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HPV Vaccination Program is Vital for Boys - a Cancer Story

By Carol Duncan - 15th February 2013

Photo copyright Carol Duncan - no reproduction permitted

This year in Australia the cervical cancer vaccine is being given to young teenage boys in Australian high schools. The vaccine has been available for girls since the program began in 2007 and the aim has been to reduce the incidence of cervical cancer. Even if you are aware of the expansion of the HPV Vaccination Program to include boys, you may be wondering why. After all, boys don’t have a cervix, right?

One of my closest friends, Brad, had spent a good part of last year grizzling about having an earache and/or a sore throat. He eventually took himself off to the doctor and was ultimately diagnosed with stage three throat cancer affecting the base of his tongue and the lymph glands on one side of his neck.
He asked me if I would help tell his story to be broadcast on the ABC ‘to give the bloody thing some point’ and, of course, I was only too happy to help. It was really all I could do. 
It is, as it turns out, a story with a twist.
Brad’s father was one of Australia's last tobacco blenders, and although Brad only smoked for a few years as a young man, like most of us over 30 or 40 he has lived surrounded by tobacco smoke at home, in the workplace and socially.
But tobacco is no longer the leading cause of throat cancer in Australia.
60% of cases of oropharyngeal cancers in Australian men are now caused by the same virus that causes almost all cases of cervical cancer.
HPV. Human Papilloma Virus.
There are over 100 types of HPV and they can affect different parts of the body.
One of the people I interviewed for my series on HPV and boys was Associate Professor Karen Canfell from the Lowy Cancer Research Centre at the University of NSW. 
Prof Canfell says that the vaccination program has been an incredible success story in cancer prevention, “This started with the vaccination of girls and women in Australia. Because HPV has a very important role in cervical cancer and, in fact HPV is responsible for virtually all cervical cancers, the types we just mentioned (types 16 & 18) are responsible for about 70% of those cancers.”
“Five years ago, in 2007, we had the implementation of the National HPV Vaccination Program in girls and women in Australia and that's really had incredible effects already. For example we've already seen a drop in the number of young girls infected with HPV, we've also seen a reduction in the numbers of high-grade abnormalities of the cervix which are the precursor to cervical cancer, and we've seen a reduction in anogenital warts which are also caused by different types of HPV which are also included in the vaccine.”
“So in terms of what's happened in females, it's just a remarkable story and we've really seen it play out in Australia before anywhere else in the world because Australia was one of the first countries to adopt the vaccine.”
Four out of five people have at least one strain of HPV at some point in their lives and never know it. For most of us, there are no symptoms and our immune system clears the virus from our bodies.
But for some, the virus can persist and cause abnormal cells to develop which potentially leads to cervical cancer in women and throat and other cancers in men.
Prof Canfell says that extending the National HPV Vaccination Program to boys will provide even greater protection, “By including young boys in the program we have even greater coverage and we also have protection of the gay community, so I think this really does provide and important incremental step to protecting males even further against HPV infection and the cancers that can be caused by it.”
“These include anogenital cancers but also cancers of the head and neck. These are an important set of cancers. I think the complication is that not all of these cancers are caused by HPV but still a significant fraction are and probably that fraction is increasing in the case of head and neck cancers.”
“A US study has recently shown that cancers of the head and neck maybe now about 70% of them could be attributable to HPV, so that is a high proportion of those cases.”
On the Friday night before Christmas 2012, I spent six hours in an operating theatre with Brad as an amazing group of people assembled to try to save his life. It was an incredible experience and a privilege to be there. His journey isn’t over as he’s about to commence an extensive regime of radiation therapy. But we are positive all will be well. 
However, if a simple vaccination can prevent this from happening to my sons, I’ll be lining up to get them the HPV vaccine.
* The National HPV Vaccination Program (which previously only included girls) extends this year to include boys aged 12-13 years in the free school-based program. Boys aged 14-15 years will also be offered the vaccine as part of a catch-up program until the end of 2014.
* You can read and listen to Carol’s full ABC Radio series here:
http://www.abc.net.au/local/photos/2013/01/24/3675773.htm?site=newcastle
For more information about the National HPV Vaccination Program:
http://www.hpvvaccine.org.au

One of my closest friends, Brad, had spent a good part of last year grizzling about having an earache and a sore throat. He eventually took himself off to the doctor and was ultimately diagnosed with stage three throat cancer affecting the base of his tongue and the lymph glands on one side of his neck.

Brad asked me if I would help tell his story to be broadcast on the ABC "to give the bloody thing some point" and, of course, I was only too happy to help. It was really all I could do. 
It is, as it turns out, a story with a twist.

Brad’s father was one of Australia's last tobacco blenders, and although Brad only smoked for a few years as a young man, like most of us over 30 or 40 he has lived surrounded by tobacco smoke at home, in the workplace and socially.

But tobacco is no longer the leading cause of throat cancer in Australia.

60% of cases of oropharyngeal cancers in Australian men are now caused by the same virus that causes almost all cases of cervical cancer. HPV. Human Papilloma Virus. There are over 100 types of HPV and they can affect different parts of the body.

One of the people I interviewed for my series on HPV and boys was Associate Professor Karen Canfell from the Lowy Cancer Research Centre at the University of NSW
Professor Canfell says that the vaccination program has been an incredible success story in cancer prevention, “This started with the vaccination of girls and women in Australia. Because HPV has a very important role in cervical cancer and, in fact HPV is responsible for virtually all cervical cancers, the types we just mentioned (types 16 & 18) are responsible for about 70% of those cancers.”

“Five years ago, in 2007, we had the implementation of the National HPV Vaccination Program in girls and women in Australia and that's really had incredible effects already. For example we've already seen a drop in the number of young girls infected with HPV, we've also seen a reduction in the numbers of high-grade abnormalities of the cervix which are the precursor to cervical cancer, and we've seen a reduction in anogenital warts which are also caused by different types of HPV which are also included in the vaccine.”

“So in terms of what's happened in females, it's just a remarkable story and we've really seen it play out in Australia before anywhere else in the world because Australia was one of the first countries to adopt the vaccine.”

Four out of five people have at least one strain of HPV at some point in their lives and never know it. For most of us, there are no symptoms and our immune system clears the virus from our bodies.

But for some, the virus can persist and cause abnormal cells to develop which potentially leads to cervical cancer in women and throat and other cancers in men.

Professor Canfell says that extending the national HPV Vaccination Program to boys will provide even greater protection, “By including young boys in the program we have even greater coverage and we also have protection of the gay community, so I think this really does provide and important incremental step to protecting males even further against HPV infection and the cancers that can be caused by it.”

“These include anogenital cancers but also cancers of the head and neck. These are an important set of cancers. I think the complication is that not all of these cancers are caused by HPV but still a significant fraction are and probably that fraction is increasing in the case of head and neck cancers.”

“A US study has recently shown that cancers of the head and neck maybe now about 70% of them could be attributable to HPV, so that is a high proportion of those cases.”

On the Friday night before Christmas 2012, I spent six hours in an operating theatre with Brad as an amazing group of people assembled to try to save his life. It was an incredible experience and a privilege to be there. His journey isn’t over as he’s about to commence an extensive regime of radiation therapy. But we are positive all will be well. 

However, if a simple vaccination can prevent this from happening to my sons, I’ll be lining up to get them the HPV vaccine.

* The National HPV Vaccination Program (Australia) (which previously only included girls) extends this year to include boys aged 12-13 years in the free school-based program. Boys aged 14-15 years will also be offered the vaccine as part of a catch-up program until the end of 2014.

You can read and listen to Carol’s full ABC Radio series on HPV and Brad's story here.

And you can read more information about the National HPV Vaccination Program here.

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