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Update on Genital Warts and Cancer Risk

Men and women who have had genital warts are at increased risk for cancers of the anus, vulva, vagina, cervix, penis, skin (non-melanoma), head and neck, smoking-related cancers, Hodgkin and non-Hodgkin lymphoma (J Infect Dis., May 1, 2012;205 (9), published online March 15, 2012). HPV causes almost all cases of cervical cancer, most cases of anal and penile cancers, and many vaginal and vulvar cancers.

MOST PEOPLE WITH GENITAL WARTS DO NOT DEVELOP CANCERS. Fewer than five percent of the 49,000 people with genital warts developed cancers over 30 years of follow-up. However, men with genital warts had 21 times increased risk for anal cancer. One percent of those with genital warts developed non-melanoma skin cancer.

GENITAL WARTS ARE CAUSED BY HPV. There are more than 150 different Human Papilloma Viruses (HPV). Infection with one type of HPV makes you immune to that virus so that once you clear that virus, you are not likely to ever become infected with that specific virus again. However, being infected with one type of HPV does not protect you from developing any of the other types. So you have the potential to become infected 150 times with 150 different HPV.

Most people clear a specific HPV within 6 to 9 months of becoming infected. However, some people do not clear these viruses and chronic infections with some HPV cause cancer.

HOW COMMON IS HPV? HPV is the most common sexually transmitted disease. Your risk for acquiring HPV can be as high as 15 percent per sexual contact. More than 90 percent of sexually- active people have been infected with HPV, and more than 50 percent of people infected with HPV have more than one HPV virus (The Journal of Infectious Diseases, published online Nov. 4, 2011).

NOT ALL HPV VIRUSES CAUSE CANCERS. Genital HPV are classified as low-risk and high-risk for causing cancers. Low- risk HPV types (6, 11, 42, 43, 44, 54, 61, 70, 72, and 81) are virtually never found in cancers. High-risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82) have been found in cancers of the cervix, vagina, vulva, anus, and penis. More than 80 percent of cervical cancers are caused by types 16, 18, 31, and 45. The two vaccines against HPV available today, together, protect a person from infection with the four types of HPV that cause the most cervical and anal cancers, but they do not protect a person from infection with the remaining HPV viruses.

WHY MOST PEOPLE INFECTED WITH HPV DO NOT DEVELOP CANCERS: Most infected people clear HPV from their bodies in 6 to 12 months. Continued exposure to new partners brings new infections with new viruses. The more contacts you have, the more viruses you acquire.

We do not have strong data to explain why some people clear HPV from their bodies while others continue to be infected. We do know that 6.9 percent of North Americans, 14 to 69 years of age, are now infected with HPV in their mouths and that the more cigarettes you smoke, and the more sexual partners you have, the more likely you are to carry these viruses (JAMA. 2012;307(7):693- 703). Having infections with other germs increases cancer risk. For example, being infected with chlamydia as well as HPV increases cancer risk (Cancer Epidemiol Biomarkers, published online October 12, 2011).

WHAT YOU SHOULD DO IF YOU ARE INFECTED WITH HPV: The vaccine against HPV is totally ineffective if you already have those specific HPVs. However it can help protect you against the viruses that you have never had. Those who are infected with HPV should do everything they can to help strengthen their immunities to help it clear the virus from their bodies. The following steps have not been proven to protect you against HPV, but they have been shown to strengthen your immunity and to help protect you against certain cancers, heart attacks and premature death:

• exercise,
• eat lots of fruits and vegetables,
• treat any other infections,
• limit the number of sexual partners,
• do not smoke,
• do not take more than two alcoholic drinks a day,
• restrict sugared drinks and foods with added sugars,
• restrict red meat,
• restrict fried foods,
• avoid overweight.



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Dietary treatment of diabetes



Why Excess Alcohol Increases Diabetes Risk

Taking more than two drinks daily, and binge drinking larger amounts, are associated with increased risk for diabetes (Diabetic Medicine, April 2012;29(4):441-452). More than 5100 Swedish men and women, age 35-61, were followed for up to 10 years. Men and women who drank more than two beers or hard drinks daily had double the likelihood of developing diabetes, compared to those who did not drink.

Alcohol is a poison and your liver is the only organ in your body that can clear it from your bloodstream. It takes an hour for your liver to clear one drink (12 ounces of beer, 5 ounces of wine, or 2/3rds of shot glass of hard liquor). Until the liver does its job, your levels of blood alcohol remain high. More than two hours daily of high blood alcohol levels over years can damage your liver, causing a fatty liver which can lead to diabetes. Fat deposited in any cell prevents that cell from responding to insulin. Then cells full of fat are unable to remove sugar from the bloodstream and blood sugar levels rise very high. This makes you diabetic which can damage every cell in your body. Fat deposited in liver and muscle cells prevents these tissues from storing more sugar. Then all extra sugar is converted to fat to raise blood fat levels even higher and make you even fatter.

Type II diabetes (the overwhelming majority of diabetes cases) is caused by inability to respond to insulin. Alcohol decreases tissue sensitivity to insulin (Alcohol and Alcoholism, 1988;23(2):103-109).


Dental X-rays Associated with Increased Risk for Brain Tumors

1,433 patients who had a brain tumor called meningioma were compared to 1,350 people who did not have tumors. Those with the brain tumor were more than twice as likely to have had a bitewing X-ray sometime in their lives (Cancer, April 2012). A bitewing X-ray requires a patient to hold the film in place by biting down on a tab. Those who recalled receiving X-rays once per year had increased risk at all ages.

Those who had panorex X rays when they were younger than 10 years of age were five times as likely to suffer a meningioma. Panorex X rays are images of all of the teeth on one film. They expose a person to twice as much radiation as four bitewing X- rays.

This study does not prove that dental X rays cause brain tumors. It only shows a possible association between having dental X rays and a certain type of brain tumor. It takes 20 to 30 years after exposure to radiation for a meningioma to develop.

Dental X-rays have also been associated with increased risk for thyroid cancer. About one percent of all cancers in the United States are due to medical radiation (N Engl J Med 2007; 357:2277-2284). Ionizing radiation is the major known risk factor for meningiomas and dental X-rays are the most common artificial source of exposure to ionizing radiation in the United States.

The American Dental Association recommends dental X rays every two to three years for adults who are not at increased risk for cavities, and every one to two years for children without cavities.


Recipe of the Week:

Artichoke-Wild Rice Salad

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April 15th, 2012
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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