September 17, 2014 by rebelwithalabelmaker
Oropharyngeal cancer is one of the hardest cancers to treat. Hard on the physician, I mean.
Hard on the patient, too. They’re usually young, in cancer terms… below fifty. They start with radiation and chemo—which involve massive pain and other discomforts. If that doesn’t work, Gary usually splits the man’s (it’s usually a man’s) jaw. The patient is more likely to live than die, but a lifetime of pain and trouble swallowing is common. A feeding tube can be needed, sometimes permanently.
Used to be, you got this cancer from heavy smoking and drinking. Then some public health people did some great things to address those problems, and those cancers have been falling off steadily. So now, when the patient asks “Why did this happen to me?” (as patients often do), there is a sense of injustice. Often, the guy is a non smoker, and doesn’t drink much.
“Well…” Gary will say in these cases “Did you, uh, perform a lot of oral sex when you were younger?”
Usually the patient grins when he nods. Gary tells me that they usually own up to this as a bit of a badge of honour. Some cancers you get from bad choices, and some cancers you get from… generous choices.
It’s not the worst cancer Gary treats. I mean, it’s pretty bad. It’s got worse lifetime complications than Cervical Cancer, and higher odds of killing you than Breast Cancer. But the kicker, the thing that makes it so hard on him isn’t that it’s a bad cancer. Or that the men getting it are young.
It’s that it’s almost entirely preventable.
The HPV vaccine works—not perfectly, but pretty well. We can prevent the strain of HPV that causes this cancer and we… well, we just don’t.
“Why aren’t we vaccinating the boys?” I asked, when my son was a baby.
“If the girls are all vaccinated,” replied the public health lady, patiently “then it can’t spread.”
I’m sorry, whaaaaat????
A) They aren’t all vaccinated (around 3 out of 4, although it varies widely from region to region, B) The vaccine isn’t 100% effective (different rates or different strains of HPV, but think “pretty good”), and C) THERE ARE TYPES OF SEX THAN DON’T JUST INVOLVE A MALE AND A FEMALE.
This isn’t about money. The cancers that are prevented by HPV vaccines are expensive to treat, and they more than make up for the cost of prevention. It’s about short-sightedness. It’s about a limited way of thinking of sexuality… as something that happens between a man and a women, preferably in the missionary position and ideally with not very many people over the course of a lifetime. If you’re having trouble imagining your adorable Mindcraft-loving cherub ever wanting to do all that stuff, don’t worry. Nobody’s asking you to imagine all that. Instead, try imagining him in a cancer surgeon’s office. This is not about sex. It’s about Cancer.
When the vaccination form comes home from school, know that you don’t have to just fill out the designated blanks. You can attach a letter asking for better policies. You can email the public health nurse. You can ask for more for your son (the vaccine is available, and recommended for boys by just about every professional in the field).
You can ask for more for your son’s classmates. Or your daughter’s classmates (who she might be sleeping with in a few years, FYI, protected by a vaccine that is only pretty good in terms of effectiveness. Think about that for a minute).
Gary: How do you do this? Do I click on your picture, or on your statement? Who are all these people with comments? I don’t know these people.
Me: What are you doing?
Gary: I’m trying to Facebook. I want to comment on that thing you posted about Oropharyngeal Cancer. There is a presentation by the American Head and Neck Association that I think the Facebook would find informative.
Me: You click here. Beside the picture of you, where it says “comment”.
Gary: How do I upload a file?
Me: I can’t believe you are on Facebook. You didn’t go on for the bed bugs or the hepatitis or when I wrote all that stuff about you almost dying in Paris.
Gary: This is about people who have actually died, Liz. The public health people get it. They just need public support to make the changes, and we will prevent those kids from getting sick.
Me: I could blog about this.
Gary: You should.
Me: I don’t know how to make it funny.
Gary: Liz. We discovered how to prevent a horrible disease and then used that knowledge to protect only half of the children.
Right. It’s never going to be funny.