High-Risk HPV: Cancer of Penis

By: Roslyn A. Douglas, M.A., Founder of Central Health - Grenada

In recent months there was a huge campaign in Grenada to raise the awareness of cervical cancer among women, however the commonest cause of this disease, High-risk human papilloma virus (HPV), can also cause cancer of the penis.  Due to this fact, men need to be aware that they too are at risk of developing cancer from this sexually transmitted infection.

Dr. Francis Martin, who holds the position of Senior Medical Officer and Director of Primary Health Care within the Ministry of Health wants residents of Grenada, Carriacou and Petite Martinique to start taking this health concern seriously, “HPV is a very serious infection.  It is very common.  It is the main culprit for sexually transmitted infections and for cervical cancer.  And not just cervical cancer, but we have seen men with cancer of the penis as a result of HPV.  I personally have managed men with cancers of the penis as a result of HPV.  So again, the implications are far reaching and the population should take serious note of it and its consequences it can have on our population.”

Photo Source: WikiHow.com

The American Cancer Association (ACA) states on their website that high-risk HPV strains numbers 16, 18 and 31 have been linked to cancer of the penis, vagina, vulva, and cervix. Low-risk HPV strains numbers 6 and 11 cause the growth of warts on the genitalia of both men and women.  Their website went on to say that, “In most people, the body is able to clear the infection on its own. In some, however, the infection does not go away and becomes chronic. Chronic infection, especially with high-risk HPV types, can eventually cause certain cancers, including penile cancer. Men who are not circumcised are more likely to get and stay infected with HPV.”

Statistically, women are diagnosed with reproductive cancers at higher rates than men, and according to Dr. Amy Baldwin, Associate Professor at St. George’s University in the Department of Microbiology - School of Medicine, this adds to the misconception that men have nothing to worry about when it comes to HPV, “A lot of misconceptions going around about any number of viruses especially things that are sexually transmitted, but one main [misconception] is that men seem like they really don’t have to worry about much with sexually transmitted infections. And this goes to the very realistic fact that women get the crappy end of the deal on a number of things in life and one of those is the brunt of sexually transmitted infections. And so you have men having a less number of cancers that will result, less number of symptoms et cetera, and so there becomes a misconception that it’s not a problem for them. Or maybe even they think that they don’t even get infected with the virus and there is a lot of danger in that because it is a sexually transmitted infection. [Men] in fact do get infected and then they transmit the infection to others when they have sex."

If abnormal cells on a man’s penis are found early it can often be treated and/or removed with minimal damage. However, according to the ACA because some men avoid going to the doctor for abnormalities on their penises over time things can get worse, “If a cancer is found early, it can often be removed with little or no damage to the penis. If it is not diagnosed until later, part of or all of the penis may need to be removed to treat the cancer. It is also more likely to require other, more invasive treatments, and may even be life threatening.”

All sexually active men, especially uncircumcised men, should see their doctor immediately if they notice any of the following things on their penises, whether or not pain is involved:  any abnormality, blisters, sores, ulcers, and/or white patches. 

Cervical Cancer Is On the Rise In The Caribbean

By:  Roslyn A. Douglas, Founder of Central Health  - Grenada

According to Professor Sir Trevor Hassell President of the Healthy Caribbean Coalition (HCC) approximately six deaths per day in the Caribbean are caused by cervical cancer, and efforts are on the way to raise awareness.

Infection with high-risk human papilloma virus (HPV) is the main cause of cervical cancer. It is also the most common sexually transmitted infection (STI) globally. Low-risk classification of HPV generally can lead to benign lesions such as warts.  Similar to other STIs, high risk HPV is transmitted via unprotected oral, vaginal and anal sex, and can lead to cancers of the vulva, vagina, penis, or anus.  According to the Centers for Disease Control and Prevention HPV is so common that nearly all sexually active men and women get it at some point in their lives, “There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening.”

 

The President of HCC and its Manager - Maisha Hutton, recently travelled to Grenada and several other islands of the Caribbean, to speak with NGOs and Government officials to share their vision of reducing the number of deaths and disability from cervical cancer by promoting the Cervical Cancer Electronic Petition. “Once the petition is finished we are going to take the petition’s findings and take them to the heads of government. Because this petition really asks heads of government across the Caribbean to use the powers that they have to ensure that every woman in their territories has access to cervical cancer screening,” said Maisha Hutton.  HCC’s target goal for E-signatures is 50,000.  They are currently at approximately 9, 000. By press time just over 100 signatures have been received from Grenada. The Cayman Islands has shown the highest support with over 2000 signatures.

“Cervical cancer is the second commonest cause of cancer deaths among women.  That’s a very important thing to appreciate.  In fact annually over two thousand women in the Caribbean die from cervical cancer. That averages out I think about 6 deaths per day, from cervical cancer, throughout the Caribbean.  And the thing about it is that cervical cancer for the most part is preventable,” said Sir Hassell.  

Researchers from St. George's University, Department of Microbiology will present preliminary findings of a recently conducted study on cervical cancer in Grenada at the annual American Association for Cancer Research (AACR) conference in San Diego, CA, USA, April 5th-9th. Their research involved an in-depth analysis on cervical cancer and its associated mortality in Grenada from 2000-2010 and has revealed a higher mortality associated with cervical cancer than the current WHO estimates for the region. The study results are being prepared for publication at this time.

Two virgins having sex (oral and vaginally) with each other is the only guaranteed protection from high-risk HPV and any other STI. However as most individuals have had or will have more than one sexual experience, the usage of condoms and vaccinations given to virgin boys and girls can reduce the risk of infection. It however must be noted that these vaccines do not protect recipients from all HPV strains, only types 6, 11, 16, and 18, and condoms do not provide 100% protection from any STIs or pregnancy – they simply lower the risk considerably. Additionally, a person can obtain HPV from oral sex.

All sexually active women are encouraged to have pap smears as it is the best way to screen for cervical cancer.  A pap smear is a procedure in which a small medical brush/swab is inserted into the vagina so as to retrieve cells from the cervix.  The cells obtained on the brush/swab are then analyzed for abnormalities. 

Chief Medical Officer of the Ministry of Health Dr. George Mitchell confirmed that pap smears are available to all women who have reach the age of consent, “Grenadian women can access pap smears at our three (3) hospitals, six (6) health centers and 30 medical stations. Pap smears are also done privately throughout the country.”


Central Health - Grenada would like to thank Amy Baldwin, PhD, Associate Professor, Department of Microbiology, School of Medicine, St. George's University for providing technical expertise with this article.

GNAP Needs Committed Abstinence Advocates

Director/Coordinator of GNAP Monica Alexander (left) and Advocate Judith Regis (right)

The Grenada National Abstinence Program (GNAP) is need of individuals to serve as Abstinence Advocates. This person, male or female, must be committed to promoting the faith based stance of abstaining from sex before marriage, and are living a life style that is not contradictory to that message.

According the Director and Coordinator of GNAP, Monica Alexander, the aim of the program is to encourage behavioral change and bring about awareness of the social and personal responsibilities surrounding sex, the physical effects of non-committal sexual activity - in particular sexually transmitted infections (STIs).  Additionally the goal is to bring this message to children in grades and low as six as more and more young children are engaged in sexual activity without even being aware of what they are actually doing. 

“I say to my advocates that this program can be taught to any age group within the school system.  You just have to bring it down to the level of the kids and get it across there. The younger for us the better, because I suppose long ago you could say, “What a little five year old would know about that?”  I still say what do they know about that, but the only difference is that they are practicing some of the things we don’t expect them to.  So whereas they may not have a full understanding of what they are doing, they are actually involved.  And if we don’t try dealing with it there, they [will] grow up thinking it is normal for them to behave like that.  So it is important to start as young as possible, so we can cut out and curb some of the values that we really don’t want them to be developing.” said the Mrs. Alexander.

There are numerous sexually transmitted infections that affect individuals worldwide, some even when condoms are used or used incorrectly. A popular STI is the Human papillomavirus (HPV), which certain strains can cause gynecological cancers and throat cancers.  Dr. Francis Martin, the Director of Primary Health Care within the Grenada Government's Ministry of Health said that a lot of persons who contract HPV do so during their teenage years.  “It is well understood now that HPV has a significant effect on the female population, as it relates to cervical cancer leading to the discussions about HPV vaccinations.” said the Director of the Primary Heath Care program.  “There was some research done in the past years especially in the United States which reported that a lot of young men were dying from throat cancer. And when they tested to see what was the cause of the throat cancer - that caused fatality in men, they found HPV to be the cause.” said Dr. Martin.  He added, “And interestingly, the men population had more throat cancer than ladies in the last 10 years in Grenada from the data that I have collected.”

Mrs. Alexander insists the GNAP’s intent is not to scare people, “The aim of the program is not to scare people to death. It’s definitely not.  What we want to do is first and foremost is to make them aware of what is happening out there, in terms of what can be detrimental to them. That is the bottom line.  So it is an awareness program first and foremost. Do you know that these things are out there?  Do you know the statistics that are available based on people’s life style? The age group that is most vulnerable to it and things like that.  We use the program to educate them.” It is her desire to see the program expanded outside of classrooms and into the community as adults also need to be aware of the benefits of abstinence.  She is also open to teaching parents so they in turn can teach their own children.  

Judith Regis, who has been one of GNAP’s advocates for the past three years echoes the sentiments of Mrs. Alexander, “I would really encourage anybody to get involved because our young people are faced with a lot of challenges and they need help. They may not say the words, “I need help,” but by their behaviors they are crying out for help.”  She added, “A lot of them, yes they belong to homes but are not guided.  They are not directed. A lot of them are just left to their own, and that’s how they are growing up.  So they are just picking up things, by the wayside. There is no definite pattern for their life. So they definitely need people to stand in the gap, or to be there for them. They need mentors, they need advocates, they need people to come up and say, there is a right way and this is the way.”

Under the GNAP program the goal is to have self-sustaining abstinence clubs in every school and for them to participate in special projects and yearly activities. Samantha Dixon-Roberts a guidance counselor, and educator at T. A. Marryshow Community College and lecturer at St. George’s University, who has been an Advocate since the program’s inception views it as an opportunity to assist young adults with decision making and conflict resolution skills as many of them engage in sexual activity as a means of survival. “We have been bombarded by the issues of poverty and other things that fuel transactional sex for example.  And so you find a lot of young people coming and saying, well Miss if I had better choices, if I had better circumstances I would have not found myself in these circumstance to have sex for money, to come to school, to pay for transportation, to get food, to do my hair and all the things that come up.”  She closed by saying, “It does not make it right, but a lot of them, the circumstances that they face socially and economically kind of fuel one of the reasons why they have not deliberately remained abstinent.” 

GNAP was adapted from a program developed in Baton Rouge, Louisiana called the Governor’s Program on Abstinence.  It covers a 12 lesson format that discuss topics such as:  Sexually Transmitted Infections, Myths and Infatuations vs. Love, Parental Relationships and Communication, Dreams and Goals, Dating, Courtship and Marriage, Peer Pressure and Choosing the right friends, Media and Pornography and Renewed Virginity to name a few.  

For more information contact:  GNAP at 473-440-2542 



This article was written by Roslyn A. Douglas, MA - Founder of Central Health - Grenada.  Central Health is a faith based initiative that focuses on educating the public about chronic diseases.