Sometimes, the people who hate the HPV vaccine dismiss the awful consequences of an HPV infection as if they are unimportant. HPV is linked to several deadly and disfiguring cancers. Maybe you heard the story of a man who received a penis transplant. And it has a lot to do with the HPV vaccine.
Setting aside all of the jokes and uncomfortable thoughts, this procedure could be an important medical procedure for men who have lost their penis through injury or disease. For example, veterans of wars are at grave risk to injuries that cause the loss of their penis. Mines and IEDs in war are particularly damaging in ways that can cause permanent trauma to a soldier’s penis. Having a method to replace it, like a transplant, can be a great way to improve the soldier’s mental health and personal self-image.
However, this story is about a 64-year-old Boston man, Thomas Manning, who had to have his penis surgically removed in 2012 because of HPV-related penile cancer, a rare and devastating disease. In 2016, he had an innovative penis transplant to replace his cancer.
All about HPV vaccines
Many of you have read this section an enormous number of times, however, for some of the readers of this blog, this article might be their first bit of research into the human papillomavirus (HPV) vaccine. Thus, it’s important to get a brief overview of HPV and the vaccines. If you’ve read this section before, just skip to the next section if you want.
Genital and oral HPV infections are the most common sexually transmitted infections (STI) in the USA. HPV is generally transmitted from personal contact during vaginal, anal or oral sex.
It’s important to note that there are more than 150 strains or subtypes of HPV that can infect humans – however, only 40 of these strains are linked to one or more different cancers. Although the early symptoms of HPV infections aren’t serious and many HPV infections resolve themselves without long-term harm, HPV infections are causally linked to many types of cancers in men and women. According to current medical research, here are some of the cancers that are linked to HPV:
These are all dangerous and disfiguring cancers that can be mostly prevented by the HPV cancer vaccine. If you’re a male, and you think that these are mostly female cancers, penile cancer can lead to amputation of your penis. Just think about that guys.
HPV is believed to cause nearly 5% of all new cancers across the world, making it almost as dangerous as tobacco in that respect. According to the CDC, roughly 79 million Americans are infected with HPV – approximately 14 million Americans contract a new HPV every year. Most individuals don’t even know they have the infection until the onset of cancer. Accordingly, over 31,000 HPV-related cancers are diagnosed in the USA every year.
There were two HPV vaccines on the world market before 2014. GSK, also known as GlaxoSmithKline manufactured Cervarix, a bivalent vaccine. It has been withdrawn from the US market (although available in many other markets), because of the competition from the quadrivalent (immunizes against four different HPV subtypes) and 9-valent (against nine subtypes) Gardasil vaccines.
Merck manufactures Gardasil, probably the most popular HPV vaccine in the world. The first version of the vaccine, quadrivalent Gardasil, targets the two HPV genotypes known to cause about 70% of cervical cancer and two other HPV genotypes that cause genital warts. In Europe and other markets, Gardasil is known as Silgard.
The newer Gardasil 9, approved by the FDA in 2014, is a 9-valent vaccine, protecting against HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58. It targets the four HPV genotypes in the quadrivalent version, along with five additional ones that are linked to cervical and other HPV-related cancers. Both versions of Gardasil are prophylactic, meant to be given before females or males become exposed to possible HPV infection through intimate contact.
Gardasil is one of the easiest and best ways to prevent a few deadly cancers that are related to HPV. It is definitely a cancer-preventing vaccine.
(Just a quick note. There are actually two cancer-preventing vaccines. Along with the HPV vaccines, the hepatitis B vaccine is also important for the prevention of some cancers. The vaccine prevents hepatitis B viral infections. Chronic hepatitis B infections can lead to liver cirrhosis or cancer. Liver cancer is actually one of the few cancers in the USA where the incidence has increased over the past few years. And if you follow the anti-vaccine rhetoric, you know the hepatitis B vaccine is almost as controversial as the HPV vaccine.)
Currently, in the United States, the Advisory Committee on Immunization Practices (ACIP) recommends that preteen girls and boys aged 11 or 12 are vaccinated against HPV. The immunization is also recommended for teenage girls and young women up to the age of 26 who did not receive it when they were younger, and teenage boys and young men up to the age of 21.
More about penile cancer
Penile cancer, or cancer of the penis, is one of the rarer cancers in the USA – there are approximately 2300 new cases and 380 deaths every year from the disease. But it’s not just some random cancer that happens to a small number of people – HPV infections are a significant risk factor for penile cancer. The CDC estimates that around 700 penile cancer cases per year are probably causally linked to an HPV infection.
Even though this is a rare disease, it is devastating men for a number of physical and psychological reasons. Most of these cancers are caused by HPV types 11 and 16, against which HPV vaccines provide protection. Even the rarer HPV types that are linked to penile cancer, including HPV types 31, 33, 45, 52, and 58, are stopped by the newer Gardasil9 vaccine.
Given that the HPV vaccines are extraordinarily safe (despite the unscientific claims of the anti-vaccine religion), why would anyone not protect themselves against penile cancer, even if it is rare? Many of the two hundred and more cancers are rare, many of which cannot be prevented. But here’s one that can protect a man from penile cancer, along with several cancers like anal, oropharyngeal, prostate, and others. Sounds like getting the HPV vaccine is a slam dunk, and it should be.
I guess one could ignore the HPV vaccine and risk getting a cancer-causing infection that leads to penile cancer. I guess one could believe that the transplant is better than the HPV vaccine, though one would have to not know anything about transplants – transplants require a lifetime of powerful and expensive medications.
Furthermore, I don’t know if the penis transplant is going to be a viable medical procedure for men who lose their penises to disease or trauma over the long-term. There have only been three cases in the world, so it’s very early in research on the procedure. For those who have had traumatic injury and loss of their penis from war or other accidents, this may be one of the great advances in medicine.
But for those of you, men or women, who are at risk for HPV related cancers, then get the cancer-preventing HPV vaccine. There are so few ways to actually prevent cancer, why not go for the slam dunk? Your long-term health will appreciate the effort.
Editor’s note – this article was originally published in May 2016. It’s been updated to fix some spelling and grammar issues, to repair broken links, to improve formatting, and to give it a thorough cleaning.
Pow-Sang MR, Ferreira U, Pow-Sang JM, Nardi AC, Destefano V. Epidemiology and natural history of penile cancer. Urology. 2010 Aug;76(2 Suppl 1):S2-6. doi: 10.1016/j.urology.2010.03.003. Review. PubMed PMID: 20691882.
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