Doctors used to think this STD threatened only women. Then the men started dying

[starz85]

ERIC STATLER'S WISDOM teeth were impacted. Inconvenient, sure, but certainly not life threatening. As general manager of a hotel in Idaho's picturesque Clearwater County, Statler spent his 12-hour days charming and chatting up guests, which meant he couldn't afford a week of bloated cheeks and Percocet. Nor, given his myriad responsibilities at the hotel, did Statler feel he could justify time off for at-home recovery. So he procrastinated until the pain was almost unbearable and eating a turkey sandwich felt like chewing tacks.

Two months after he finally underwent the operation, Statler was still waiting for relief—his molars were gone but the pain remained. Not only did he find it excruciating to chew, but now he was losing weight and beginning to feel emotionally beat down. He decided to return to his dentist, who sent him to a local ear, nose, and throat specialist the same day. The ENT needed just minutes to solve the mystery: He took one look at Statler and said, "Son, I think you have cancer."

Statler couldn't believe it. A former college athlete, he still ran nearly every day, never smoked, and drank only a few beers a week.

"My wife used to say I was the healthiest man she'd ever known," he says. The average oral cancer patient, by contrast, is a lifelong smoker or heavy drinker in his mid-60s.

An Invisible Enemy

You've probably heard of human papillomavirus, or HPV, the rampant sexually transmitted disease most often associated with cervical cancer in women. How rampant? Odds are good that you once had the virus, you have it now, or you will contract it soon. In fact, the CDC estimates that half of all sexually active people become HPV positive at some time in their lives. With 6 million new infections each year, HPV is the most widely spread and overexposed STD we've ever known—the Kim Kardashian of communicable diseases, if you will.

The reason HPV moves around the way it does has to do with its stealth: In 99 percent of cases, the disease is symptom-free. (The remaining 1 percent present as bumpy, cauliflowery warts on the penis or groin area in men and in and around the vagina in women.) Most people infected with HPV have no idea they have it, who they contracted it from, or that they could be infecting others.

Cancer researchers have known about HPV's connection with cervical cancer since the 1970s, but they've only recently discovered a similar link between the virus and oral cancer. For years, the rate of new head and neck cancers had been declining in tandem with falling smoking rates. But then, after noticing a major upswing in the number of young nonsmokers being diagnosed with oropharyngeal cancer—a form of oral cancer found in the tonsils and in the base of the tongue—doctors at Johns Hopkins acted on a hunch and began testing cancerous tissue for HPV. The resulting study, published in the New England Journal of Medicine, revealed that exposure to HPV-16, a high-risk strain known to cause cervical cancer, made patients 32 times as likely to develop oropharyngeal cancer. By comparison, the previous top risk factors—a history of heavy smoking and a history of heavy drinking—were found to increase that risk by just 3 and 2.5 times, respectively.

"HPV is replacing alcohol and smoking as the leading cause of oropharyngeal cancer," says Ted Teknos, M.D., a professor of medicine in the head and neck oncology program at Ohio State University's comprehensive cancer center. HPV fuels cancerous growth in a man's mouth much as it does in a woman's cervix: by integrating into his DNA and hindering the function of proteins that are supposed to reduce cellular stress and suppress tumors.

Figures from the National Cancer Institute reveal that between 1998 and 2008, oropharyngeal cancer rates rose 36 percent in men—or 3.6 percent each year on average. And sometimes its victims are shockingly young, even men in their late 30s, says Robert I. Haddad, M.D., chief of the center for head and neck oncology at the Dana-Farber Cancer Institute. "Many of these cases are missed or diagnosed late because there are no symptoms until it's moved into the lymph nodes; plus, the patient is young and otherwise healthy," he says.

Many doctors view the increase in HPV-related oral cancer as a direct result of a change in sexual practices in the past decade—that is, our orally promiscuous ways. Because HPV is a locally invasive virus, it can spread to your mouth only through direct contact. (In other words, HPV in or around your penis won't "travel" on its own through your body to your mouth.) The most likely way to contract oral HPV is to perform oral sex on an infected partner. However, simply kissing someone who has oral HPV can also lead to infection, according to many researchers who believe that it's possible for HPV to be transmitted through saliva.

It should seem obvious, then, that oral sex is not safer sex—and that your chances of developing oral cancer increase with every type of sexual encounter. According to the same New England Journal of Medicine study, people who have had six or more oral sex partners over the course of their lifetime are nearly nine times as likely to develop oropharyngeal cancer.

"Many people don't think oral sex counts as sex," says Gregory Masters, M.D., an oncologist at the Helen F. Graham Cancer Center in Newark, Delaware, and a spokesman for the American Society of Clinical Oncology. "But oral sex comes with risks. And cancer may be one of them."