No free lunch

Pub date June 17, 2008


Dear Readers:

Have you ever read Geek Love (Random House, 1983) by Katherine Dunn? It’s a love it/hate it kind of thing that was very popular among a certain segment (now called "hipsters," I guess) and it begins, unforgettably, "When your mama was the geek, my dreamlets … " Don’t ask me why, but I’m having an apparently irresistible urge to call you, the readers, "my dreamlets" today. So:

My Dreamlets:

This is not good news, but neither is it as dismal as it might first appear. Have you heard the latest about human papillomavirus (warts) and throat cancer? Did it disappear with unseemly haste from such headlines as it made, or am I just overly sensitive to the way news that interests us (for some value of "us") never seems to get as much play as news that interests them?

It ought to come as no surprise that HPV can cause throat cancers if you use your throat receptively for sex, same as it does with cervixes and anuses (did you know that "What is the plural of anus?" is quite a popular topic of Webular discussion?). But it’s only been in the past few years that researchers have established a clear link. What’s even newer is the epidemiology: who is getting it and how. What we now know is that there has been an upsurge in throat cancers (6,000 cases a year and an annual increase of up to 10 percent in men younger than 60), and that most of the cases in these younger patients can be ascribed to HPV. Cancers caused by HPV can hang around for decades before making themselves known, and these recent cases are thought to have been incubating since as far back as the late 1960s and ’70s. What else were people doing in the late ’60s and ’70s? What year did Deep Throat come out, again?

I have been known to roll my eyes at the idea that the boomers invented sex as we know it. "There are only so many possible combinations of body parts," I’ll say. "Do you really think nobody thought to put that in their mouths until sometime after World War II?" It’s actually true, though — as far as we can tell from what research we have — that oral sex became madly more common some time, yes, after World War II. Before that it was obviously well-known (and popularly blamed on the French), but it really wasn’t ubiquitous, as it is now. And those who did indulge probably did so with far fewer partners. Especially during that one brief shining moment between the dawn of the sexual revolution and the appearance first of herpes and then of course, AIDS, people really did put that in their mouths a whole lot more than they had previously. It seemed like a good idea at the time.

So OK, now what? Well, we have to admit that oral sex, especially on men, is not necessarily safe sex. And while this is not the first time that the blow job’s sacred status as the Safe Hot Thing has been challenged, it is probably the most serious. Not only does HIV really not pass readily through oral sex, it is itself quite rare. HPV is as common as dirt.

So — panic? I think not yet. These new cancers are nowhere near as common as you’d expect if HPV infections just automatically turned into cancers 30 years after your sluttiest year at college. It’s estimated that at least 50 percent of Americans have been infected at some point. The CDC itself uses that "at some point" to mean that many — indeed probably most — people infected at some point simply clear it from their systems at some other point. These people will not get cancer, and only a small percentage of the remaining, non-clearing cases will.

Meanwhile, you know that vaccine some people are agitating against giving to little girls — just in case the admission that one day they will be sexually active ends up making that day come sooner than they’d like? It doesn’t only work on little girls. That’s just the suggested target group right now, for a number of purely sociological reasons. It was extensively tested on young women and the maker, Merck, hopes to begin testing in males this year. If it works for men too, there’s no reason we can’t begin to eradicate the entire class: HPV-caused cancers of the throat, cervix, penis, anus, and other mucus-membraney places where people have been putting things.

Not that this is great news for people who have been infected, not cleared the infection, and could go on to develop cancer. We have no routine test yet. The pretty-good news seems to be that throat cancers caused by HPV are more curable than their non-HPV counterparts. And my advice, my dreamlets? Well, I really hate to say this, or even think it, but it may be time to start thinking about condoms, at least if we’re planning to become raging blow-job queens anytime in the near future. I know! I’m sorry!



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.

Andrea is also teaching two classes: "You’ve Really Got Your Hands Full" — a realistic look at having twins — at Birthways in Berkeley, and "Is There Sex After Motherhood?" at Day One Center in San Francisco and other venues.