:00:32.680 --> 0:00:35.320 That's good? I hear the beat starting in the background. 0:00:35.720 --> 0:00:39.320 It's just a good, good album. We got to add 0:00:39.320 --> 0:00:40.559 some kind of good spin to this. 0:00:41.360 --> 0:00:44.640 Sure, while we're talking about HPV, like you mentioned, and 0:00:46.360 --> 0:00:48.720 we should say right out of the gate, HPV is 0:00:48.760 --> 0:00:56.280 a very very very very common sexually transmitted infection. If 0:00:56.640 --> 0:00:59.760 you have HPV or have had it, you may have 0:00:59.840 --> 0:01:02.040 not even known about it, perhaps because your body just 0:01:02.040 --> 0:01:04.399 took care of it. But if you have it and 0:01:04.440 --> 0:01:06.640 you know about it, or have had it and knew 0:01:06.680 --> 0:01:09.920 you had it, it's no big deal. For the most part, 0:01:10.120 --> 0:01:13.279 it's nothing to be ashamed of. It is very very common. 0:01:14.200 --> 0:01:16.319 It is the problem is this, like that would be 0:01:16.319 --> 0:01:22.080 the end of the episode if if HPV wasn't a virus. Actually, 0:01:22.080 --> 0:01:27.119 the first virus found to cause cancer. That is rare 0:01:27.360 --> 0:01:30.840 in and of itself, compared to all of the HPV 0:01:30.959 --> 0:01:33.480 infections that are running around the world at any given time. 0:01:33.520 --> 0:01:36.080 There's a lot, and there's a lot of different types 0:01:36.080 --> 0:01:39.640 of HPV, but because it causes cancer, it's drawn a 0:01:39.640 --> 0:01:43.080 lot of interest from the biomedical community. And luckily, what 0:01:43.120 --> 0:01:46.480 we're finding is that HPV is super treatable if your 0:01:46.520 --> 0:01:49.200 body doesn't clear it up on its own. And in fact, 0:01:49.400 --> 0:01:52.480 there's an amazing vaccine out there that is one of 0:01:52.520 --> 0:01:56.760 the better, more effective vaccines on the market today for anything. 0:01:56.720 --> 0:02:00.920 That's right, and if people get this vaccine, were potentially 0:02:00.960 --> 0:02:04.560 looking at eradicating at least HPV caused cervical cancer. 0:02:05.120 --> 0:02:08.799 Yeah, just getting rid of it. So long, goodbye cervical cancer. 0:02:08.840 --> 0:02:11.560 You're a thing of the past. And because we brought 0:02:11.639 --> 0:02:13.880 up the vaccine so early, I believe I heard the 0:02:13.919 --> 0:02:16.680 sound of one hundred thousand people skipping to the next 0:02:16.680 --> 0:02:19.160 episode or maybe finding a new podcast altogether. 0:02:19.680 --> 0:02:22.600 Oh come on. So the other thing that you might 0:02:22.720 --> 0:02:25.720 think about when you hear of HPV besides cervical cancer 0:02:25.960 --> 0:02:30.680 is genital warts. Maybe the last few or made people 0:02:30.800 --> 0:02:34.799 have tuned out now, right, But we're gonna dig into 0:02:34.800 --> 0:02:37.880 this because those including talk of genital awards and cervical cancer. 0:02:38.240 --> 0:02:42.359 But HPV itself, we should say, is a larger name, 0:02:42.400 --> 0:02:47.880 an umbrella term basically for many, many different viruses. But 0:02:48.040 --> 0:02:51.359 there are a handful that are pretty key to our 0:02:51.440 --> 0:02:54.600 story here, and they are you'll hear say, various numbers 0:02:54.639 --> 0:02:58.720 like HPV eleven, HPV sixteen. That's how they have them labeled. 0:02:59.440 --> 0:03:02.560 Yeah, and one of the stars the villain, I guess, 0:03:03.000 --> 0:03:06.360 is HPV sixteen. It's the strain that causes the most 0:03:06.480 --> 0:03:11.080 kind of cancers and it's actually it's really ancient. Like 0:03:11.120 --> 0:03:13.800 the reason they call it human pepioma virus is because 0:03:14.120 --> 0:03:16.920 it is specific to humans, Like you can give it 0:03:16.960 --> 0:03:18.840 to your dog all day long and your dog's not 0:03:18.840 --> 0:03:22.359 gonna get it. Your dog here has pepio right, Your 0:03:22.400 --> 0:03:26.840 dog and other animals have pepioma viruses. Apparently, cottontail rabbits 0:03:27.040 --> 0:03:30.840 get warts very easily from their papioma virus, and we 0:03:30.960 --> 0:03:34.079 can't get it from them, So it's very very specific. 0:03:34.600 --> 0:03:38.840 And HPV sixteen, which is a kind of human papioma 0:03:38.920 --> 0:03:43.920 virus that causes cervical cancer, among others. They believe that 0:03:44.080 --> 0:03:49.000 humans us modern Homo sapiens got it from Neanderthals and 0:03:49.320 --> 0:03:53.240 Denisovans when we used to have sex with them and 0:03:53.280 --> 0:03:53.920 them with us. 0:03:54.840 --> 0:03:56.200 You know what you gotta do before you try and 0:03:56.200 --> 0:04:01.480 give your dog HPV? Though, Well, you gotta make upset. 0:04:02.360 --> 0:04:06.720 I don't get it. What you gonna make your dogs 0:04:06.800 --> 0:04:08.600 sit before you give it HPV? 0:04:09.280 --> 0:04:12.119 All right, I'm just gonna scoot right on past that one. 0:04:12.560 --> 0:04:13.000 Okay. 0:04:13.120 --> 0:04:15.640 So we're talking a little bit of history. We'll see, 0:04:15.680 --> 0:04:17.560 we'll do a pull of people who get that joke 0:04:17.600 --> 0:04:18.600 and don't I want to hear from it. 0:04:20.760 --> 0:04:22.960 Okay, all right, Well, you explain it later and i'll 0:04:22.960 --> 0:04:25.120 see if I'm guessing it right. All right? 0:04:25.560 --> 0:04:28.600 Uh No, I get chastised for explaining jokes, so I'm 0:04:28.600 --> 0:04:30.159 not even gonna do that this time. We'll let the 0:04:30.160 --> 0:04:30.800 people speak. 0:04:31.480 --> 0:04:33.360 Wait, why don't you do it next time? I really 0:04:33.360 --> 0:04:36.760 want to know this, I'll tell you after, Okay. 0:04:37.000 --> 0:04:42.160 So, looking at our history of human beings, people have 0:04:42.520 --> 0:04:48.200 long suspected that warts that you see, like you got 0:04:48.200 --> 0:04:51.560 a word on your nose or a word on your elbow, 0:04:52.279 --> 0:04:56.080 there was an infection that was responsible for that happening. Finally, 0:04:56.120 --> 0:04:59.080 we prove that in the middle of the nineteenth century 0:04:59.200 --> 0:05:02.160 or so, when the people there were scientists that were 0:05:02.200 --> 0:05:06.160 intentionally trying to give themselves warts and it worked by 0:05:06.200 --> 0:05:08.320 infecting their skin. So like, all right, we figured that 0:05:08.360 --> 0:05:13.840 out with more extracts. Yeah, gross, it's trying to point 0:05:13.839 --> 0:05:17.320 that out. So it took a little while for that 0:05:17.440 --> 0:05:23.599 to go downstairs and apply to genital awarts, because people 0:05:23.680 --> 0:05:25.919 thought for a very long time, hey, if you have 0:05:26.000 --> 0:05:29.279 genital awarts, that's just a symptom of like syphilis or something, 0:05:30.279 --> 0:05:32.400 and we eventually learned that that's not the case at all. 0:05:32.880 --> 0:05:36.520 Yeah, there was a nineteen seventeen German paper that purposely 0:05:36.560 --> 0:05:41.279 infected a virgin girl to prove that genital warts exist 0:05:42.440 --> 0:05:47.880 outside of STIs that's it's its own thing, and they did. 0:05:47.920 --> 0:05:52.720 They proved it. So there's another thread going on. At 0:05:52.760 --> 0:05:56.640 the same time, back in the nineteenth century, they figured 0:05:56.640 --> 0:06:01.200 out that cervical cancer was a strange conundrum scientifically speaking, 0:06:01.440 --> 0:06:03.359 because if you took a group of nuns and you 0:06:03.400 --> 0:06:05.640 took a group of married women and put them together, 0:06:05.920 --> 0:06:09.039 the incidents of breast cancer would probably be about the same, 0:06:09.520 --> 0:06:11.840 the incidents of lung cancer probably about the same. The 0:06:11.880 --> 0:06:15.040 one that diverged is cervical cancer, and they couldn't figure 0:06:15.040 --> 0:06:18.520 out why because it didn't really make sense, except the 0:06:18.560 --> 0:06:21.520 only way that did make sense is that cervical cancer 0:06:21.680 --> 0:06:24.920 somehow developed from a sexually transmitted infection. 0:06:25.360 --> 0:06:28.200 I wonder if like one person knew it and they 0:06:28.200 --> 0:06:30.200 were sharing with other scientists and they were like, I 0:06:30.240 --> 0:06:33.560 don't know, and they're like, what do nuns not do that? 0:06:33.720 --> 0:06:40.640 Other married ladies might doine no, no, with something am 0:06:41.000 --> 0:06:45.040 on you and in the bedroom, maybe watch TV. 0:06:45.720 --> 0:06:47.440 I don't know, just tell me. 0:06:48.520 --> 0:06:50.400 Oh, there's a good sketch in there somewhere. 0:06:50.440 --> 0:06:54.040 I think. Sure. So they figured all this out, they 0:06:54.040 --> 0:06:56.440 put it all together, and they finally realized thanks to 0:06:56.640 --> 0:07:02.040 a German virologist, another one named Horror Zerhausen great name. 0:07:03.560 --> 0:07:06.719 In nineteen eighty three, he found that if you took 0:07:06.720 --> 0:07:10.200 a specimen of cervical cancer a biopsy and studied it closely, 0:07:10.440 --> 0:07:14.120 you would actually find a papioma virus inside, and specifically 0:07:14.480 --> 0:07:16.480 it would turned out to be what we now know 0:07:16.720 --> 0:07:19.960 as HPV sixteen. The chances are there's going to be 0:07:20.080 --> 0:07:24.840 some form of HPV sixteen found in that biopsy in 0:07:24.880 --> 0:07:29.400 that cancerous cell taken from a cervical cancer patient. 0:07:29.320 --> 0:07:31.360 That's right, And like you said, that was in nineteen 0:07:31.400 --> 0:07:34.720 eighty three. Flash forward to two thousand and eight when 0:07:35.760 --> 0:07:41.280 Harald Zerhausen gets a Nobel Prize in Physiology or Medicine 0:07:42.200 --> 0:07:46.920 for his continued work developing that HPB vaccine that we mentioned. Right, 0:07:47.000 --> 0:07:48.280 it's a nice word, Housen. 0:07:48.760 --> 0:07:50.960 Yeah, way to go. I think he deserved it because 0:07:51.000 --> 0:07:53.679 he found this is the first virus that we've ever 0:07:54.160 --> 0:07:58.200 shown to cause cancer. It's like this whole field of 0:07:58.240 --> 0:08:00.560 medicine that's starting to kind of wrap its around the 0:08:00.640 --> 0:08:03.400 role that viruses playing all sorts of diseases. I know 0:08:03.440 --> 0:08:07.640 there's a hypothesis that schizophrenia might actually be triggered by 0:08:07.800 --> 0:08:11.960 a dormant virus that comes to life later on around 0:08:12.000 --> 0:08:15.040 your teenage years. So this is the first time we 0:08:15.320 --> 0:08:17.160 pointed to it. And that's one of the things that 0:08:17.200 --> 0:08:20.160 makes HPV so fascinating. There's not a lot of viruses 0:08:20.200 --> 0:08:22.920 running around that cause cancer, and this one definitely does. 0:08:23.280 --> 0:08:27.120 Yeah. So we mentioned that it's a lot of viruses 0:08:27.520 --> 0:08:29.880 over two hundred if you want to get a little 0:08:29.880 --> 0:08:32.839 more exact, and they generally divide these into a couple 0:08:32.880 --> 0:08:38.120 of different groups, the cutaneous and the mucosal types cutaneous 0:08:38.240 --> 0:08:42.240 HPVs are. This is where you think of the worts. 0:08:42.280 --> 0:08:45.280 They infect the skin. If you have like planar worts 0:08:45.320 --> 0:08:47.000 on your feet, or you have worts on your hands 0:08:47.080 --> 0:08:50.320 or something like that, it's because of the cutaneous type 0:08:50.360 --> 0:08:55.240 of HPV, the mucosal type. And it's a little grosser 0:08:55.240 --> 0:08:57.280 here because we have to say the word moist, but 0:08:57.400 --> 0:09:01.160 they specifically infect moist parts of the boy. This is 0:09:01.160 --> 0:09:06.000 where you get warts on genitals, your throat, maybe your nose, 0:09:06.240 --> 0:09:10.080 your anus, your cervix of course, and your inner eyelids, 0:09:10.080 --> 0:09:11.319 which can't be comfortable. 0:09:12.240 --> 0:09:15.320 Yeah, And because all of those or a lot of 0:09:15.320 --> 0:09:18.400 those are sexy parts, the inside of your eyelid. Notwithstanding, 0:09:20.160 --> 0:09:24.680 it goes to show that HPV infection can be transmitted sexually. 0:09:25.040 --> 0:09:27.959 It's not all the time like the other kind of 0:09:28.880 --> 0:09:32.040 the cutaneous type that causes plantar works. You can get 0:09:32.040 --> 0:09:34.640 that from walking around a pool, a pool deck or 0:09:34.720 --> 0:09:37.520 somewhere there's HPV hanging out. But it's a different kind 0:09:37.559 --> 0:09:42.000 of HPV HPV sixteen that can cause cancer. That is 0:09:42.040 --> 0:09:45.800 a sexually transmitted HPV. It's mucosal and it's also in 0:09:45.880 --> 0:09:49.959 a subcategory of mucostal HPV called high risk. There's high 0:09:50.040 --> 0:09:52.560 risk and there's low risk, And as you may guess 0:09:52.720 --> 0:09:55.720 just from the names, high risk typically leads to cancer 0:09:55.800 --> 0:09:58.120 or can. The low risk almost never does. 0:09:58.760 --> 0:10:01.240 Yeah, that's right. If you think, hey, can I use 0:10:01.240 --> 0:10:06.120 a condom to get around this? That helps. But HPV, 0:10:06.559 --> 0:10:11.480 the mucoastal type of lead, doesn't require bodily fluids for transmission. 0:10:11.600 --> 0:10:15.760 So if you are sexually active as a person, and 0:10:15.800 --> 0:10:19.079 you have been so for a few years, then chances 0:10:19.080 --> 0:10:22.440 are you've probably had HPV and maybe not even known it. 0:10:22.960 --> 0:10:26.080 Yeah, and that's a really big point that you don't 0:10:26.120 --> 0:10:30.040 have to exchange body fluids. And also, similarly, Chuck, I 0:10:30.080 --> 0:10:33.160 want to make sure it's totally clear genital awarts doesn't 0:10:33.200 --> 0:10:37.320 cause cancer. It's a different type of HPV. So you 0:10:37.360 --> 0:10:41.240 actually can give somebody genital awarts from sexual contact, but 0:10:41.320 --> 0:10:43.719 that's almost certainly not going to lead to any kind 0:10:43.760 --> 0:10:46.320 of cancer. They're just different types, even though they can 0:10:46.360 --> 0:10:49.400 be passed along similarly through skin to skin contact. 0:10:49.600 --> 0:10:50.040 That's right. 0:10:51.280 --> 0:10:56.520 So yeah, I think you said just from being sexually active, 0:10:56.800 --> 0:11:00.000 you're probably going to pick up some form of HPV. 0:11:00.320 --> 0:11:06.800 Another about fourteen million Americans, Yeah, just Americans. Alone get 0:11:06.800 --> 0:11:09.839 a new infection every year. There's at least eighty million 0:11:09.880 --> 0:11:13.560 Americans running around with an HPV infection right now. And 0:11:13.640 --> 0:11:16.440 if you do the math, here in America, we have 0:11:16.440 --> 0:11:20.600 a pretty close replacement rate where we have just a 0:11:20.679 --> 0:11:24.400 few more one hundred thousand berths than deaths every year. Right, 0:11:24.520 --> 0:11:27.520 so let's just say that's a wash. At fourteen million 0:11:27.600 --> 0:11:31.480 new infections every year, that means everything's staying exactly the 0:11:31.520 --> 0:11:34.600 same as it is now. In twenty four years, every 0:11:34.640 --> 0:11:38.760 single American will be infected with HPV. And we already 0:11:38.800 --> 0:11:41.800 said that HPV sixteen we got from Neanderthals, so it's 0:11:41.840 --> 0:11:44.559 been around a really long time. So it makes you wonder, well, 0:11:44.559 --> 0:11:49.120 why this sudden surge in infections. And apparently a lot 0:11:49.160 --> 0:11:52.199 of the incidences of HPV, or this rise in incidents 0:11:52.400 --> 0:11:55.800 can be traced to changes in sexual morais and behaviors 0:11:55.800 --> 0:11:57.720 that have occurred over the last few decades. 0:12:00.080 --> 0:12:03.400 We just put a pin in that. Sure, Okay, we'll 0:12:03.440 --> 0:12:06.600 reveal what that might mean later on. Maybe we should 0:12:06.600 --> 0:12:09.920 take a break. Yeah, yes, pretty good intro, and we'll 0:12:09.960 --> 0:12:44.800 talk about genital warts when we get back. All right, 0:12:44.840 --> 0:12:47.520 so we're back, We promise talk of more talk that 0:12:47.679 --> 0:12:53.000 is of genital warts. I believe you mentioned the low 0:12:53.160 --> 0:12:57.840 risk mucosal type usually six and eleven HBB are the 0:12:57.840 --> 0:13:02.520 ones that calls these warts or other you know, moist membranes, 0:13:02.760 --> 0:13:07.560 mucous membranes. They don't generally cause a lot of health 0:13:07.600 --> 0:13:13.480 problems or any really, they can be painful. Sometimes they 0:13:13.480 --> 0:13:16.679 can be itchy. Obviously, there's a lot of embarrassment that 0:13:16.679 --> 0:13:20.840 surrounds genital awarts. Just saying those words together isn't something 0:13:20.920 --> 0:13:22.840 you're probably gonna like advertise to people. 0:13:23.240 --> 0:13:25.840 No, you don't say, like, just disregard my genital awarts. 0:13:26.040 --> 0:13:27.720 Yeah, I mean, well, I'm sure plenty of people have 0:13:27.800 --> 0:13:29.120 said that, but who knows. 0:13:29.120 --> 0:13:30.240 It doesn't always work. 0:13:30.280 --> 0:13:33.160 That's what it works. But it's nothing to be ashamed 0:13:33.160 --> 0:13:36.720 of because it is quite common and they can be removed. 0:13:37.920 --> 0:13:41.560 Sometimes medication can do it. Sometimes they'll do the old 0:13:41.880 --> 0:13:44.040 freeze with liquid nitrogen routine. 0:13:44.600 --> 0:13:46.200 I used to get that. I got warts on my 0:13:46.240 --> 0:13:48.000 elbows and I used to get it burned off with 0:13:48.080 --> 0:13:51.800 liquid nitrogen pretty regularly. I think it's. 0:13:50.360 --> 0:13:54.320 At Yeah, I feel like I've had that done with. 0:13:56.840 --> 0:13:59.000 I think I had plan awarts that they did that too. 0:13:59.000 --> 0:13:59.959 When I was in college. 0:14:00.520 --> 0:14:02.840 Yeah, I mean you can get rid of warts that way. 0:14:03.200 --> 0:14:06.040 Yeah, there's also lasers these days that can handle that 0:14:08.240 --> 0:14:11.880 different different methods to get rid of those general awards 0:14:12.920 --> 0:14:15.640 in due time. So don't worry about it. If you 0:14:15.720 --> 0:14:19.160 have those people, just you know, keep soldiering on. You'll 0:14:19.200 --> 0:14:19.640 be okay. 0:14:20.320 --> 0:14:27.120 Yes, So there are some some types of HPV infections 0:14:27.160 --> 0:14:31.360 that lead to warts mucoastal warts that can be a problem. 0:14:31.640 --> 0:14:36.040 There's one in particular, Respiratory pepiomatosis is a condition that's 0:14:36.080 --> 0:14:39.680 caused by warts and the airways, and it typically happens 0:14:39.680 --> 0:14:42.480 in kids and it's treatable, but it can narrow the 0:14:42.520 --> 0:14:46.000 airway and that in and of itself is problematic. They 0:14:46.000 --> 0:14:49.720 think that it's transferred, that HPV infection is transferred during 0:14:49.760 --> 0:14:55.440 birth or from the antiotic fluid inside the womb. But 0:14:55.560 --> 0:14:57.960 it's pretty it's pretty rare. It's one of the rare 0:14:58.000 --> 0:15:00.960 ones that Okay, this is actually be a bit of 0:15:01.000 --> 0:15:02.480 a health problem from. 0:15:02.520 --> 0:15:06.080 Warts, Yeah for sure, But that is only in young children. 0:15:06.120 --> 0:15:08.880 It's usually you see it between the ages of two 0:15:08.920 --> 0:15:11.680 and six. It canic are and adults. But I think 0:15:11.680 --> 0:15:16.720 it's even more rare. But again, you can remove these surgically, 0:15:18.360 --> 0:15:20.440 so you can get that taken care of as well. 0:15:20.880 --> 0:15:22.560 Yeah, Plus you get to go back to school in 0:15:22.600 --> 0:15:24.560 the fall and be like, yeah, they shot lasers down 0:15:24.560 --> 0:15:26.200 my throat, what did you do this summer? 0:15:26.920 --> 0:15:30.920 That's right to get rid of my warts. Ye. There's 0:15:30.960 --> 0:15:36.240 also infections with the high risk kinds of APV that 0:15:36.680 --> 0:15:38.920 don't clear up on their own, and these are the 0:15:38.920 --> 0:15:41.560 ones that could eventually lead to cancer. 0:15:43.040 --> 0:15:47.560 Yeah. So this is a very very long process. But essentially, 0:15:47.640 --> 0:15:53.200 this HPV infection that can is akin to causing warts, 0:15:53.360 --> 0:15:56.760 just causes hijacks a sell just like any other virus, 0:15:57.000 --> 0:15:59.720 causes it to multiply and multiply and multiply, and then 0:16:00.080 --> 0:16:03.440 has these cells rupture. They released more viruses into the 0:16:03.480 --> 0:16:06.040 extracellular membrane, and they get into more cells and it 0:16:06.080 --> 0:16:09.320 just gets worse and worse. The difference between an HPV 0:16:09.440 --> 0:16:12.800 infection and other types of infections from viruses is that 0:16:12.840 --> 0:16:16.960 they're not systemic. They stay very very localized, and so 0:16:17.080 --> 0:16:20.400 they form a very recognizable legion. 0:16:20.800 --> 0:16:23.800 Yeah. But it isn't just cervical cancer though, that we 0:16:23.800 --> 0:16:27.560 should point out. I believe there are six kinds of cancer. 0:16:28.520 --> 0:16:31.160 I think the data that we got was this Libya? 0:16:31.200 --> 0:16:32.040 Did she help us with this? 0:16:32.600 --> 0:16:34.520 Yeah? Hats off, I can tell. 0:16:35.360 --> 0:16:38.160 In a good way. I was like, oh, geez, I 0:16:38.160 --> 0:16:39.560 could tell. 0:16:39.280 --> 0:16:42.080 All the dirty jokes. Yeah, we can't say. 0:16:43.760 --> 0:16:47.120 Twenty twenty one is when we got the latest CDC 0:16:47.280 --> 0:16:51.200 data with more than thirty seven thousand cases of cancer 0:16:51.720 --> 0:16:57.720 associated per year of that are associated with HPV twenty 0:16:57.760 --> 0:17:00.600 two thousand and women sixteen thousand and men. And the 0:17:00.640 --> 0:17:03.600 six kinds of cancer or I guess the five besides 0:17:03.720 --> 0:17:11.360 cervical are anal cancer, penile cancer, vaginal cancer, bulvar cancer cancer, 0:17:11.840 --> 0:17:13.959 bulvar cancer. Man. That's hard to say. 0:17:14.119 --> 0:17:14.480 It is. 0:17:14.520 --> 0:17:18.200 That's a good pre stage warm up. Okay, so you 0:17:18.320 --> 0:17:22.280 hear me backstage saying good lord. And then finally oro 0:17:22.560 --> 0:17:26.439 fairyngeal cancer, which is the base of the tongue, the 0:17:26.440 --> 0:17:30.280 back of the throat tonsils. You can also get that 0:17:30.359 --> 0:17:34.600 through tobacco use, not surprisingly, so you should also not 0:17:34.640 --> 0:17:36.880 be surprised to learn that as tobacco use has gone down, 0:17:37.359 --> 0:17:42.120 so have incidences of non HPV oro fare engeal cancer. 0:17:42.280 --> 0:17:47.359 But incidents of orofair andngeal cancer overall has increased because 0:17:47.400 --> 0:17:51.560 there's been a rise in HPV infections to that man, 0:17:51.640 --> 0:17:55.120 and I think I made it pretty clear. HPV sixteen 0:17:55.240 --> 0:17:58.560 is one of the big batties of this episode. So 0:17:58.760 --> 0:18:03.520 is HPV eighteen. Those are the two most common cancer 0:18:03.640 --> 0:18:08.960 causing types of HPV. They're responsible. HPV sixteen is responsible 0:18:09.000 --> 0:18:14.120 for ninety percent of HPV related orofare andngeal cancers, half 0:18:14.119 --> 0:18:16.960 of all cervical cancers, and all the other cancers that 0:18:17.000 --> 0:18:20.000 are related to HPV. It's it makes up a significant 0:18:20.040 --> 0:18:22.080 portion of them, just sixteen alone. 0:18:22.480 --> 0:18:25.879 Yeah, and I think eighteen causes twenty percent of cervical cancer. 0:18:26.000 --> 0:18:28.800 So between those two, you know, you're looking at seventy percent. 0:18:29.920 --> 0:18:32.480 So let's talk cervical cancer, shall we, Because it is 0:18:32.520 --> 0:18:36.600 a it's really important. It's become I guess, how do 0:18:36.600 --> 0:18:41.120 you put it. It's really emerged as a condition that's 0:18:41.160 --> 0:18:45.760 gotten a lot of attention because there's so much potential 0:18:45.880 --> 0:18:47.679 for getting rid of it altogether. 0:18:48.560 --> 0:18:51.880 Yeah, and it's a situation where here in the United States, 0:18:52.600 --> 0:18:57.400 due to early detection and treatment, it is really really lowered. 0:18:57.520 --> 0:19:00.000 I think it's gone down by more than fifty percent 0:19:00.600 --> 0:19:04.080 from the mid seventies to the mid two thousands and 0:19:04.200 --> 0:19:07.080 only and you know, of course four thousand people. It's 0:19:07.080 --> 0:19:09.679 a lot of people. But when you're talking about what 0:19:09.720 --> 0:19:12.119 the rates could and would have been in the past, 0:19:12.880 --> 0:19:16.399 four thousand Americans dying of cervical cancer each year is 0:19:17.080 --> 0:19:18.760 a lot of progress has been made. 0:19:19.000 --> 0:19:21.840 Yeah, And overall, I think there's three hundred and fifty 0:19:21.960 --> 0:19:26.240 thousand deaths from cervical cancer worldwide every year. Yeah, And 0:19:26.480 --> 0:19:30.560 I mean Americans make up a decent portion of the 0:19:30.600 --> 0:19:34.000 world population, but not a good portion of the cervical 0:19:34.000 --> 0:19:37.680 cancer death population. The reason why is because America has 0:19:37.720 --> 0:19:43.280 a really robust screening process that is easily accessed by 0:19:43.640 --> 0:19:47.240 American women to search for cervical cancer and catch it 0:19:47.359 --> 0:19:50.720 early on, and it's not nearly as robust in some 0:19:50.840 --> 0:19:52.560 other developing parts of the world. 0:19:53.040 --> 0:19:58.840 Yeah, because in America, once you turn twenty one, if 0:19:58.840 --> 0:20:02.560 you're a woman, generally for about from about twenty one 0:20:02.560 --> 0:20:04.760 to sixty five, you're going to be getting a PAP 0:20:04.880 --> 0:20:09.000 test about every three years, or at least you're supposed to. 0:20:09.760 --> 0:20:16.480 And the US Preventative Services Task Force the USPSTF says 0:20:16.480 --> 0:20:19.800 if you're under thirty, they don't recommend that you get 0:20:19.840 --> 0:20:22.600 tested for HPV unless you have some you know, some 0:20:22.680 --> 0:20:29.120 pretty obvious risk factors. Why, well, because generally by then 0:20:29.440 --> 0:20:32.720 you have probably gotten it and it is probably cleared 0:20:32.800 --> 0:20:35.480 up on its own. And that also means that you 0:20:35.560 --> 0:20:39.800 have some kind of immunity, sometimes very long lasting immunity. 0:20:40.400 --> 0:20:43.080 Yes, so they say, don't bother with the HPV test, 0:20:43.200 --> 0:20:46.800 but definitely do get your PAP test. PAP, by the way, 0:20:46.840 --> 0:20:49.760 isn't short for papioma. It's short for the guy who 0:20:49.800 --> 0:20:54.199 came up with the test. Georgios Papa Nicolau pap, I 0:20:54.240 --> 0:20:57.320 guess to his friends and family. Sure, so that's looking 0:20:57.320 --> 0:20:59.680 for abnormal cells in your cervix. If they find that, 0:21:00.240 --> 0:21:02.879 you test for HPV to see what kind of HPV 0:21:02.960 --> 0:21:06.520 infection you might have that could account for those abnormal cells. 0:21:06.840 --> 0:21:11.199 And then the American Cancer Society says, forget that, just 0:21:11.240 --> 0:21:14.359 start at twenty five. Forget the PAP smerror, start with 0:21:14.440 --> 0:21:17.240 an HPV test, like if you have to prioritize one, 0:21:17.600 --> 0:21:20.360 do that. Yeah, And you might say, well, I'm confused. 0:21:20.440 --> 0:21:24.479 The Preventative Services Test for says thirty and focus on 0:21:24.520 --> 0:21:28.240 the PAP test. In the meantime, the ACS so sort 0:21:28.280 --> 0:21:30.680 the PAP test out, focus on the HPV test starting 0:21:30.720 --> 0:21:33.719 at twenty five, which one should I choose, And you 0:21:33.720 --> 0:21:35.879 don't have to worry if you're an American, because your 0:21:35.920 --> 0:21:38.920 insurance company will choose for you, and that'll probably be neither. 0:21:40.080 --> 0:21:45.119 That's right. If during your screening you happen to see 0:21:46.400 --> 0:21:50.120 what's a pre cancer or a dysplasia, then what they're 0:21:50.119 --> 0:21:52.840 probably going to do next is to examine the cervix. 0:21:53.960 --> 0:21:57.639 It's not a pleasant process. It's done using an instrument 0:21:57.720 --> 0:22:02.960 called a colposcope. You may get a biopsy performed, but 0:22:03.119 --> 0:22:06.119 a lot of times it's a minor thing that's going 0:22:06.200 --> 0:22:08.520 to go on its own, and so what they what 0:22:08.560 --> 0:22:10.760 they might do is say, hey, let's just monitor this 0:22:10.800 --> 0:22:13.840 thing instead of removing it, and just sort of get 0:22:13.840 --> 0:22:17.160 you tested more regularly to see what's happening with that. 0:22:17.280 --> 0:22:21.320 Hey, welcome to your year of anxiety. Yeah until your 0:22:21.359 --> 0:22:25.680 next test. It sucks, Yeah, but the odds are with you. Yeah, yeah, 0:22:25.720 --> 0:22:28.680 for sure, because we've got this early screening, because they 0:22:29.359 --> 0:22:34.760 have like a lot of tale signatures. They might they 0:22:34.800 --> 0:22:38.000 may also do a biopsy. If it does seem like 0:22:38.040 --> 0:22:42.320 it's a big deal, they may do more invasive surgery. 0:22:42.920 --> 0:22:47.240 But for the most part, we'll set cervical cancer aside 0:22:47.240 --> 0:22:50.080 for a second, until we get to the vaccine. It's 0:22:50.119 --> 0:22:53.160 if you go get a PAP test and you do 0:22:53.320 --> 0:22:57.920 some form of HPV testing whether if needed, you're probably 0:22:58.000 --> 0:23:01.080 going to catch it early for it to be treated. 0:23:01.560 --> 0:23:06.760 That's right, that's the great news with cervical cancer. Unfortunately, 0:23:06.880 --> 0:23:08.840 the other kinds of cancer is the other five that 0:23:08.880 --> 0:23:13.160 we mentioned caused by HBB. There isn't a routine screening 0:23:13.240 --> 0:23:18.000 for those or preventative treatments for those. And that is 0:23:18.359 --> 0:23:20.880 one of the reasons why you mentioned oor a fair 0:23:20.920 --> 0:23:25.320 andngeal cancer is growing even though tobacco use and tobacco 0:23:25.440 --> 0:23:28.560 caused oor a fair and geal cancer is falling. 0:23:29.359 --> 0:23:32.760 Yeah, because people stopped using tobacco as much, but they 0:23:32.960 --> 0:23:36.960 replaced tobacco use with oral sex, which is one of 0:23:37.000 --> 0:23:40.960 the it's actually the biggest risk factor now for developing 0:23:41.080 --> 0:23:44.880 oor fair andngeal cancer. And the more oral sex partners 0:23:44.920 --> 0:23:49.040 you've had, the greater your risk of developing oro faar 0:23:49.119 --> 0:23:52.920 andngeal cancer a few decades later. Is as a matter 0:23:52.920 --> 0:23:55.160 of fact, So that's what I was saying earlier, when 0:23:55.520 --> 0:23:58.000 I was saying that there's been a change in sexual 0:23:58.080 --> 0:24:01.520 morais and behavior. Oral sex has become much more prevalent 0:24:02.680 --> 0:24:06.360 since the sixties and seventies than before, and a lot 0:24:06.400 --> 0:24:10.240 of those men in particular, are starting to age into 0:24:10.280 --> 0:24:15.199 that point in their life where that HPV infection is 0:24:15.240 --> 0:24:20.080 developing into a cancer and is developing into orofair andngeal cancer. 0:24:20.840 --> 0:24:25.000 Right, and we're talking specifically about oral sex performed on women. 0:24:26.080 --> 0:24:29.720 So I guess the idea is that you can get 0:24:29.720 --> 0:24:35.439 that HPV and many many years later, when you're, like 0:24:35.480 --> 0:24:37.720 you said, in your fifties or or sixties, that's when 0:24:37.720 --> 0:24:40.120