HPV vaccines will save lives... and it's not just women's lives, and it's not just sexually active people's lives. HPV-linked cancers strike men and women and it's not just cervical cancer, although that certainly is a very prevalent HPV-linked cancer that could be greatly reduced by widespread use of the HPV vaccine. I have a personal stake in this, as I just spent all of this just-passed summer getting radiation treatment for throat cancer caused by HPV-induced papilloma growth on my vocal cords, making me part of a growing contingent of men with HPV-linked throat cancers (e.g. stories like this one). It's a sad statement on the world that a decision to prevent loss of life can be turned into what looks like the most potent weapon against a man with otherwise insane policies, simply because Republican voters fear sex.
Yes, HPV is a sexually transmitted disease. There are many strains of HPV, and these many strains also cause other non-sexually transmitted warts. However, the specific strains that Gardasil protects against (6, 11, 16 and 18) are usually only sexually transmitted. Of these 4 strains, 6 and 11 are the most frequent cause of visible outbreaks of genital warts, while the 16 and 18 are the most common strains linked to cervical cancer.
However, many people are infected with one or more of these strains in their respiratory system. A certain small subset of these people will actually develop papilloma (wart) growth in their throats, typically on the vocal cords, but sometimes in other poritons of the respiratory tract as well. This is called either laryngeal papillomatosis (Wikipedia link) or recurrent respiratory papillomatosis (RRP; link to the RRP foundation). It is called RRP as it does typically recur, and the major treatment method is repeated surgeries, usually several times a year, sometimes as frequently as every few weeks.
While it is caused by the same HPV strains as the more familiar STD expression of genital warts, RRP is not merely a disease of sexually active people. In fact, it is more common in children, and is generally more aggressive in these cases. Mode of transmission is not well-understood, but many people think it is transmitted from the mother during the birth process. Less commonly, it shows up as an adult-onset disease, and this is typically less aggressive, although certainly not a trivial condition, still generally requiring frequent surgeries to maintain vocal function.
Starting last winter, I noticed that my voice was gradually becoming hoarse. As is typical for many people, I ignored it. Over time it grew worse, but I treated it as a symptom of allergies (tree pollen in the South is something fierce!). Finally after six months of continually increasing hoarseness, my wife talked me into going to the doctor. My GP sent me to an ENT, who scoped my throat and fortunately immediately recognized the papilloma growth for what it was. Since this is not a common condition, misdiagnosis is common. It is either never scoped, or diagnosed as nodes or polyps and not treated correctly.
My ENT assured me that it was unlikely to be cancerous, as RRP is usually caused by strains 6 or 11, which are low risk for cancer development. After the removal, my voice was back to normal after about a week of recovery, but the pathology report was less thrilling. I did indeed have papilloma growth, and the HPV testing did indicate it was caused by one of the low-risk strains. However, low-risk is not no-risk, and I was one of the fortunate few to have cancer developing as well. It was very early (carcinoma in situ), but complete surgical removal is problematic on vocal cords, where excessive surgery poses great risks to vocal function. So it was off to get 6 weeks of radiation to my throat.
For those of you who haven't experienced radiation treatment, it is not fun. You have to go get it done every day, and the side effects accumulate over time. I'm young, and I wasn't doing adjuvant chemotherapy, so I held up very well. I did however become very tired, and my voice was reduced to a whisper, and I felt like I had a terrible throat infection that would not get better for weeks at a time. Not fun, and nothing compared to what many go through.
So I have a rare condition, but it would be much rarer if the prevalence of HPV infection were greatly reduced. And it's not just people like me who frist have papilloma growth for an obvious vocal symptom, enabling early discovery of cancer. Many others simply develop oral and throat cancers with no papilloma growth, but HPV testing of these cancers indicates presence of the virus. Likely, it's a causal agent in many of these cases. And even for those with RRP that never develop cancer, it can be a crippling disease. I teach for a living, and if I can't speak, I can't do my job. Fortunately, the radiation seems to have put the papilloma into remission for the moment, and I'm not having to deal with multiple surgeries (although I am freqeuntly getting cameras shoved into my larynx, which is not the most enjoyable way to spend an afternoon).
All of these cervical and throat cancers, and children facing constant surgeries, can be greatly reduced by the widespread use of the HPV vaccine. My daughters shouldn't have to worry about this cancer, wherever it may display itself. Rick Perry was doing the right thing to require this vaccine, regardless of his motivations. He's wrong about so much, but one of the few things he was right on may very well be his undoing in the Republican nomination contest. How sick is that?