Michael Douglas, who is now three years post diagnosis for head and neck cancer, blamed oral sex with women for his disease. Apparently, he also says cunnilingus is the cure, but we’ll tackle that nugget another day.
Douglas revealed his tumor was HPV positive while doing his press tour for Behind the Candelabra (which is great, by the way, and Douglas is appropriately both creepy and predatory as Liberace).
Some strains of the human papilloma virus (HPV) are benign and simply cause warts (papilloma), but others are oncogenic and cause cancer. Cervical and anal cancers are the most common, but HPV-related head and neck cancers are on the rise, specifically head and neck squamous cells carcinoma (HNSCC).
HPV is detected in about 25% of all HNSCC. It is most commonly identified in oropharyngeal cancers (tonsils and base of tongue), 45–90% of these cancers are HPV positive. Douglas apparently had an oropharyngeal cancer (he reported his tumor was on the base of his tongue). However, HPV is also implicated as a co factor in 25% of cancers of the larynx and 23% of oral cavity cancers.
Studies are conflicting as to the role of kissing in oral HPV acquisition. The clearest link between oral HPV and thus oral HPV related cancers is, as Douglas states, via cunnilingus (possibly explaining why this disease is more common among men, although it would be interesting to know if the incidence of HPV related head and neck cancers among women who have sex with women is the same as heterosexual men).
However, there are a few things that Douglas left out (or perhaps were left out by the press, to give him the benefit of the doubt of course). First of all, typically it requires more than one oral sex partner to increase the risk of HPV related head and neck cancers. For example, oral sex with 6 or more partners increases the risk of HPV associated head and neck cancers 8-fold. It’s simply math…almost everyone has been exposed to HPV, but only a small percentage are actively shedding the virus and thus contagious. So, the more people you have oral sex with, the more likely you are to be exposed to someone shedding HPV.
While there is no denying that exposure to oncogenic (high-risk) HPV is a co factor, smoking should not be dismissed. Smoking more than doubles the risk of head and neck squamous cell cancers and alcohol is also a risk factor. Douglas is an ex-smoker and admitted in his biography to having a problem with alcohol (and other drugs).
This was a great opportunity to reinforce the important fact that oral sex is sex and carries with is the risk of both STDs and cancer. But Michael Douglas’s claim that “Oral sex caused my cancer” seems to gloss over the fact that he probably had oral sex with at least 6 partners, smoked a lot, and drank enough alcohol to need rehab.
Whether Douglas simply wanted to forget his other risk factors, was looking for the best headline to promote his Liberace biopic, or is truly invested in his cancer being simply a-bad-luck-you-went-down-on-the-wrong-woman kind of thing, I don’t know. Regardless, Douglas seems to have has missed the irony in blaming his cancer on the act of oral sex while promoting a movie about a man who died because of risky sexual behavior. It wasn’t anal sex that gave Liberace HIV, it was unprotected anal sex with multiple partners. There’s a big difference.
Douglas had a great opportunity to discuss several risky behaviors for oral cancer, both sexual and lifestyle, and it was sadly squandered.