› andrea@altsexcolumn.com
Dear Andrea:
I’m a 36-year-old woman who’s been married for nine years. Last year a routine annual exam led to several other tests that led to a diagnosis of early-stage cervical cancer. I had a hysterectomy and will most likely not need any other treatment.
I’m past the initial shock of this, but now there is something I’m wondering about. I have not been tested for human papillomavirus, but I am told that I have it since that’s what caused the cervical cancer. Should I be contacting exes to notify them of this? Should my husband? Neither of us has been with anyone else for more than 10 years, and we have no way of knowing which of us contracted this from whom, or when. Neither of us has ever had an STD with any symptoms. I hate the thought of trying to track down exes from so long ago with such personal news. I’m reassuring myself with statistics that most people are exposed to HPV at some point in their lives and women should be getting Pap smears anyway. Still, I would hate to feel responsible for someone else developing cancer and not finding out in time.
Love,
Loyal Reader
Dear Loyal:
Sorry to hear you had to go through all that. I know, or know of, way too many people struggling with cancers right now and am in a serious "oh, fuck cancer" mood myself. Here’s hoping you’ve heard the last from yours. Now. This is a great question and a nice break from some of the sillier stuff. Let’s see what we can do.
Back in the first half of the AIDS epidemic when the current discourse around infectious diseases, and especially sexually transmitted infectious diseases (oh, how I long for the return of "VD") was forged, a new orthodoxy about disclosure developed. Whom do we tell if we think we might have been infectious with something at some point, however distant? Everydamnedone — the "100-percenter" approach — was the rule, and only a self-centered pig of a person would consider deviating from that. I’ve followed this myself, once calling a number of long-past partners to tell them that an ex-something-or-other of mine had something, though I, in fact did not. I followed the script but felt kind of dopey doing it. And I can’t say anyone sounded particularly happy to hear from me.
But enough about me. I do have one question I can’t ask you since you are represented only by an anonymous message in my inbox: did your healthcare providers do some sort of sequencing to determine that your cancer was in fact caused by HPV/human papillomavirus? HPV is hardly innocent, but last I heard, it (two strains, 16 and 18) was thought to cause 70 percent of cervical cancers, with the other causes unknown. Thirty percent is a not-insignificant number. I think you might want to follow up on this with your doctors before you start thinking about getting on Facebook (I just joined, finally! I am so cutting-edge) and digging up long-ago partners, or people with the same name as long-ago partners, and telling them something scary yet terribly vague about cancer. If it turns out that they were only assuming HPV, or that you actually don’t test positive for HPV after pressing for a real test (not a Pap smear), you really don’t have anything to worry about except, you know, all the normal stuff you have to worry about.
Even if it turns out that you are HPV positive, I’m not entirely sure you need to turn your whole life inside-out at this point by contacting people. (I don’t expect that everyone will agree with me here, but when do they anyway?) Ten years is a hell of a long time. Fifteen years is (duh) even longer. How far back is the reasonable woman (and you do sound like one of those) supposed to go?
It’s not that one’s ethics should be built on a foundation of "is it convenient for me?", but one does have to take into account whether something can even be done before deciding that doing it is the only ethical choice. If you and your exes tended to get around rather freely and not keep much track, then there is a very high probability that they have been exposed, completely independent of any contact with you or your contacts. Women with lots of partners are probably getting Pap smears too — or at least we’d better hope they are. If you were HPV positive back then, it’s possible you were responsible for a secondhand infection. But you will never find that person now, and she will have discovered it one way or another.
If, on the other hand, you had two boyfriends and your husband had two girlfriends, and one of you may have infected one of that small group, drop them a line if possible. After you get your (positive) HPV test. Otherwise, forget it.
Love,
Andrea
Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.