Hello,
Thank you for your query at DoctorSpring.com. I can understand the concern and anxiety you have regarding your partner. To answer you question directly without any medical jargon,
1. You are not the cause of your partner's cancer. Usually hpv needs decades to produce cancer. So 9 months is too early to cause cancer in her anal region.
2. Any uncircumcised male can harbor hpv in penile region. So any male stands a chance of developing cancer in 4th/5th decade of life. Circumcision can reduce the risk but cannot completely eliminate it. Many unknown factors including smoking contributes to it.
3. You can continue with your sexual life. Hpv is a integral part of microenvironment in any sexually active person. You can advice your partner for regular cervical pap smear annually followed by once in 3 - 5 years.
Hope this cleared all your doubts. I would be glad to answer any more queries.
Kind regards
Patient replied :
Thank you very much for your response.
I need some more clarification if you please.
1- Can you clarify in a detailed manner with more scientific proofs that hdv can't produce cancer ever in 9 months. I.e. The minimum life cycle from hdv infection to producing cancer cells to having a cancer tumor in the anal. Please the more detailed scientific and medical info from an oncologist point of view the better for me that I can be very confident about this subject matter.
And does this mean that the cause of her anal cancer is an hpv transmitted to her years ago from another partner?
2- I am from Egypt where circumcise mandatory from early childhood so I had been cirumcised when I was a baby. Does this mean that in case I have the same dangerous type of hpv (type 16 or 18) from my partner who have the anal cancer or any other partner, the risks are now much lower that this hpv can produce penile cancer?
3- Sorry but understanding the human part on this, I think it is not possible before get engaged to anybody to tell her that I may have a dangerous type of hpv and you will be at high risk of producing cervical cancer accordingly please check for it each year or 3. Scientifically this can be the only solution from your respectful point of view but I think your answer is just the most merciful and human answer telling me "you have to stop your sex life otherwise your new partner will be at high risk of developing cervical cancer", definitely I am not blaming you but please be very clear with me that I can plan the rest of my life ahead without going into any relationship because if this is my destiny I can face it and live with its consequences despite how hard it is and not to harm anyone because of me.
Kind regards
Hellom
Please be assured that you can continue your routine sexual life as a normal man. Please do not panic about it. You are a normal person and you are not responsible for anal cancer in your female sexual partner whom you had met 9 months ago as per your email. Be assured that HPV has other means of transmission and I AM NOT BLAMING YOUR PARTNER FOR HPV INFECTION ALSO. There may be other reasons for her malignancy OTHER THAN HPV and SEXUAL TRANSMISSION. SO PLEASE DONT DOUBT YOUR PARTNER BASED ON THIS NOTION ONLY.
Answering specifically for your queries
1. I will try to get illustrated examples for making you understand HPV infection which will be easy for non medical person. However there are innumerable websites explaining the same in internet. Eg. http://www.cancer.gov
2. Whether circumcised or not, any male will have HPV infection. Circumcision reduces the transmission but does not completely eliminate it. So you don't have to really be concerned over it. Please be informed that you are at reduced risk of HPV transmission.
3. You can follow normal sexual practices (vaginal intercourse) than anal. The reason I advised your partner for 3 yearly Pap smear is , as a general recommendation for any female in reproductive age group. There are recommendations even to do Pap smear for Unmarried females starting age 21 as per WHO guidelines. This is part of routine recommendation issued by WHO. I AM MAKING IT CLEAR AGAIN AND AGAIN THAT NORMAL SEXUAL LIFE CAN BE CONTINUED WITHOUT ANY CONCERN.
Hope I clarified your queries. Please let me know if not clear.
Patient replied :
Thank you for you kind response and care.
For more clarification in point 1, please I will be waiting for this clarification as soon as you can.
But now I want to understand
1- if we did anal sex for only 9 months and hpv "cannot" be the reason of her anal cancer because the life cycle of hpv to be processed to cancer "must" take at least several years, the question is: can anal sex by itself without hpv infection can be a reason of anal cancer for any other reason rather than hpv infection and in only 9 months?
2- for Pap smear can be this done to virgin women or this may cause lost of virginity while doing this test?
3- I am not doubting any of your words but I can see from your kind responses that you can understand how I am panicked totally and feeling cursed! Really that's a very kind feeling to sense your patient and address his needs. So, can you refer me to another big oncologist whom you personally trust very mush to take a second opinion. For me this is the case of my life.
Thank you again and kind regards
Hello,
1. Anal sex alone cannot cause anal cancer. Do not worry about this at all
2. No virginity is not likely to be affected
3. I can do direct referral , but in that case my current country of practice is India. So I am not sure whether this will work out for you
Hope this helps
Feel free to ask followups
Thank you