July 18, 2024 • 44 mins
Human papilloma virus, HPV, is an unusually common bug among humans. Most of the time it’s benign and your body manages to overcome the infection. Sometimes it can linger and cause warts. But in the worst cases, HPV infections can actually cause cancer.
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Speaker 1 (00:01):
Welcome to Stuff you should know, a production of iHeartRadio.
Speaker 2 (00:11):
Hey, and welcome to the podcast. I'm Josh, and there's
Chuck and Jerry's here too, and this is stuff you
should know.
Speaker 1 (00:18):
Now.
Speaker 2 (00:18):
I've got an intro for this.
Speaker 1 (00:19):
Chuck, you're ready, Yeah, let's hear it.
Speaker 2 (00:22):
Dearly beloved, we are gathered here today to talk about
this thing called human papioma virus. What do you think.
Speaker 1 (00:32):
That's good? I hear the beat starting in the background.
Speaker 2 (00:35):
It's just a good, good album. We got to add
some kind of good spin to this.
Speaker 1 (00:41):
Sure, while we're talking about HPV, like you mentioned, and
we should say right out of the gate, HPV is
a very very very very common sexually transmitted infection. If
you have HPV or have had it, you may have
not even known about it, perhaps because your body just
(01:02):
took care of it. But if you have it and
you know about it, or have had it and knew
you had it, it's no big deal. For the most part,
it's nothing to be ashamed of. It is very very common.
Speaker 2 (01:14):
It is the problem is this, like that would be
the end of the episode if if HPV wasn't a virus. Actually,
the first virus found to cause cancer. That is rare
in and of itself, compared to all of the HPV
infections that are running around the world at any given time.
There's a lot, and there's a lot of different types
(01:36):
of HPV, but because it causes cancer, it's drawn a
lot of interest from the biomedical community. And luckily, what
we're finding is that HPV is super treatable if your
body doesn't clear it up on its own. And in fact,
there's an amazing vaccine out there that is one of
the better, more effective vaccines on the market today for anything.
Speaker 1 (01:56):
That's right, and if people get this vaccine, were potentially
looking at eradicating at least HPV caused cervical cancer.
Speaker 2 (02:05):
Yeah, just getting rid of it. So long, goodbye cervical cancer.
You're a thing of the past. And because we brought
up the vaccine so early, I believe I heard the
sound of one hundred thousand people skipping to the next
episode or maybe finding a new podcast altogether.
Speaker 1 (02:19):
Oh come on. So the other thing that you might
think about when you hear of HPV besides cervical cancer
is genital warts. Maybe the last few or made people
have tuned out now, right, But we're gonna dig into
this because those including talk of genital awards and cervical cancer.
But HPV itself, we should say, is a larger name,
(02:42):
an umbrella term basically for many, many different viruses. But
there are a handful that are pretty key to our
story here, and they are you'll hear say, various numbers
like HPV eleven, HPV sixteen. That's how they have them labeled.
Speaker 2 (02:59):
Yeah, and one of the stars the villain, I guess,
is HPV sixteen. It's the strain that causes the most
kind of cancers and it's actually it's really ancient. Like
the reason they call it human pepioma virus is because
it is specific to humans, Like you can give it
to your dog all day long and your dog's not
gonna get it. Your dog here has pepio right, Your
(03:22):
dog and other animals have pepioma viruses. Apparently, cottontail rabbits
get warts very easily from their papioma virus, and we
can't get it from them, So it's very very specific.
And HPV sixteen, which is a kind of human papioma
virus that causes cervical cancer, among others. They believe that
(03:44):
humans us modern Homo sapiens got it from Neanderthals and
Denisovans when we used to have sex with them and
them with us.
Speaker 1 (03:54):
You know what you gotta do before you try and
give your dog HPV? Though, Well, you gotta make upset.
Speaker 2 (04:02):
I don't get it. What you gonna make your dogs
sit before you give it HPV?
Speaker 1 (04:09):
All right, I'm just gonna scoot right on past that one.
Speaker 2 (04:12):
Okay.
Speaker 1 (04:13):
So we're talking a little bit of history. We'll see,
we'll do a pull of people who get that joke
and don't I want to hear from it.
Speaker 2 (04:20):
Okay, all right, Well, you explain it later and i'll
see if I'm guessing it right. All right?
Speaker 1 (04:25):
Uh No, I get chastised for explaining jokes, so I'm
not even gonna do that this time. We'll let the
people speak.
Speaker 2 (04:31):
Wait, why don't you do it next time? I really
want to know this, I'll tell you after, Okay.
Speaker 1 (04:37):
So, looking at our history of human beings, people have
long suspected that warts that you see, like you got
a word on your nose or a word on your elbow,
there was an infection that was responsible for that happening. Finally,
we prove that in the middle of the nineteenth century
(04:59):
or so, when the people there were scientists that were
intentionally trying to give themselves warts and it worked by
infecting their skin. So like, all right, we figured that
out with more extracts. Yeah, gross, it's trying to point
that out. So it took a little while for that
to go downstairs and apply to genital awarts, because people
(05:23):
thought for a very long time, hey, if you have
genital awarts, that's just a symptom of like syphilis or something,
and we eventually learned that that's not the case at all.
Speaker 2 (05:32):
Yeah, there was a nineteen seventeen German paper that purposely
infected a virgin girl to prove that genital warts exist
outside of STIs that's it's its own thing, and they did.
They proved it. So there's another thread going on. At
the same time, back in the nineteenth century, they figured
(05:56):
out that cervical cancer was a strange conundrum scientifically speaking,
because if you took a group of nuns and you
took a group of married women and put them together,
the incidents of breast cancer would probably be about the same,
the incidents of lung cancer probably about the same. The
one that diverged is cervical cancer, and they couldn't figure
out why because it didn't really make sense, except the
(06:18):
only way that did make sense is that cervical cancer
somehow developed from a sexually transmitted infection.
Speaker 1 (06:25):
I wonder if like one person knew it and they
were sharing with other scientists and they were like, I
don't know, and they're like, what do nuns not do that?
Other married ladies might doine no, no, with something am
on you and in the bedroom, maybe watch TV.
Speaker 2 (06:45):
I don't know, just tell me.
Speaker 1 (06:48):
Oh, there's a good sketch in there somewhere.
Speaker 2 (06:50):
I think. Sure. So they figured all this out, they
put it all together, and they finally realized thanks to
a German virologist, another one named Horror Zerhausen great name.
In nineteen eighty three, he found that if you took
a specimen of cervical cancer a biopsy and studied it closely,
you would actually find a papioma virus inside, and specifically
(07:14):
it would turned out to be what we now know
as HPV sixteen. The chances are there's going to be
some form of HPV sixteen found in that biopsy in
that cancerous cell taken from a cervical cancer patient.
Speaker 1 (07:29):
That's right, And like you said, that was in nineteen
eighty three. Flash forward to two thousand and eight when
Harald Zerhausen gets a Nobel Prize in Physiology or Medicine
for his continued work developing that HPB vaccine that we mentioned. Right,
it's a nice word, Housen.
Speaker 2 (07:48):
Yeah, way to go. I think he deserved it because
he found this is the first virus that we've ever
shown to cause cancer. It's like this whole field of
medicine that's starting to kind of wrap its around the
role that viruses playing all sorts of diseases. I know
there's a hypothesis that schizophrenia might actually be triggered by
a dormant virus that comes to life later on around
(08:12):
your teenage years. So this is the first time we
pointed to it. And that's one of the things that
makes HPV so fascinating. There's not a lot of viruses
running around that cause cancer, and this one definitely does.
Speaker 1 (08:23):
Yeah. So we mentioned that it's a lot of viruses
over two hundred if you want to get a little
more exact, and they generally divide these into a couple
of different groups, the cutaneous and the mucosal types cutaneous
HPVs are. This is where you think of the worts.
They infect the skin. If you have like planar worts
(08:45):
on your feet, or you have worts on your hands
or something like that, it's because of the cutaneous type
of HPV, the mucosal type. And it's a little grosser
here because we have to say the word moist, but
they specifically infect moist parts of the boy. This is
where you get warts on genitals, your throat, maybe your nose,
(09:06):
your anus, your cervix of course, and your inner eyelids,
which can't be comfortable.
Speaker 2 (09:12):
Yeah, And because all of those or a lot of
those are sexy parts, the inside of your eyelid. Notwithstanding,
it goes to show that HPV infection can be transmitted sexually.
It's not all the time like the other kind of
the cutaneous type that causes plantar works. You can get
that from walking around a pool, a pool deck or
(09:34):
somewhere there's HPV hanging out. But it's a different kind
of HPV HPV sixteen that can cause cancer. That is
a sexually transmitted HPV. It's mucosal and it's also in
a subcategory of mucostal HPV called high risk. There's high
risk and there's low risk, And as you may guess
just from the names, high risk typically leads to cancer
(09:55):
or can. The low risk almost never does.
Speaker 1 (09:58):
Yeah, that's right. If you think, hey, can I use
a condom to get around this? That helps. But HPV,
the mucoastal type of lead, doesn't require bodily fluids for transmission.
So if you are sexually active as a person, and
you have been so for a few years, then chances
(10:19):
are you've probably had HPV and maybe not even known it.
Speaker 2 (10:22):
Yeah, and that's a really big point that you don't
have to exchange body fluids. And also, similarly, Chuck, I
want to make sure it's totally clear genital awarts doesn't
cause cancer. It's a different type of HPV. So you
actually can give somebody genital awarts from sexual contact, but
that's almost certainly not going to lead to any kind
(10:43):
of cancer. They're just different types, even though they can
be passed along similarly through skin to skin contact.
Speaker 1 (10:49):
That's right.
Speaker 2 (10:51):
So yeah, I think you said just from being sexually active,
you're probably going to pick up some form of HPV.
Another about fourteen million Americans, Yeah, just Americans. Alone get
a new infection every year. There's at least eighty million
Americans running around with an HPV infection right now. And
(11:13):
if you do the math, here in America, we have
a pretty close replacement rate where we have just a
few more one hundred thousand berths than deaths every year. Right,
so let's just say that's a wash. At fourteen million
new infections every year, that means everything's staying exactly the
same as it is now. In twenty four years, every
(11:34):
single American will be infected with HPV. And we already
said that HPV sixteen we got from Neanderthals, so it's
been around a really long time. So it makes you wonder, well,
why this sudden surge in infections. And apparently a lot
of the incidences of HPV, or this rise in incidents
can be traced to changes in sexual morais and behaviors
(11:55):
that have occurred over the last few decades.
Speaker 1 (12:00):
We just put a pin in that. Sure, Okay, we'll
reveal what that might mean later on. Maybe we should
take a break. Yeah, yes, pretty good intro, and we'll
talk about genital warts when we get back. All right,
(12:44):
so we're back, We promise talk of more talk that
is of genital warts. I believe you mentioned the low
risk mucosal type usually six and eleven HBB are the
ones that calls these warts or other you know, moist membranes,
mucous membranes. They don't generally cause a lot of health
(13:07):
problems or any really, they can be painful. Sometimes they
can be itchy. Obviously, there's a lot of embarrassment that
surrounds genital awarts. Just saying those words together isn't something
you're probably gonna like advertise to people.
Speaker 2 (13:23):
No, you don't say, like, just disregard my genital awarts.
Speaker 1 (13:26):
Yeah, I mean, well, I'm sure plenty of people have
said that, but who knows.
Speaker 2 (13:29):
It doesn't always work.
Speaker 1 (13:30):
That's what it works. But it's nothing to be ashamed
of because it is quite common and they can be removed.
Sometimes medication can do it. Sometimes they'll do the old
freeze with liquid nitrogen routine.
Speaker 2 (13:44):
I used to get that. I got warts on my
elbows and I used to get it burned off with
liquid nitrogen pretty regularly. I think it's.
Speaker 1 (13:50):
At Yeah, I feel like I've had that done with.
I think I had plan awarts that they did that too.
When I was in college.
Speaker 2 (14:00):
Yeah, I mean you can get rid of warts that way.
Speaker 1 (14:03):
Yeah, there's also lasers these days that can handle that
different different methods to get rid of those general awards
in due time. So don't worry about it. If you
have those people, just you know, keep soldiering on. You'll
be okay.
Speaker 2 (14:20):
Yes, So there are some some types of HPV infections
that lead to warts mucoastal warts that can be a problem.
There's one in particular, Respiratory pepiomatosis is a condition that's
caused by warts and the airways, and it typically happens
in kids and it's treatable, but it can narrow the
(14:42):
airway and that in and of itself is problematic. They
think that it's transferred, that HPV infection is transferred during
birth or from the antiotic fluid inside the womb. But
it's pretty it's pretty rare. It's one of the rare
ones that Okay, this is actually be a bit of
a health problem from.
Speaker 1 (15:02):
Warts, Yeah for sure, But that is only in young children.
It's usually you see it between the ages of two
and six. It canic are and adults. But I think
it's even more rare. But again, you can remove these surgically,
so you can get that taken care of as well.
Speaker 2 (15:20):
Yeah, Plus you get to go back to school in
the fall and be like, yeah, they shot lasers down
my throat, what did you do this summer?
Speaker 1 (15:26):
That's right to get rid of my warts. Ye. There's
also infections with the high risk kinds of APV that
don't clear up on their own, and these are the
ones that could eventually lead to cancer.
Speaker 2 (15:43):
Yeah. So this is a very very long process. But essentially,
this HPV infection that can is akin to causing warts,
just causes hijacks a sell just like any other virus,
causes it to multiply and multiply and multiply, and then
has these cells rupture. They released more viruses into the
(16:03):
extracellular membrane, and they get into more cells and it
just gets worse and worse. The difference between an HPV
infection and other types of infections from viruses is that
they're not systemic. They stay very very localized, and so
they form a very recognizable legion.
Speaker 1 (16:20):
Yeah. But it isn't just cervical cancer though, that we
should point out. I believe there are six kinds of cancer.
I think the data that we got was this Libya?
Did she help us with this?
Speaker 2 (16:32):
Yeah? Hats off, I can tell.
Speaker 1 (16:35):
In a good way. I was like, oh, geez, I
could tell.
Speaker 2 (16:39):
All the dirty jokes. Yeah, we can't say.
Speaker 1 (16:43):
Twenty twenty one is when we got the latest CDC
data with more than thirty seven thousand cases of cancer
associated per year of that are associated with HPV twenty
two thousand and women sixteen thousand and men. And the
six kinds of cancer or I guess the five besides
cervical are anal cancer, penile cancer, vaginal cancer, bulvar cancer cancer,
(17:11):
bulvar cancer. Man. That's hard to say.
Speaker 2 (17:14):
It is.
Speaker 1 (17:14):
That's a good pre stage warm up. Okay, so you
hear me backstage saying good lord. And then finally oro
fairyngeal cancer, which is the base of the tongue, the
back of the throat tonsils. You can also get that
through tobacco use, not surprisingly, so you should also not
(17:34):
be surprised to learn that as tobacco use has gone down,
so have incidences of non HPV oro fare engeal cancer.
Speaker 2 (17:42):
But incidents of orofair andngeal cancer overall has increased because
there's been a rise in HPV infections to that man,
and I think I made it pretty clear. HPV sixteen
is one of the big batties of this episode. So
is HPV eighteen. Those are the two most common cancer
(18:03):
causing types of HPV. They're responsible. HPV sixteen is responsible
for ninety percent of HPV related orofare andngeal cancers, half
of all cervical cancers, and all the other cancers that
are related to HPV. It's it makes up a significant
portion of them, just sixteen alone.
Speaker 1 (18:22):
Yeah, and I think eighteen causes twenty percent of cervical cancer.
So between those two, you know, you're looking at seventy percent.
Speaker 2 (18:29):
So let's talk cervical cancer, shall we, Because it is
a it's really important. It's become I guess, how do
you put it. It's really emerged as a condition that's
gotten a lot of attention because there's so much potential
for getting rid of it altogether.
Speaker 1 (18:48):
Yeah, and it's a situation where here in the United States,
due to early detection and treatment, it is really really lowered.
I think it's gone down by more than fifty percent
from the mid seventies to the mid two thousands and
only and you know, of course four thousand people. It's
a lot of people. But when you're talking about what
(19:09):
the rates could and would have been in the past,
four thousand Americans dying of cervical cancer each year is
a lot of progress has been made.
Speaker 2 (19:19):
Yeah, And overall, I think there's three hundred and fifty
thousand deaths from cervical cancer worldwide every year. Yeah, And
I mean Americans make up a decent portion of the
world population, but not a good portion of the cervical
cancer death population. The reason why is because America has
a really robust screening process that is easily accessed by
(19:43):
American women to search for cervical cancer and catch it
early on, and it's not nearly as robust in some
other developing parts of the world.
Speaker 1 (19:53):
Yeah, because in America, once you turn twenty one, if
you're a woman, generally for about from about twenty one
to sixty five, you're going to be getting a PAP
test about every three years, or at least you're supposed to.
And the US Preventative Services Task Force the USPSTF says
(20:16):
if you're under thirty, they don't recommend that you get
tested for HPV unless you have some you know, some
pretty obvious risk factors. Why, well, because generally by then
you have probably gotten it and it is probably cleared
up on its own. And that also means that you
have some kind of immunity, sometimes very long lasting immunity.
Speaker 2 (20:40):
Yes, so they say, don't bother with the HPV test,
but definitely do get your PAP test. PAP, by the way,
isn't short for papioma. It's short for the guy who
came up with the test. Georgios Papa Nicolau pap, I
guess to his friends and family. Sure, so that's looking
for abnormal cells in your cervix. If they find that,
you test for HPV to see what kind of HPV
(21:02):
infection you might have that could account for those abnormal cells.
And then the American Cancer Society says, forget that, just
start at twenty five. Forget the PAP smerror, start with
an HPV test, like if you have to prioritize one,
do that. Yeah, And you might say, well, I'm confused.
The Preventative Services Test for says thirty and focus on
(21:24):
the PAP test. In the meantime, the ACS so sort
the PAP test out, focus on the HPV test starting
at twenty five, which one should I choose, And you
don't have to worry if you're an American, because your
insurance company will choose for you, and that'll probably be neither.
Speaker 1 (21:40):
That's right. If during your screening you happen to see
what's a pre cancer or a dysplasia, then what they're
probably going to do next is to examine the cervix.
It's not a pleasant process. It's done using an instrument
called a colposcope. You may get a biopsy performed, but
(22:03):
a lot of times it's a minor thing that's going
to go on its own, and so what they what
they might do is say, hey, let's just monitor this
thing instead of removing it, and just sort of get
you tested more regularly to see what's happening with that.
Speaker 2 (22:17):
Hey, welcome to your year of anxiety. Yeah until your
next test. It sucks, Yeah, but the odds are with you. Yeah, yeah,
for sure, because we've got this early screening, because they
have like a lot of tale signatures. They might they
may also do a biopsy. If it does seem like
(22:38):
it's a big deal, they may do more invasive surgery.
But for the most part, we'll set cervical cancer aside
for a second, until we get to the vaccine. It's
if you go get a PAP test and you do
some form of HPV testing whether if needed, you're probably
going to catch it early for it to be treated.
Speaker 1 (23:01):
That's right, that's the great news with cervical cancer. Unfortunately,
the other kinds of cancer is the other five that
we mentioned caused by HBB. There isn't a routine screening
for those or preventative treatments for those. And that is
one of the reasons why you mentioned oor a fair
andngeal cancer is growing even though tobacco use and tobacco
(23:25):
caused oor a fair and geal cancer is falling.
Speaker 2 (23:29):
Yeah, because people stopped using tobacco as much, but they
replaced tobacco use with oral sex, which is one of
the it's actually the biggest risk factor now for developing
oor fair andngeal cancer. And the more oral sex partners
you've had, the greater your risk of developing oro faar
andngeal cancer a few decades later. Is as a matter
(23:52):
of fact, So that's what I was saying earlier, when
I was saying that there's been a change in sexual
morais and behavior. Oral sex has become much more prevalent
since the sixties and seventies than before, and a lot
of those men in particular, are starting to age into
that point in their life where that HPV infection is
(24:15):
developing into a cancer and is developing into orofair andngeal cancer.
Speaker 1 (24:20):
Right, and we're talking specifically about oral sex performed on women.
So I guess the idea is that you can get
that HPV and many many years later, when you're, like
you said, in your fifties or or sixties, that's when
it might rear its ugly head.
Speaker 2 (24:40):
Yeah. Do you remember when Michael Douglas said that he
had oral cancer throat cancer, I think, and he's like,
it's from oral sex.
Speaker 1 (24:47):
Yeah, and everyone laughs.
Speaker 2 (24:48):
Yeah, that's exactly what he was talking about. And he's
right in that age group of boomers that were like,
you know, let me try this right back in the day.
So we don't I have a good handle on really
anything besides cervical cancer. So the orofare engeal cancer field,
like the researchers and doctors who study this kind of stuff,
(25:11):
were like, Okay, it's go time for us, because you know,
we thought everything was just ducky with the tobacco usee
going down, and now we've got this, we've got to
figure this one out.
Speaker 1 (25:21):
That's right, Good time for a second break, I think.
So all right, great, we're going to take a break,
and you know, we talked about the vaccine a couple
of times. We're going to come back and put all
our cards or all our vaccine cards on the table
right after this.
Speaker 2 (25:42):
Star Chuck, before we move on to the vaccines, which
(26:09):
I agree we should do post taste, we do want
to mention that the other kinds of high risk HPV
mucosal cancers include I think, like you said, anal cancer,
vulgar cancer, penal cancer, and vaginal cancer, and they start
to get much much more rare, starting with anal cancer
down to vaginal cancer as far as cancer cases go
(26:33):
caused by HPV. Hopefully we'll be able to figure this
out and there won't be any of those cases. But
that's another reason why cervical cancer got so much attention,
because there was it was much more prevalent, in addition
to much more treatable.
Speaker 1 (26:49):
That's right, I'm glad you said that stuff.
Speaker 2 (26:52):
So now we can talk about the vaccine.
Speaker 1 (26:54):
Okay, yeah, let's do it.
Speaker 2 (26:58):
There are two guys, Jean Jao and Ian Fraser, and
they both worked at the University of Queensland. I believe
Ian Fraser ran the lab in Jean ju Jao and
his partner worked for Ian Fraser, and together they started
studying HPV, specifically HPV sixteen, and they figured out that
(27:21):
you could take HPV sixteen and isolate proteins from it,
and you could use those proteins ostensibly in a vaccine,
and in very short order, within a few well a
decade or so, like a vaccine finally did come out.
Apparently the drug companies took some pep talks I guess
(27:43):
about how much money they could make on this. They
finally saw the light and we ended up with the
HPV vaccine in two thousand and six. The first one
was called Gardaseel, and I remember when this came out
from the outset. It came out essentially in the midst
of the firestorm of the vaccines caused autism stuff that
(28:03):
was going on at the same time. Merk was like, hey,
we got a new one. Everybody, come check this one out.
Speaker 1 (28:09):
That's right, it's meant for girls and women between nine
and twenty six years old. There's a group called the ACIP,
the Advisory Committee on Immunization and Practices, that said, you know,
this stuff's good to go, let's get it out there.
And it protected against HBB sixteen and eighteen, which is
(28:32):
the most common high risk types we talked about, and
then six and eleven, which caused more readily caused the
a genital awards, so it basically kind of took care
of the four bad guys.
Speaker 2 (28:44):
Yeah, after this thing was released, they started launching studies
on the real world studies on people who gotten and
they found like, this is actually pretty good at protecting
people against those four HPV strains, and they also figured
out that it could protect men against genital wards and
(29:05):
anal cancer because anal cancer or HPV that causes anal
cancer I think sixteen or probably eighteen as well, can
be transmitted from anal intercourse I can't remember, receptive anal intercourse,
that's the word, and so you can transmit it like that.
(29:26):
And they found that if men got this vaccine, it
protected them against that, which was pretty surprising because at
the beginning they're like, yeah, we just need to give
this to little girls, and then they were like, no,
we need to give it to little boys too.
Speaker 1 (29:38):
That's right. So that was in two thousand and nine
when the FDA licensed it for boys and men from
nine to twenty six, and again a couple of years
after that is when the ACIP said, yep, we should
get it, get it going in that population.
Speaker 2 (29:54):
Yeah. So at the same time, Glaxo smith Klein said
us too, we want to make some money off of
this too, and they released Cerverix, which I guess just
never really picked up steam against Gardisil, because in twenty
fourteen Merke released Garticil nine and that is essentially the
de facto HPV vaccine in most of the developed world.
(30:16):
It protects against, as you might have guessed from the name,
nine different strains of HPV, not just the common ones,
but also some less common ones that are still high risk.
And they also found again through more clinical trials and
more real world studies that these things were really really
effective at protecting kids if you gave them this vaccine
(30:40):
before they became sexually active. Is one of the really
big keys here is once you're infected with the strain
of HPV, that vaccine won't protect you against that strain.
It'll protect you against the other strains that you haven't
gotten yet. But it apparently won't do anything. It doesn't
cure any HPV infections. It just defends against them from
(31:01):
you from getting infected with them.
Speaker 1 (31:03):
Yeah, and that's why they went from nine, you know,
down to nine years old. It's two shots six months
to a year apart. If you're older than fifteen, I
believe you have three shots over a six month period.
And if you're like, well wait a minute at the time,
(31:23):
like you're like, well, I'm older now, and this stuff
just came out and sucks for you. Yeah, well they
you know, you're not going to get the full benefit
necessarily from that vaccination, but they said it's still maybe
worth getting if you weren't vaccinated as a kid.
Speaker 2 (31:41):
Especially if you had fewer sexual partners, so less sex.
The older you are, the likelier the vaccine is to
protect you against it later in life.
Speaker 1 (31:53):
Right, And if you were a forty year old virgin,
then they made a movie about you, Steve Carell pretty
good movie too. Yeah, I like that one.
Speaker 2 (32:01):
So, like I said, this thing was released in the
midst of the vaccine vaccines caused autism firestorm, and so
it was controversial, right, out of the gate. But Rick Perry,
who was governor of Texas at the time, did not
help things at all. He did something that seems extraordinarily
bizarre today in retrospect. He was the Republican governor of
(32:23):
Texas who ended up serving as Department of Energy secretary
under Trump, and he mandated as governor that every girl
entering sixth grade who lived in Texas had to get
the Gardasil vaccine in two thousand and seven, a year
after it got FDA approval, And that did not sit
(32:46):
well with a lot of parents.
Speaker 1 (32:49):
No, a lot of parents were either just you know,
sort of like stuff you hear about today, like you know,
parents rights groups saying that we want to make those decisions.
Some of them were part of the anti vaccine movement
and some of them also and just people in general
I think, were like, well, wait a minute, Perry, you've
got you're cozied up to these lobbyists for MERK, Like,
(33:11):
is that what's going on here? So it was a
big deal. And like you said in retrospect, is it's
very odd to see at Texas republican governor mandating vaccines
for anybody.
Speaker 2 (33:21):
Yeah, and Rick Perry had big time ties to Mark.
That was the only HPV vaccine on the market at
the time, so it's not like he could choose from
a different type, but it just those ties made the
whole thing smell fishy. There was another really big thing
that parents came out against. There was a lot of
fear that when you vaccinated your kid with an HPV vaccine,
(33:46):
they were going to run right out and start having
receptive anal sex because now they were protected. They're going
to have intercourse or you have oral sex starting at
age nine because you just gave them this license to
go have sex because you vaccinated him against HPV. And
that was the one that the most vocal opponents sounded
the alarm about. But it turns out from studies follow
(34:10):
up studies about hesitation of HPV vaccine hesitancy among parents
that's almost like not even on the charts, Like very
few parents are actually worried about that. They're more worried
about things like whether it's safe, or they think that
their kid actually doesn't need it because my kid's ugly.
Like there's a whole other cadre of reasons, and that
(34:32):
one apparently didn't pan out, and studies that looked at
it that possibility, found that girls who had been given
the HPV vaccine preteen, compared to girls from the same cohort,
had no more incidences of seeking birth control, of pregnancies,
or of any other things that indicated they had more
(34:52):
sex than the girls who weren't vaccinated with the HPV vaccine.
Speaker 1 (34:56):
Yeah, and I bet one reason is because parents probably
didn't say, all right, you're going to the doctor and
you're getting this vaccine, and you know what that means.
So the other one of the other things that popped
up was the idea that whether or not you need
to vaccinate boys. In twenty eleven, that was a story
(35:19):
in the New York Times that basically kind of suggested
that the biggest benefit for male vaccination was either protecting
female partners, because well, it was protecting female partners because
the only way to if you're going to get it
as a man or a boy, is to have, like
you said, had that receptive anal sex. And so we've
(35:43):
learned since then that straight men are also at risk,
especially for that oro fare andngeal cancer. So that was
sort of I mean, I was about to say quickly quash,
but also it wasn't because people got up in arms
about it.
Speaker 2 (35:56):
Yeah, because I mean they HPV sixteen causes seventy percent
of oral cancers, right, So if you give a boy
the vaccine against HPV sixteen, you're going to take a
big bite out of that possibility of them developing oro
fare and geal cancer later in life. It just makes sense.
So it does make sense for boys and girls to
(36:17):
both get the vaccine. And yet there's thanks to the
anti vaxx movement, thanks to Rick Perry and his merctise,
thanks to that study that linked autism with vaccines, they're
still today just a lot of hesitancy in mandating HPV
as part of a required vaccine schedule among boys and
(36:39):
girls in America. I think Delaware, Rhode Island, Hawaii, Virginia,
and DC are the only ones that require vaccines for students.
They require it for boys and girls. But even with
that hesitancy among states, among individuals, the cases of cervical
cancer and death from cervical cancer have fallen dramatically since
(37:03):
two thousand and six when we started vaccinating kids against HPV.
Speaker 1 (37:08):
Yeah, I mean, that's the one takeaway is that this
is a vaccine that really seems to work. Yeah, there's
a study in twenty twenty one that found that among
women who had been vaccinated between twelve and thirteen, there
were eighty seven percent fewer cases of cervical cancer.
Speaker 2 (37:26):
Yeah, that's nuts. And Johns Hopkins came up with a
model that said that because of vaccination rates among men,
there should be one thousand fewer cases of oro a
fare and geal cancer by twenty forty five. You might
be like, that's it, that doesn't seem like that much. Well,
the reason why is because only twenty to thirty percent
of boys age thirteen to seventeen are getting that vaccine.
(37:48):
If you increase that percentage to like what girls are getting,
which is more like the sixty to seventy percent range,
it would take an even bigger bite out of or
a fair geal cancer in the future, because those kids
will eventually ate and if they got the vaccine, they
won't have contracted that strain of HPV.
Speaker 1 (38:04):
That's right. How many people are getting this vaccine more
and more. In twenty twenty two, fifty fifty seven percent
of kids between the ages of fifteen and seventeen had
it gotten at least one dose. If you are from
a family that has parents that are college educated and
(38:25):
maybe a little more money, you're more likely to be
vaccinated against it, statistics show, and you know, public public
education is one of the big reasons that people are
more aware of it and more inclined to get it.
Speaker 2 (38:38):
Yep, So I guess that's it, Chuck.
Speaker 1 (38:41):
HPV.
Speaker 2 (38:44):
Yeah, if you want to know more about HPV, there's
a lot to go read out there and educate yourself on.
Same with the HPV vaccines that are available. You should
probably read up on anything like that first, but make
sure that you are getting your info from trusted so horses.
And since I said that, of course it's time for
listener mail.
Speaker 1 (39:06):
This is good because it ties into an episode on
whistling and something we both love, which is whistling the scorpions.
Speaker 2 (39:14):
Oh yeah, I love this one.
Speaker 1 (39:16):
Hey, guys, listening to the show about whistling and got
to the part of the episode about popular songs and
as I hoped you guys, did mention the classic wind
of Change by scorpions. Side note, he says it's just scorpions,
not the Oh sorry, I didn't know that. Kind of
like eagles and Indigo girls.
Speaker 2 (39:34):
And Edie brickl and New Bohemians.
Speaker 1 (39:36):
Yeah. And Edie Brikel and New Bohemians. Yeah that's right. Yeah,
you know what you said. Yeah yeah, brand New Bohemians.
Speaker 2 (39:46):
And brand New Heavies.
Speaker 1 (39:48):
That's right. Oh god, I used to love.
Speaker 2 (39:49):
That band and New Pornographers.
Speaker 1 (39:52):
Oh well, you know I still love them.
Speaker 2 (39:55):
Who else? Jethro Tull?
Speaker 1 (39:56):
Okay, I look Jet Throw Toll too. Oh god, he
whistled through his flute. However, guys, I was at half
expecting one of you to mention this crazy fact, and
you passed over it. Just state it briefly. There exists
a conspiracy theory that the song Wind of Change was
written or partially written by the CIA as a mode
of propaganda to help bring an end to the Cold War.
(40:17):
I'd never heard this ad.
Speaker 2 (40:18):
You no, but it really rang true because I remember
when the song came out and what the sentiments were.
Speaker 1 (40:24):
Like, Oh sure, down to God, keep back. The song
was written and released just months before the Berlin Wall
was brought down and became hugely popular throughout the Soviet
Union at the time. A political leaning song was very
out of character for Scorpions. I just can't say it. Yeah,
that just picture a bunch of Scorpions.
Speaker 2 (40:45):
Yeah, it doesn't quite sit right. It's not like Jetro Toll.
Speaker 1 (40:50):
No, very out of character for thus Scorpions, and the
band claims that the song was written by lead singer
Klaus Meinik, who typically never wrote music for the group.
I didn't know that either, their manager, Doc McGee. Somehow
weaseled out of a large drug case with a mysterious
deal from the US government. The Scorpions claim the song
was inspired during a rock festival called the Moscow Music
(41:13):
Peace Festival, where the bands were surrounded by CIA and
KGB handlers. The interesting wrinkles go on from there. Probably
not doing it justice, but highly recommend the podcast Wind
of Change by Patrick Raiden Keith, which chases down a
number of these connections and threads. If nothing else, it's
a pretty amusing story about the eighties hairband. They were
(41:36):
more than a hairband.
Speaker 2 (41:37):
Yeah, they were political hairband.
Speaker 1 (41:39):
Yeah that's right. I hope this email finds you guys
well have been a huge fan for years. I'm glad
I could share this with you. That is Jimmy from Spokane,
Washington and Jimmy, I want to just follow up and
Josh with a recommendation of my own. If you're a
fan of Scorpions, I recommend that you go look immediately
(42:05):
at the video for the song from nineteen seventy eight,
sales of.
Speaker 2 (42:10):
Charon Charon like the river Sticks Boatkeeper.
Speaker 1 (42:15):
Yeah, char On sales of char On ha Ron. Yeah.
If you only know the Scorpions from like the early eighties,
then check out this gym from nineteen seventy eight because
it's awesome.
Speaker 2 (42:26):
All right, Well, we've got a couple of minutes left
before we hit forty five, so I am going to
tell you about a movie that I watched last night
from nineteen seventy nine called Tourist Trap.
Speaker 1 (42:36):
Have you ever seen Jack? I don't think so.
Speaker 2 (42:40):
It is the definition of camp without intentionally being camp,
without being annoying camp. It's one of the best schlocky
late seventies horror movies I've ever seen in my life.
It is really good, all right, what you're in nineteen
seventy seventy nine. You can stream it online somewhere looking
(43:01):
at it, and if you have to pay for it,
please watch it. It's it's a really good one. It's
like a highly watchable, enjoyable movie. And there's some surprising
little like directorial like bits in there that you're like, well,
it seems sophisticated for this.
Speaker 1 (43:14):
Movie, Tany Roberts and Chuck Connors, aren't it. That's enough
for me.
Speaker 2 (43:18):
That's all you need right there.
Speaker 1 (43:19):
Yeah, ninety minutes also perfect.
Speaker 2 (43:22):
Yeah, so go forth look up sales of Charun video
by Scorpions.
Speaker 1 (43:29):
Yeah, you need to watch that one. You're you're gonna
love it.
Speaker 2 (43:31):
I still need to watch your whistling video that you
send me.
Speaker 1 (43:34):
Watch that.
Speaker 2 (43:35):
I know, I feel like a jerk. I'm sorry.
Speaker 1 (43:37):
All right, you got you got work to do.
Speaker 2 (43:39):
I do well. I'll well while I do that. Uh,
you guys, go out and send us a listener mail.
You can send it off to stuff Podcasts at iHeartRadio
dot com. Stuff you Should Know is a production of iHeartRadio.
Speaker 1 (43:58):
For more podcasts my heart Radio, visit the iHeartRadio app,
Apple Podcasts, or wherever you listen to your favorite shows.
Welcome to Stuff you should know, a production of iHeartRadio.
Speaker 2 (00:11):
Hey, and welcome to the podcast. I'm Josh, and there's
Chuck and Jerry's here too, and this is stuff you
should know.
Speaker 1 (00:18):
Now.
Speaker 2 (00:18):
I've got an intro for this.
Speaker 1 (00:19):
Chuck, you're ready, Yeah, let's hear it.
Speaker 2 (00:22):
Dearly beloved, we are gathered here today to talk about
this thing called human papioma virus. What do you think.
Speaker 1 (00:32):
That's good? I hear the beat starting in the background.
Speaker 2 (00:35):
It's just a good, good album. We got to add
some kind of good spin to this.
Speaker 1 (00:41):
Sure, while we're talking about HPV, like you mentioned, and
we should say right out of the gate, HPV is
a very very very very common sexually transmitted infection. If
you have HPV or have had it, you may have
not even known about it, perhaps because your body just
(01:02):
took care of it. But if you have it and
you know about it, or have had it and knew
you had it, it's no big deal. For the most part,
it's nothing to be ashamed of. It is very very common.
Speaker 2 (01:14):
It is the problem is this, like that would be
the end of the episode if if HPV wasn't a virus. Actually,
the first virus found to cause cancer. That is rare
in and of itself, compared to all of the HPV
infections that are running around the world at any given time.
There's a lot, and there's a lot of different types
(01:36):
of HPV, but because it causes cancer, it's drawn a
lot of interest from the biomedical community. And luckily, what
we're finding is that HPV is super treatable if your
body doesn't clear it up on its own. And in fact,
there's an amazing vaccine out there that is one of
the better, more effective vaccines on the market today for anything.
Speaker 1 (01:56):
That's right, and if people get this vaccine, were potentially
looking at eradicating at least HPV caused cervical cancer.
Speaker 2 (02:05):
Yeah, just getting rid of it. So long, goodbye cervical cancer.
You're a thing of the past. And because we brought
up the vaccine so early, I believe I heard the
sound of one hundred thousand people skipping to the next
episode or maybe finding a new podcast altogether.
Speaker 1 (02:19):
Oh come on. So the other thing that you might
think about when you hear of HPV besides cervical cancer
is genital warts. Maybe the last few or made people
have tuned out now, right, But we're gonna dig into
this because those including talk of genital awards and cervical cancer.
But HPV itself, we should say, is a larger name,
(02:42):
an umbrella term basically for many, many different viruses. But
there are a handful that are pretty key to our
story here, and they are you'll hear say, various numbers
like HPV eleven, HPV sixteen. That's how they have them labeled.
Speaker 2 (02:59):
Yeah, and one of the stars the villain, I guess,
is HPV sixteen. It's the strain that causes the most
kind of cancers and it's actually it's really ancient. Like
the reason they call it human pepioma virus is because
it is specific to humans, Like you can give it
to your dog all day long and your dog's not
gonna get it. Your dog here has pepio right, Your
(03:22):
dog and other animals have pepioma viruses. Apparently, cottontail rabbits
get warts very easily from their papioma virus, and we
can't get it from them, So it's very very specific.
And HPV sixteen, which is a kind of human papioma
virus that causes cervical cancer, among others. They believe that
(03:44):
humans us modern Homo sapiens got it from Neanderthals and
Denisovans when we used to have sex with them and
them with us.
Speaker 1 (03:54):
You know what you gotta do before you try and
give your dog HPV? Though, Well, you gotta make upset.
Speaker 2 (04:02):
I don't get it. What you gonna make your dogs
sit before you give it HPV?
Speaker 1 (04:09):
All right, I'm just gonna scoot right on past that one.
Speaker 2 (04:12):
Okay.
Speaker 1 (04:13):
So we're talking a little bit of history. We'll see,
we'll do a pull of people who get that joke
and don't I want to hear from it.
Speaker 2 (04:20):
Okay, all right, Well, you explain it later and i'll
see if I'm guessing it right. All right?
Speaker 1 (04:25):
Uh No, I get chastised for explaining jokes, so I'm
not even gonna do that this time. We'll let the
people speak.
Speaker 2 (04:31):
Wait, why don't you do it next time? I really
want to know this, I'll tell you after, Okay.
Speaker 1 (04:37):
So, looking at our history of human beings, people have
long suspected that warts that you see, like you got
a word on your nose or a word on your elbow,
there was an infection that was responsible for that happening. Finally,
we prove that in the middle of the nineteenth century
(04:59):
or so, when the people there were scientists that were
intentionally trying to give themselves warts and it worked by
infecting their skin. So like, all right, we figured that
out with more extracts. Yeah, gross, it's trying to point
that out. So it took a little while for that
to go downstairs and apply to genital awarts, because people
(05:23):
thought for a very long time, hey, if you have
genital awarts, that's just a symptom of like syphilis or something,
and we eventually learned that that's not the case at all.
Speaker 2 (05:32):
Yeah, there was a nineteen seventeen German paper that purposely
infected a virgin girl to prove that genital warts exist
outside of STIs that's it's its own thing, and they did.
They proved it. So there's another thread going on. At
the same time, back in the nineteenth century, they figured
(05:56):
out that cervical cancer was a strange conundrum scientifically speaking,
because if you took a group of nuns and you
took a group of married women and put them together,
the incidents of breast cancer would probably be about the same,
the incidents of lung cancer probably about the same. The
one that diverged is cervical cancer, and they couldn't figure
out why because it didn't really make sense, except the
(06:18):
only way that did make sense is that cervical cancer
somehow developed from a sexually transmitted infection.
Speaker 1 (06:25):
I wonder if like one person knew it and they
were sharing with other scientists and they were like, I
don't know, and they're like, what do nuns not do that?
Other married ladies might doine no, no, with something am
on you and in the bedroom, maybe watch TV.
Speaker 2 (06:45):
I don't know, just tell me.
Speaker 1 (06:48):
Oh, there's a good sketch in there somewhere.
Speaker 2 (06:50):
I think. Sure. So they figured all this out, they
put it all together, and they finally realized thanks to
a German virologist, another one named Horror Zerhausen great name.
In nineteen eighty three, he found that if you took
a specimen of cervical cancer a biopsy and studied it closely,
you would actually find a papioma virus inside, and specifically
(07:14):
it would turned out to be what we now know
as HPV sixteen. The chances are there's going to be
some form of HPV sixteen found in that biopsy in
that cancerous cell taken from a cervical cancer patient.
Speaker 1 (07:29):
That's right, And like you said, that was in nineteen
eighty three. Flash forward to two thousand and eight when
Harald Zerhausen gets a Nobel Prize in Physiology or Medicine
for his continued work developing that HPB vaccine that we mentioned. Right,
it's a nice word, Housen.
Speaker 2 (07:48):
Yeah, way to go. I think he deserved it because
he found this is the first virus that we've ever
shown to cause cancer. It's like this whole field of
medicine that's starting to kind of wrap its around the
role that viruses playing all sorts of diseases. I know
there's a hypothesis that schizophrenia might actually be triggered by
a dormant virus that comes to life later on around
(08:12):
your teenage years. So this is the first time we
pointed to it. And that's one of the things that
makes HPV so fascinating. There's not a lot of viruses
running around that cause cancer, and this one definitely does.
Speaker 1 (08:23):
Yeah. So we mentioned that it's a lot of viruses
over two hundred if you want to get a little
more exact, and they generally divide these into a couple
of different groups, the cutaneous and the mucosal types cutaneous
HPVs are. This is where you think of the worts.
They infect the skin. If you have like planar worts
(08:45):
on your feet, or you have worts on your hands
or something like that, it's because of the cutaneous type
of HPV, the mucosal type. And it's a little grosser
here because we have to say the word moist, but
they specifically infect moist parts of the boy. This is
where you get warts on genitals, your throat, maybe your nose,
(09:06):
your anus, your cervix of course, and your inner eyelids,
which can't be comfortable.
Speaker 2 (09:12):
Yeah, And because all of those or a lot of
those are sexy parts, the inside of your eyelid. Notwithstanding,
it goes to show that HPV infection can be transmitted sexually.
It's not all the time like the other kind of
the cutaneous type that causes plantar works. You can get
that from walking around a pool, a pool deck or
(09:34):
somewhere there's HPV hanging out. But it's a different kind
of HPV HPV sixteen that can cause cancer. That is
a sexually transmitted HPV. It's mucosal and it's also in
a subcategory of mucostal HPV called high risk. There's high
risk and there's low risk, And as you may guess
just from the names, high risk typically leads to cancer
(09:55):
or can. The low risk almost never does.
Speaker 1 (09:58):
Yeah, that's right. If you think, hey, can I use
a condom to get around this? That helps. But HPV,
the mucoastal type of lead, doesn't require bodily fluids for transmission.
So if you are sexually active as a person, and
you have been so for a few years, then chances
(10:19):
are you've probably had HPV and maybe not even known it.
Speaker 2 (10:22):
Yeah, and that's a really big point that you don't
have to exchange body fluids. And also, similarly, Chuck, I
want to make sure it's totally clear genital awarts doesn't
cause cancer. It's a different type of HPV. So you
actually can give somebody genital awarts from sexual contact, but
that's almost certainly not going to lead to any kind
(10:43):
of cancer. They're just different types, even though they can
be passed along similarly through skin to skin contact.
Speaker 1 (10:49):
That's right.
Speaker 2 (10:51):
So yeah, I think you said just from being sexually active,
you're probably going to pick up some form of HPV.
Another about fourteen million Americans, Yeah, just Americans. Alone get
a new infection every year. There's at least eighty million
Americans running around with an HPV infection right now. And
(11:13):
if you do the math, here in America, we have
a pretty close replacement rate where we have just a
few more one hundred thousand berths than deaths every year. Right,
so let's just say that's a wash. At fourteen million
new infections every year, that means everything's staying exactly the
same as it is now. In twenty four years, every
(11:34):
single American will be infected with HPV. And we already
said that HPV sixteen we got from Neanderthals, so it's
been around a really long time. So it makes you wonder, well,
why this sudden surge in infections. And apparently a lot
of the incidences of HPV, or this rise in incidents
can be traced to changes in sexual morais and behaviors
(11:55):
that have occurred over the last few decades.
Speaker 1 (12:00):
We just put a pin in that. Sure, Okay, we'll
reveal what that might mean later on. Maybe we should
take a break. Yeah, yes, pretty good intro, and we'll
talk about genital warts when we get back. All right,
(12:44):
so we're back, We promise talk of more talk that
is of genital warts. I believe you mentioned the low
risk mucosal type usually six and eleven HBB are the
ones that calls these warts or other you know, moist membranes,
mucous membranes. They don't generally cause a lot of health
(13:07):
problems or any really, they can be painful. Sometimes they
can be itchy. Obviously, there's a lot of embarrassment that
surrounds genital awarts. Just saying those words together isn't something
you're probably gonna like advertise to people.
Speaker 2 (13:23):
No, you don't say, like, just disregard my genital awarts.
Speaker 1 (13:26):
Yeah, I mean, well, I'm sure plenty of people have
said that, but who knows.
Speaker 2 (13:29):
It doesn't always work.
Speaker 1 (13:30):
That's what it works. But it's nothing to be ashamed
of because it is quite common and they can be removed.
Sometimes medication can do it. Sometimes they'll do the old
freeze with liquid nitrogen routine.
Speaker 2 (13:44):
I used to get that. I got warts on my
elbows and I used to get it burned off with
liquid nitrogen pretty regularly. I think it's.
Speaker 1 (13:50):
At Yeah, I feel like I've had that done with.
I think I had plan awarts that they did that too.
When I was in college.
Speaker 2 (14:00):
Yeah, I mean you can get rid of warts that way.
Speaker 1 (14:03):
Yeah, there's also lasers these days that can handle that
different different methods to get rid of those general awards
in due time. So don't worry about it. If you
have those people, just you know, keep soldiering on. You'll
be okay.
Speaker 2 (14:20):
Yes, So there are some some types of HPV infections
that lead to warts mucoastal warts that can be a problem.
There's one in particular, Respiratory pepiomatosis is a condition that's
caused by warts and the airways, and it typically happens
in kids and it's treatable, but it can narrow the
(14:42):
airway and that in and of itself is problematic. They
think that it's transferred, that HPV infection is transferred during
birth or from the antiotic fluid inside the womb. But
it's pretty it's pretty rare. It's one of the rare
ones that Okay, this is actually be a bit of
a health problem from.
Speaker 1 (15:02):
Warts, Yeah for sure, But that is only in young children.
It's usually you see it between the ages of two
and six. It canic are and adults. But I think
it's even more rare. But again, you can remove these surgically,
so you can get that taken care of as well.
Speaker 2 (15:20):
Yeah, Plus you get to go back to school in
the fall and be like, yeah, they shot lasers down
my throat, what did you do this summer?
Speaker 1 (15:26):
That's right to get rid of my warts. Ye. There's
also infections with the high risk kinds of APV that
don't clear up on their own, and these are the
ones that could eventually lead to cancer.
Speaker 2 (15:43):
Yeah. So this is a very very long process. But essentially,
this HPV infection that can is akin to causing warts,
just causes hijacks a sell just like any other virus,
causes it to multiply and multiply and multiply, and then
has these cells rupture. They released more viruses into the
(16:03):
extracellular membrane, and they get into more cells and it
just gets worse and worse. The difference between an HPV
infection and other types of infections from viruses is that
they're not systemic. They stay very very localized, and so
they form a very recognizable legion.
Speaker 1 (16:20):
Yeah. But it isn't just cervical cancer though, that we
should point out. I believe there are six kinds of cancer.
I think the data that we got was this Libya?
Did she help us with this?
Speaker 2 (16:32):
Yeah? Hats off, I can tell.
Speaker 1 (16:35):
In a good way. I was like, oh, geez, I
could tell.
Speaker 2 (16:39):
All the dirty jokes. Yeah, we can't say.
Speaker 1 (16:43):
Twenty twenty one is when we got the latest CDC
data with more than thirty seven thousand cases of cancer
associated per year of that are associated with HPV twenty
two thousand and women sixteen thousand and men. And the
six kinds of cancer or I guess the five besides
cervical are anal cancer, penile cancer, vaginal cancer, bulvar cancer cancer,
(17:11):
bulvar cancer. Man. That's hard to say.
Speaker 2 (17:14):
It is.
Speaker 1 (17:14):
That's a good pre stage warm up. Okay, so you
hear me backstage saying good lord. And then finally oro
fairyngeal cancer, which is the base of the tongue, the
back of the throat tonsils. You can also get that
through tobacco use, not surprisingly, so you should also not
(17:34):
be surprised to learn that as tobacco use has gone down,
so have incidences of non HPV oro fare engeal cancer.
Speaker 2 (17:42):
But incidents of orofair andngeal cancer overall has increased because
there's been a rise in HPV infections to that man,
and I think I made it pretty clear. HPV sixteen
is one of the big batties of this episode. So
is HPV eighteen. Those are the two most common cancer
(18:03):
causing types of HPV. They're responsible. HPV sixteen is responsible
for ninety percent of HPV related orofare andngeal cancers, half
of all cervical cancers, and all the other cancers that
are related to HPV. It's it makes up a significant
portion of them, just sixteen alone.
Speaker 1 (18:22):
Yeah, and I think eighteen causes twenty percent of cervical cancer.
So between those two, you know, you're looking at seventy percent.
Speaker 2 (18:29):
So let's talk cervical cancer, shall we, Because it is
a it's really important. It's become I guess, how do
you put it. It's really emerged as a condition that's
gotten a lot of attention because there's so much potential
for getting rid of it altogether.
Speaker 1 (18:48):
Yeah, and it's a situation where here in the United States,
due to early detection and treatment, it is really really lowered.
I think it's gone down by more than fifty percent
from the mid seventies to the mid two thousands and
only and you know, of course four thousand people. It's
a lot of people. But when you're talking about what
(19:09):
the rates could and would have been in the past,
four thousand Americans dying of cervical cancer each year is
a lot of progress has been made.
Speaker 2 (19:19):
Yeah, And overall, I think there's three hundred and fifty
thousand deaths from cervical cancer worldwide every year. Yeah, And
I mean Americans make up a decent portion of the
world population, but not a good portion of the cervical
cancer death population. The reason why is because America has
a really robust screening process that is easily accessed by
(19:43):
American women to search for cervical cancer and catch it
early on, and it's not nearly as robust in some
other developing parts of the world.
Speaker 1 (19:53):
Yeah, because in America, once you turn twenty one, if
you're a woman, generally for about from about twenty one
to sixty five, you're going to be getting a PAP
test about every three years, or at least you're supposed to.
And the US Preventative Services Task Force the USPSTF says
(20:16):
if you're under thirty, they don't recommend that you get
tested for HPV unless you have some you know, some
pretty obvious risk factors. Why, well, because generally by then
you have probably gotten it and it is probably cleared
up on its own. And that also means that you
have some kind of immunity, sometimes very long lasting immunity.
Speaker 2 (20:40):
Yes, so they say, don't bother with the HPV test,
but definitely do get your PAP test. PAP, by the way,
isn't short for papioma. It's short for the guy who
came up with the test. Georgios Papa Nicolau pap, I
guess to his friends and family. Sure, so that's looking
for abnormal cells in your cervix. If they find that,
you test for HPV to see what kind of HPV
(21:02):
infection you might have that could account for those abnormal cells.
And then the American Cancer Society says, forget that, just
start at twenty five. Forget the PAP smerror, start with
an HPV test, like if you have to prioritize one,
do that. Yeah, And you might say, well, I'm confused.
The Preventative Services Test for says thirty and focus on
(21:24):
the PAP test. In the meantime, the ACS so sort
the PAP test out, focus on the HPV test starting
at twenty five, which one should I choose, And you
don't have to worry if you're an American, because your
insurance company will choose for you, and that'll probably be neither.
Speaker 1 (21:40):
That's right. If during your screening you happen to see
what's a pre cancer or a dysplasia, then what they're
probably going to do next is to examine the cervix.
It's not a pleasant process. It's done using an instrument
called a colposcope. You may get a biopsy performed, but
(22:03):
a lot of times it's a minor thing that's going
to go on its own, and so what they what
they might do is say, hey, let's just monitor this
thing instead of removing it, and just sort of get
you tested more regularly to see what's happening with that.
Speaker 2 (22:17):
Hey, welcome to your year of anxiety. Yeah until your
next test. It sucks, Yeah, but the odds are with you. Yeah, yeah,
for sure, because we've got this early screening, because they
have like a lot of tale signatures. They might they
may also do a biopsy. If it does seem like
(22:38):
it's a big deal, they may do more invasive surgery.
But for the most part, we'll set cervical cancer aside
for a second, until we get to the vaccine. It's
if you go get a PAP test and you do
some form of HPV testing whether if needed, you're probably
going to catch it early for it to be treated.
Speaker 1 (23:01):
That's right, that's the great news with cervical cancer. Unfortunately,
the other kinds of cancer is the other five that
we mentioned caused by HBB. There isn't a routine screening
for those or preventative treatments for those. And that is
one of the reasons why you mentioned oor a fair
andngeal cancer is growing even though tobacco use and tobacco
(23:25):
caused oor a fair and geal cancer is falling.
Speaker 2 (23:29):
Yeah, because people stopped using tobacco as much, but they
replaced tobacco use with oral sex, which is one of
the it's actually the biggest risk factor now for developing
oor fair andngeal cancer. And the more oral sex partners
you've had, the greater your risk of developing oro faar
andngeal cancer a few decades later. Is as a matter
(23:52):
of fact, So that's what I was saying earlier, when
I was saying that there's been a change in sexual
morais and behavior. Oral sex has become much more prevalent
since the sixties and seventies than before, and a lot
of those men in particular, are starting to age into
that point in their life where that HPV infection is
(24:15):
developing into a cancer and is developing into orofair andngeal cancer.
Speaker 1 (24:20):
Right, and we're talking specifically about oral sex performed on women.
So I guess the idea is that you can get
that HPV and many many years later, when you're, like
you said, in your fifties or or sixties, that's when
it might rear its ugly head.
Speaker 2 (24:40):
Yeah. Do you remember when Michael Douglas said that he
had oral cancer throat cancer, I think, and he's like,
it's from oral sex.
Speaker 1 (24:47):
Yeah, and everyone laughs.
Speaker 2 (24:48):
Yeah, that's exactly what he was talking about. And he's
right in that age group of boomers that were like,
you know, let me try this right back in the day.
So we don't I have a good handle on really
anything besides cervical cancer. So the orofare engeal cancer field,
like the researchers and doctors who study this kind of stuff,
(25:11):
were like, Okay, it's go time for us, because you know,
we thought everything was just ducky with the tobacco usee
going down, and now we've got this, we've got to
figure this one out.
Speaker 1 (25:21):
That's right, Good time for a second break, I think.
So all right, great, we're going to take a break,
and you know, we talked about the vaccine a couple
of times. We're going to come back and put all
our cards or all our vaccine cards on the table
right after this.
Speaker 2 (25:42):
Star Chuck, before we move on to the vaccines, which
(26:09):
I agree we should do post taste, we do want
to mention that the other kinds of high risk HPV
mucosal cancers include I think, like you said, anal cancer,
vulgar cancer, penal cancer, and vaginal cancer, and they start
to get much much more rare, starting with anal cancer
down to vaginal cancer as far as cancer cases go
(26:33):
caused by HPV. Hopefully we'll be able to figure this
out and there won't be any of those cases. But
that's another reason why cervical cancer got so much attention,
because there was it was much more prevalent, in addition
to much more treatable.
Speaker 1 (26:49):
That's right, I'm glad you said that stuff.
Speaker 2 (26:52):
So now we can talk about the vaccine.
Speaker 1 (26:54):
Okay, yeah, let's do it.
Speaker 2 (26:58):
There are two guys, Jean Jao and Ian Fraser, and
they both worked at the University of Queensland. I believe
Ian Fraser ran the lab in Jean ju Jao and
his partner worked for Ian Fraser, and together they started
studying HPV, specifically HPV sixteen, and they figured out that
(27:21):
you could take HPV sixteen and isolate proteins from it,
and you could use those proteins ostensibly in a vaccine,
and in very short order, within a few well a
decade or so, like a vaccine finally did come out.
Apparently the drug companies took some pep talks I guess
(27:43):
about how much money they could make on this. They
finally saw the light and we ended up with the
HPV vaccine in two thousand and six. The first one
was called Gardaseel, and I remember when this came out
from the outset. It came out essentially in the midst
of the firestorm of the vaccines caused autism stuff that
(28:03):
was going on at the same time. Merk was like, hey,
we got a new one. Everybody, come check this one out.
Speaker 1 (28:09):
That's right, it's meant for girls and women between nine
and twenty six years old. There's a group called the ACIP,
the Advisory Committee on Immunization and Practices, that said, you know,
this stuff's good to go, let's get it out there.
And it protected against HBB sixteen and eighteen, which is
(28:32):
the most common high risk types we talked about, and
then six and eleven, which caused more readily caused the
a genital awards, so it basically kind of took care
of the four bad guys.
Speaker 2 (28:44):
Yeah, after this thing was released, they started launching studies
on the real world studies on people who gotten and
they found like, this is actually pretty good at protecting
people against those four HPV strains, and they also figured
out that it could protect men against genital wards and
(29:05):
anal cancer because anal cancer or HPV that causes anal
cancer I think sixteen or probably eighteen as well, can
be transmitted from anal intercourse I can't remember, receptive anal intercourse,
that's the word, and so you can transmit it like that.
(29:26):
And they found that if men got this vaccine, it
protected them against that, which was pretty surprising because at
the beginning they're like, yeah, we just need to give
this to little girls, and then they were like, no,
we need to give it to little boys too.
Speaker 1 (29:38):
That's right. So that was in two thousand and nine
when the FDA licensed it for boys and men from
nine to twenty six, and again a couple of years
after that is when the ACIP said, yep, we should
get it, get it going in that population.
Speaker 2 (29:54):
Yeah. So at the same time, Glaxo smith Klein said
us too, we want to make some money off of
this too, and they released Cerverix, which I guess just
never really picked up steam against Gardisil, because in twenty
fourteen Merke released Garticil nine and that is essentially the
de facto HPV vaccine in most of the developed world.
(30:16):
It protects against, as you might have guessed from the name,
nine different strains of HPV, not just the common ones,
but also some less common ones that are still high risk.
And they also found again through more clinical trials and
more real world studies that these things were really really
effective at protecting kids if you gave them this vaccine
(30:40):
before they became sexually active. Is one of the really
big keys here is once you're infected with the strain
of HPV, that vaccine won't protect you against that strain.
It'll protect you against the other strains that you haven't
gotten yet. But it apparently won't do anything. It doesn't
cure any HPV infections. It just defends against them from
(31:01):
you from getting infected with them.
Speaker 1 (31:03):
Yeah, and that's why they went from nine, you know,
down to nine years old. It's two shots six months
to a year apart. If you're older than fifteen, I
believe you have three shots over a six month period.
And if you're like, well wait a minute at the time,
(31:23):
like you're like, well, I'm older now, and this stuff
just came out and sucks for you. Yeah, well they
you know, you're not going to get the full benefit
necessarily from that vaccination, but they said it's still maybe
worth getting if you weren't vaccinated as a kid.
Speaker 2 (31:41):
Especially if you had fewer sexual partners, so less sex.
The older you are, the likelier the vaccine is to
protect you against it later in life.
Speaker 1 (31:53):
Right, And if you were a forty year old virgin,
then they made a movie about you, Steve Carell pretty
good movie too. Yeah, I like that one.
Speaker 2 (32:01):
So, like I said, this thing was released in the
midst of the vaccine vaccines caused autism firestorm, and so
it was controversial, right, out of the gate. But Rick Perry,
who was governor of Texas at the time, did not
help things at all. He did something that seems extraordinarily
bizarre today in retrospect. He was the Republican governor of
(32:23):
Texas who ended up serving as Department of Energy secretary
under Trump, and he mandated as governor that every girl
entering sixth grade who lived in Texas had to get
the Gardasil vaccine in two thousand and seven, a year
after it got FDA approval, And that did not sit
(32:46):
well with a lot of parents.
Speaker 1 (32:49):
No, a lot of parents were either just you know,
sort of like stuff you hear about today, like you know,
parents rights groups saying that we want to make those decisions.
Some of them were part of the anti vaccine movement
and some of them also and just people in general
I think, were like, well, wait a minute, Perry, you've
got you're cozied up to these lobbyists for MERK, Like,
(33:11):
is that what's going on here? So it was a
big deal. And like you said in retrospect, is it's
very odd to see at Texas republican governor mandating vaccines
for anybody.
Speaker 2 (33:21):
Yeah, and Rick Perry had big time ties to Mark.
That was the only HPV vaccine on the market at
the time, so it's not like he could choose from
a different type, but it just those ties made the
whole thing smell fishy. There was another really big thing
that parents came out against. There was a lot of
fear that when you vaccinated your kid with an HPV vaccine,
(33:46):
they were going to run right out and start having
receptive anal sex because now they were protected. They're going
to have intercourse or you have oral sex starting at
age nine because you just gave them this license to
go have sex because you vaccinated him against HPV. And
that was the one that the most vocal opponents sounded
the alarm about. But it turns out from studies follow
(34:10):
up studies about hesitation of HPV vaccine hesitancy among parents
that's almost like not even on the charts, Like very
few parents are actually worried about that. They're more worried
about things like whether it's safe, or they think that
their kid actually doesn't need it because my kid's ugly.
Like there's a whole other cadre of reasons, and that
(34:32):
one apparently didn't pan out, and studies that looked at
it that possibility, found that girls who had been given
the HPV vaccine preteen, compared to girls from the same cohort,
had no more incidences of seeking birth control, of pregnancies,
or of any other things that indicated they had more
(34:52):
sex than the girls who weren't vaccinated with the HPV vaccine.
Speaker 1 (34:56):
Yeah, and I bet one reason is because parents probably
didn't say, all right, you're going to the doctor and
you're getting this vaccine, and you know what that means.
So the other one of the other things that popped
up was the idea that whether or not you need
to vaccinate boys. In twenty eleven, that was a story
(35:19):
in the New York Times that basically kind of suggested
that the biggest benefit for male vaccination was either protecting
female partners, because well, it was protecting female partners because
the only way to if you're going to get it
as a man or a boy, is to have, like
you said, had that receptive anal sex. And so we've
(35:43):
learned since then that straight men are also at risk,
especially for that oro fare andngeal cancer. So that was
sort of I mean, I was about to say quickly quash,
but also it wasn't because people got up in arms
about it.
Speaker 2 (35:56):
Yeah, because I mean they HPV sixteen causes seventy percent
of oral cancers, right, So if you give a boy
the vaccine against HPV sixteen, you're going to take a
big bite out of that possibility of them developing oro
fare and geal cancer later in life. It just makes sense.
So it does make sense for boys and girls to
(36:17):
both get the vaccine. And yet there's thanks to the
anti vaxx movement, thanks to Rick Perry and his merctise,
thanks to that study that linked autism with vaccines, they're
still today just a lot of hesitancy in mandating HPV
as part of a required vaccine schedule among boys and
(36:39):
girls in America. I think Delaware, Rhode Island, Hawaii, Virginia,
and DC are the only ones that require vaccines for students.
They require it for boys and girls. But even with
that hesitancy among states, among individuals, the cases of cervical
cancer and death from cervical cancer have fallen dramatically since
(37:03):
two thousand and six when we started vaccinating kids against HPV.
Speaker 1 (37:08):
Yeah, I mean, that's the one takeaway is that this
is a vaccine that really seems to work. Yeah, there's
a study in twenty twenty one that found that among
women who had been vaccinated between twelve and thirteen, there
were eighty seven percent fewer cases of cervical cancer.
Speaker 2 (37:26):
Yeah, that's nuts. And Johns Hopkins came up with a
model that said that because of vaccination rates among men,
there should be one thousand fewer cases of oro a
fare and geal cancer by twenty forty five. You might
be like, that's it, that doesn't seem like that much. Well,
the reason why is because only twenty to thirty percent
of boys age thirteen to seventeen are getting that vaccine.
(37:48):
If you increase that percentage to like what girls are getting,
which is more like the sixty to seventy percent range,
it would take an even bigger bite out of or
a fair geal cancer in the future, because those kids
will eventually ate and if they got the vaccine, they
won't have contracted that strain of HPV.
Speaker 1 (38:04):
That's right. How many people are getting this vaccine more
and more. In twenty twenty two, fifty fifty seven percent
of kids between the ages of fifteen and seventeen had
it gotten at least one dose. If you are from
a family that has parents that are college educated and
(38:25):
maybe a little more money, you're more likely to be
vaccinated against it, statistics show, and you know, public public
education is one of the big reasons that people are
more aware of it and more inclined to get it.
Speaker 2 (38:38):
Yep, So I guess that's it, Chuck.
Speaker 1 (38:41):
HPV.
Speaker 2 (38:44):
Yeah, if you want to know more about HPV, there's
a lot to go read out there and educate yourself on.
Same with the HPV vaccines that are available. You should
probably read up on anything like that first, but make
sure that you are getting your info from trusted so horses.
And since I said that, of course it's time for
listener mail.
Speaker 1 (39:06):
This is good because it ties into an episode on
whistling and something we both love, which is whistling the scorpions.
Speaker 2 (39:14):
Oh yeah, I love this one.
Speaker 1 (39:16):
Hey, guys, listening to the show about whistling and got
to the part of the episode about popular songs and
as I hoped you guys, did mention the classic wind
of Change by scorpions. Side note, he says it's just scorpions,
not the Oh sorry, I didn't know that. Kind of
like eagles and Indigo girls.
Speaker 2 (39:34):
And Edie brickl and New Bohemians.
Speaker 1 (39:36):
Yeah. And Edie Brikel and New Bohemians. Yeah that's right. Yeah,
you know what you said. Yeah yeah, brand New Bohemians.
Speaker 2 (39:46):
And brand New Heavies.
Speaker 1 (39:48):
That's right. Oh god, I used to love.
Speaker 2 (39:49):
That band and New Pornographers.
Speaker 1 (39:52):
Oh well, you know I still love them.
Speaker 2 (39:55):
Who else? Jethro Tull?
Speaker 1 (39:56):
Okay, I look Jet Throw Toll too. Oh god, he
whistled through his flute. However, guys, I was at half
expecting one of you to mention this crazy fact, and
you passed over it. Just state it briefly. There exists
a conspiracy theory that the song Wind of Change was
written or partially written by the CIA as a mode
of propaganda to help bring an end to the Cold War.
(40:17):
I'd never heard this ad.
Speaker 2 (40:18):
You no, but it really rang true because I remember
when the song came out and what the sentiments were.
Speaker 1 (40:24):
Like, Oh sure, down to God, keep back. The song
was written and released just months before the Berlin Wall
was brought down and became hugely popular throughout the Soviet
Union at the time. A political leaning song was very
out of character for Scorpions. I just can't say it. Yeah,
that just picture a bunch of Scorpions.
Speaker 2 (40:45):
Yeah, it doesn't quite sit right. It's not like Jetro Toll.
Speaker 1 (40:50):
No, very out of character for thus Scorpions, and the
band claims that the song was written by lead singer
Klaus Meinik, who typically never wrote music for the group.
I didn't know that either, their manager, Doc McGee. Somehow
weaseled out of a large drug case with a mysterious
deal from the US government. The Scorpions claim the song
was inspired during a rock festival called the Moscow Music
(41:13):
Peace Festival, where the bands were surrounded by CIA and
KGB handlers. The interesting wrinkles go on from there. Probably
not doing it justice, but highly recommend the podcast Wind
of Change by Patrick Raiden Keith, which chases down a
number of these connections and threads. If nothing else, it's
a pretty amusing story about the eighties hairband. They were
(41:36):
more than a hairband.
Speaker 2 (41:37):
Yeah, they were political hairband.
Speaker 1 (41:39):
Yeah that's right. I hope this email finds you guys
well have been a huge fan for years. I'm glad
I could share this with you. That is Jimmy from Spokane,
Washington and Jimmy, I want to just follow up and
Josh with a recommendation of my own. If you're a
fan of Scorpions, I recommend that you go look immediately
(42:05):
at the video for the song from nineteen seventy eight,
sales of.
Speaker 2 (42:10):
Charon Charon like the river Sticks Boatkeeper.
Speaker 1 (42:15):
Yeah, char On sales of char On ha Ron. Yeah.
If you only know the Scorpions from like the early eighties,
then check out this gym from nineteen seventy eight because
it's awesome.
Speaker 2 (42:26):
All right, Well, we've got a couple of minutes left
before we hit forty five, so I am going to
tell you about a movie that I watched last night
from nineteen seventy nine called Tourist Trap.
Speaker 1 (42:36):
Have you ever seen Jack? I don't think so.
Speaker 2 (42:40):
It is the definition of camp without intentionally being camp,
without being annoying camp. It's one of the best schlocky
late seventies horror movies I've ever seen in my life.
It is really good, all right, what you're in nineteen
seventy seventy nine. You can stream it online somewhere looking
(43:01):
at it, and if you have to pay for it,
please watch it. It's it's a really good one. It's
like a highly watchable, enjoyable movie. And there's some surprising
little like directorial like bits in there that you're like, well,
it seems sophisticated for this.
Speaker 1 (43:14):
Movie, Tany Roberts and Chuck Connors, aren't it. That's enough
for me.
Speaker 2 (43:18):
That's all you need right there.
Speaker 1 (43:19):
Yeah, ninety minutes also perfect.
Speaker 2 (43:22):
Yeah, so go forth look up sales of Charun video
by Scorpions.
Speaker 1 (43:29):
Yeah, you need to watch that one. You're you're gonna
love it.
Speaker 2 (43:31):
I still need to watch your whistling video that you
send me.
Speaker 1 (43:34):
Watch that.
Speaker 2 (43:35):
I know, I feel like a jerk. I'm sorry.
Speaker 1 (43:37):
All right, you got you got work to do.
Speaker 2 (43:39):
I do well. I'll well while I do that. Uh,
you guys, go out and send us a listener mail.
You can send it off to stuff Podcasts at iHeartRadio
dot com. Stuff you Should Know is a production of iHeartRadio.
Speaker 1 (43:58):
For more podcasts my heart Radio, visit the iHeartRadio app,
Apple Podcasts, or wherever you listen to your favorite shows.
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