Michael Douglas was diagnosed with throat cancer (oropharyngeal cancer) in 2010. He initially said it was caused by years of heavy smoking, alcohol abuse, and stress. However, he told The Guardian newspaper in 2013 that it was caused by oral sex (cunnilingus).
His agent later said that Douglas had been talking generally, and not about his own cancer, but the Guardian responded by publishing the sound recording of the interview that clearly showed he blamed oral sex for his cancer, and not years of drinking, smoking, and stress.
In this article, we will discuss the links between oral sex, HPV, and throat cancer. We also cover the major risk factors for throat cancer.
Contents of this article:
How does HPV cause cancer?
The link between HPV and cancer is well known
Although smoking tobacco and drinking alcohol are the primary risk factors for oral cancer, the HPV virus is now thought to be a significant factor, too.
According to the National Health Service (NHS), United Kingdom, 25-35 percent of throat cancers are HPV-related.
HPV does not directly cause cancer; it causes changes in the cells that it infects.
These cells can later become cancerous. However, very few people with an HPV infection will develop cancer; in fact, around 90 percent of infections are cleared up by the body within 2 years.
Smokers are less likely to be able to clear the infection because smoking damages immune surveillance cells in the skin that normally help protect against damage caused by the virus.
What is the risk of developing throat cancer from oral sex?
At the American Society of Clinical Oncology annual meeting in Chicago, Illinois, in 2013, Gypsyamber D'Souza, Ph.D., MPH, from the Johns Hopkins School of Public Health explained that throat cancers that arise from HPV do not appear to raise the risk for domestic partners of the same cancer.
Dr. D'Souza explained that in their pilot study, they found that the prevalence of HPV among partners/spouses of an affected patient was approximately 7 percent, no different from that of the general population.
The team found that the HPV 16 subtype was present in just 2 percent of female partners and 0 percent of male partners. HPV 16 is responsible for the majority of throat cancers. Of the partners/spouses who underwent a visual oral exam, none had cancer or pre-cancer.
D'Souza explained that the risk of developing head and neck cancers for people whose partners have HPV-related cancer is very low.
At a press briefing, D'Souza said: "Many people become infected but are able to clear those infections." The researchers added that partners who have been together for a long time probably already share whatever infections they have. No changes in physical intimacy are needed, they emphasized. Put more simply "Couples will infect each other with whatever they have anyway - oral sex will neither increase nor reduce infection risk."
Oral sex with six or more partners raises risk of throat cancer, said one study
In a study published in the New England Journal of Medicine in 2007, Dr. Maura Gillison of Johns Hopkins Bloomberg School of Public Health suggested that people who have oral sex with at least six different partners have a significantly higher risk of developing throat cancer.
The team recruited 100 patients who had recently been diagnosed with oropharyngeal cancer, as well as 200 healthy individuals (the control group).
They found that people who had at least six oral-sex partners during their lifetime were 3.4 times more likely to have throat cancer. Those with 26 or more vaginal-sex partners had a 3.1 times higher risk of developing throat cancer.
Risk factors for throat cancer
Smoking - tobacco smoking is by far the most important risk factor for throat cancer. Regular, long-term, heavy smokers are 20 times more likely to develop some type of throat cancer compared with non-smokers.
Alcohol - heavy, chronic alcohol consumption, particularly spirits, also raises the risk of developing throat cancer.
People who do both - drink and smoke heavily - have the highest risk. It is also worth noting a piece of research from May 2013 that suggested that non-drinkers and non-smokers who have frequent heartburn have a higher risk of developing cancers of the throat and vocal cord.