Actor Michael Douglas once said that oral sex caused his throat cancer. We asked a panel of experts if that’s likely to be true. Here’s what they had to say.
- HPV can be transmitted through oral sex.
- HPV is linked to several types of cancer, including several oral cancers in men.
- Heterosexual men in their 40s and 50s may be at a higher risk of HPV-related oral cancers due to historical lack of awareness, differences in sexual practices, and the timing of HPV exposure.
- HPV vaccination, ideally administered before sexual encounters, is a highly effective preventive measure for HPV-related cancers.
- Practicing safer sex with barrier methods like condoms or dental dams can reduce the risk of HPV-related oral cancers.
In 2013, actor Michael Douglas stated that oral sex caused his throat cancer. We asked a panel of experts if that’s likely to be true. Following are the questions we asked our panelists about the likelihood of oral sex causing cancer along with a round-up of their responses.
A: There are many misconceptions about HPV. For example, some people incorrectly assume that HPV only affects women. But our experts agreed that the virus doesn’t discriminate; men can also contract HPV from oral, anal, or vaginal sex.
According to Dr. Sridhar PS, a radiation oncologist, it’s possible for men to contract HPV from performing cunnilingus, or oral sex, on a female partner. He commented, “HPV is a sexually transmitted infection that can spread through direct contact with infected genital areas, as well as the mouth and throat. Oral HPV can cause cancers of the oropharynx, which is the back of the throat, including the base of the tongue and tonsils.”
Dr. Michael Green, an OB/GYN, summarized this more plainly by explaining, “Human papillomavirus is a group of viruses that can infect the genital area, mouth, and throat.”
Dr. Sarah Melancon, a sociologist and clinical sexologist at Women’s Health Interactive, reinforced the idea that oral sex can, indeed, be a conduit for HPV transmission. She pointed to a study indicating a 15 percent increase in the risk of developing oral cancer associated with oral sex.
Dr. Sara Amini, a dentist, affirmed the connection between HPV and throat cancer and highlighted the statement made by Michael Douglas in 2013 for bringing this topic to the spotlight in mainstream media.
In summary, all the experts agree that there is a definitive link between performing cunnilingus and the potential transmission of HPV. HPV is a sexually transmitted infection that can lead to various health issues, including throat cancer.
Though most people are aware of the link between HPV and cervical cancer, many aren’t aware that HPV is also linked to oral cancers in men. We asked our experts to shed light on the factors contributing to the prevalence of HPV-related oral cancers in heterosexual men in their 40s and 50s. They agreed that many factors contribute to this trend.
Dr. Amini emphasized, “The peak age for diagnosis of HPV-related oral cancers is typically in the 40s and 50s, as the individuals who were exposed to HPV through oral sex in their earlier years are now reaching an age where cancer is more likely to develop.”
Dr. Jennifer Silver, a dentist with Macleod Trail Dental, explained, “Men in their 40s and 50s have had more time to accumulate these exposures, increasing their risk.”
Dr. Green suggested that the prevalence of HPV-related oral cancers in heterosexual men in their 40s and 50s may be related to the timing of HPV vaccination. He explained that the “HPV vaccine, introduced in the mid-2000s, primarily targets the strains of HPV that are linked to cervical cancer, but it has also been effective in reducing the risk of oral HPV infections.” However, straight men in their 40s and 50s were having sex when HPV vaccination wasn’t as prevalent.
Dr. Silver attributed this phenomenon to historical factors. She explained that in the past, “there wasn't as much awareness about HPV and its link to oral cancers. Safe sex practices weren't emphasized like they are today, potentially leading to more exposure to the virus.”
Dr. Sridhar PS offered multiple reasons for the higher prevalence of HPV-related oral cancers in this demographic. He first noted that “men are more likely to have oral sex with multiple partners than women, and thus have a higher chance of exposure to HPV.”
Dr. Danielle Leonardo, an oncologist and writer at My Breast Cancer Team, provided a unique perspective by noting that the female genital tract, because of its thin and moist lining, may contain a higher HPV viral load than the dry, thick skin of the penis. This means that “males performing oral sex on females may be more exposed to the HPV virus because of easier transmission.”
Dr. Melancon mentioned several risk factors for oral cancer, including tobacco and alcohol use, poor nutrition, age over 55, and certain genetic syndromes, in addition to oral HPV infection. She explained that “women tend to consume tobacco and alcohol less often and engage in more health behaviors than men, so they face fewer risk factors and can clear infections more easily. Sex hormones may also play a role.”
Dr. Sridhar PS agreed that men may have a weaker immune response to HPV than women. He added that “men may not be aware of the symptoms of oral cancer, such as a sore throat, earache, or lump in the neck, and may delay seeking medical attention.”
Summary: Our experts agree that multiple factors contribute to the higher incidence of HPV in heterosexual males in their 30s and 40s — including time, sexual habits, and lifestyle risk factors.
Our experts see a link between more people having oral sex and the risk of HPV-related oral cancers. However, they also agree that the extent of this connection depends on certain health factors and sexual behaviors.
Dr. Silver acknowledged the potential for an increase in HPV-related cancers due to the recent rise in oral sex “if safe sex practices are not consistently followed.”
Dr. Leonardo commented that this is theoretically possible. But she added, “Compared to previous decades, we are now more strongly advocating HPV vaccination to males and females, which should prevent a patient from contracting HPV vaccine when given early.”
Dr. Melancon pointed out that oral sex has become increasingly common over the last 30 years and is now considered a normative sex act. She mentioned that while there has been a rise in oral cancer cases, the increase is proportionally much smaller than the increase in oral sex.
She also highlighted research that suggests oral sex “is only associated with a 15 percent increase in the risk of developing oral cancer, so it’s unlikely the rise in oral sex has or will lead to a substantial increase in oral cancer rates.”
Dr. Sridhar PS agreed that the rise in oral sex may lead to more HPV-related cancers, but clarified, “It is not clear how much of this increase is due to HPV alone, and how much is due to other factors, such as smoking or alcohol use.”
Dr. Green agreed with the rest of the panel but reminded us, “It's important to remember that contracting HPV does not always lead to cancer, and often, infections clear over time.”
Summary: Our experts feel that there is a potential link between the rise in oral sex and an increased risk of HPV-related oral cancers. However, they emphasize that the relationship is nuanced and influenced by various factors such as safe sex practices, HPV vaccinations, and other health behaviors like smoking and alcohol use. While oral sex has become more common, the proportional increase in oral cancer rates is relatively small. Additionally, HPV infections do not always lead to cancer and can clear over time.
The past few decades have brought remarkable advances in prevention and treatment for sexually transmitted infections (STIs). It’s no surprise that our experts recommend several popular prevention methods, like HPV vaccination and safer sex practices, to protect yourself during oral sex.
The best way to prevent HPV-related cancers is to get vaccinated for HPV before you’re exposed.
Dr. Leonardo discussed the importance of HPV vaccination, ideally administered before the onset of sexual encounters. She noted that vaccination may not prevent HPV infection if an individual has already been exposed to the virus.
Dr. Green highlighted the effectiveness of the HPV vaccine in reducing the risk of oral HPV infections. He encourages individuals to consider getting the vaccine and to discuss their partners' vaccination status.
Getting vaccinated isn’t the only way to protect yourself against HPV. Each of our experts mentioned the importance of using barrier methods, such as condoms or dental dams, to protect yourself during oral sex.
Dr. Melancon highlighted, “It is unlikely that Michael Douglas’ oral cancer was solely due to oral sex; however, oral sex may have contributed alongside other risk factors.”[a] She added that condoms and dental dams are the safest protection for performing oral sex.
Dr. Sridhar PS cautioned that barrier methods “can offer some protection, but they aren't 100% effective, as they may not cover all areas of infection.” He discussed the value of HPV vaccination and other safer sex practices, such as limiting your number of sexual partners.
Dr. Sridhar PS also emphasized the importance of routine healthcare in prevention and treatment. “Regular check-ups and screenings for oral cancer and other cancers are also important. If you notice any symptoms of oral cancer, such as a sore throat, earache, or lump in the neck, see your doctor immediately. Early diagnosis and treatment can improve your chances of survival and recovery.”
Dr. Amini suggested several preventive measures, including getting vaccinated if eligible, and practicing safe sex with the use of barrier methods like dental dams during oral sex. In addition to practicing safe sex, she encourages maintaining good oral hygiene, “as a healthy mouth can potentially be more resistant to infections.”
Summary: Our experts feel that the best methods for protecting yourself during oral sex involve a multi-faceted approach. HPV vaccination is highly recommended, ideally before the onset of sexual activity, as it can significantly reduce the risk of HPV-related cancers.
In addition to vaccination, the use of barrier methods like condoms and dental dams is advised, although they are not 100% effective. Limiting the number of sexual partners and practicing good oral hygiene are also beneficial. Regular healthcare check-ups and screenings for oral cancer are emphasized for early diagnosis and treatment.
In a nutshell, experts unanimously agree that oral sex can lead to the transmission of HPV, which is linked to various cancers, including throat and mouth cancers. [b]They emphasized that while the risk exists, not every HPV infection leads to cancer, and many are cleared by the immune system.
Heterosexual men in their 40s and 50s may be at a higher risk for HPV-related oral cancers due to historical lack of awareness, differences in sexual practices, and the timing of HPV exposure. However, the experts emphasized that regular check-ups and screening, HPV vaccination, and practicing safer sex can significantly reduce the risk of HPV-related oral cancers, ensuring better sexual health.
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Background information for each expert consulted for this article is provided below.
Jennifer Silver, DDS, Dentist
Dr. Jennifer Silver[c][d][e][f] is an experienced dentist and owner of Macleod Trail Dental. She has been working as a dentist for the past 8 years. She has a comprehensive understanding of oral conditions, including gum disease, tooth decay, oral thrush and oral cancers.
Sridhar PS, MD, Radiation Oncologist
Sarah Melancon, PhD, Sociologist & Certified Sexologist
Dr. Sarah Melancon is a lead researcher and medical review board member for Women’s Health Interactive. She holds a Ph.D. in sociology with a specialization in sexuality and relationships and is a certified sexologist. She has completed her dissertation research on HPV and the HPV vaccine, Gardasil.
Danielle Leonardo, MD, Oncologist and Writer
Dr. Danielle Leonardo is a board-certified specialist in internal medicine and medical oncology from the Philippines. She has been practicing medicine since 2014. Her areas of interests are molecular oncology, palliative care, and public health awareness. Dr. Danielle is a patient cancer advocate with My Breast Cancer Team.
Sara Amini, DDS, Dentist
Dr. Sara Amini is an award-winning dentist with over 21 years’ work experience. She specializes in cosmetic and restorative dentistry, sleep apnea, aligners, and implants. She has been actively involved in training dental students and other dentists.
Dr. Michael Green, OB/GYN
Michael Green, MD, is a board-certified OB/GYN and former chief of OB for the Centers for Family Health in Ventura, CA. He is currently the site director for OBHG at Northridge Medical Center in Northridge, CA, where he works as an OB hospitalist as well as the co-founder of Winona, a telehealth treatment brand that empowers pre- and post-menopausal women through nutrition and hormone replacement therapy.