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Few months of anal sex and anal cancer

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An oncologist is a must please to answer this question

Std, hpv and anal cancer


Dear Dr.

Please i need an urgent medical consultation regarding the following case. Appreciate your feedback as i really need help and i cant find solid answers to my question here in my country as I am in developed country where medical issues are still far away from best practices.

I am a 36 years old year man. I am divorced since 2 years and have 2 children. After my divorce I had some casual sex in some occasions all with women in a straight manner and with condoms except that I knew a new girl friend since a year ago. We started our sex life since 9 months which was on and off, like 2-3 times per month not on a regular basis as we didn't share the same place. But as she was virgin 33 yrs old women I didn't want to break her virginity, so unfortunately we were practicing anal sex. She is now diagnosed as having anal cancer. And knowing that the main reason of this kind of cancer is hpv transmission through anal sex I have three related questions:

1- Does what we did is surely and definitely the cause of her anal cancer? I struggled on Internet and with local drs, some are saying that it needs at least two years that the HPV infection can build the cancer cells in this area and the normal is 10-20 yrs, so can the cancer cells only be built on these 9 months time?!

2- What is the opportunity that me too can have an anus/pinus cancer or any other kind of cancers because my girlfriend had it already if the cause was an hpv transmission from myself? Does this increase my risks? Is there any available analysis that I can do related to pinus hpv infection or penis cancer?

3- knowing that there is no analysis to show the hpv that I have or it's type from the hundreds of kinds of hpvs, shouldn't I have sex again ever with any new partner forever in my whole life even in a normal straight sex? If me is the reason for my girl friend to get her anal cancer can I be a source for others for cervical cancer which is more related to hpv infections? Please i don't want to transmit any harmful thing to anyone again. So do I have to stop my sex life forever?

I don't have any kind of symptoms around or on my penus or anus (warts) , but my info that the dangerous kinds of hpvs that cause cancer doesn't have any symptoms except when me or my partner get the cancer?!

My latest STDs analysis showed negative for all of the following: HIV 1 & 2, HCV antibody 3rd generation and VDRL.

To summarize my 3 questions again:
1- am I the definite cause of my girlfriend having her anal cancer?
2- what is the opportunity that in near/medium/long future term I may have any kind of similar cancer or a pinus cancer if I have an hpv that caused this cancer to my girlfriend? Is there any analysis or can I be early diagnosed wether from the hpv or the pinus/anus cancer?
3- can I have sex again on my life or this will be dangerous to my future partner and may cause her cancer?

Thank you for listening and I will be waiting for an answer to these questions which I hope i can find an answer!


thank you very much
Kind regards

Category: Oncologist

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Category: Hematologist
 26 Doctors Online

Hello,

Thank you for your query at DoctorSpring.com. I can understand the concern and anxiety you have regarding your partner. To answer you question directly without any medical jargon,

1. You are not the cause of your partner's cancer. Usually hpv needs decades to produce cancer. So 9 months is too early to cause cancer in her anal region.

2. Any uncircumcised male can harbor hpv in penile region. So any male stands a chance of developing cancer in 4th/5th decade of life. Circumcision can reduce the risk but cannot completely eliminate it. Many unknown factors including smoking contributes to it.

3. You can continue with your sexual life. Hpv is a integral part of microenvironment in any sexually active person. You can advice your partner for regular cervical pap smear annually followed by once in 3 - 5 years.

Hope this cleared all your doubts. I would be glad to answer any more queries.

Kind regards


Patient replied :

Thank you very much for your response.

I need some more clarification if you please.

1- Can you clarify in a detailed manner with more scientific proofs that hdv can't produce cancer ever in 9 months. I.e. The minimum life cycle from hdv infection to producing cancer cells to having a cancer tumor in the anal. Please the more detailed scientific and medical info from an oncologist point of view the better for me that I can be very confident about this subject matter.
And does this mean that the cause of her anal cancer is an hpv transmitted to her years ago from another partner?

2- I am from Egypt where circumcise mandatory from early childhood so I had been cirumcised when I was a baby. Does this mean that in case I have the same dangerous type of hpv (type 16 or 18) from my partner who have the anal cancer or any other partner, the risks are now much lower that this hpv can produce penile cancer?

3- Sorry but understanding the human part on this, I think it is not possible before get engaged to anybody to tell her that I may have a dangerous type of hpv and you will be at high risk of producing cervical cancer accordingly please check for it each year or 3. Scientifically this can be the only solution from your respectful point of view but I think your answer is just the most merciful and human answer telling me "you have to stop your sex life otherwise your new partner will be at high risk of developing cervical cancer", definitely I am not blaming you but please be very clear with me that I can plan the rest of my life ahead without going into any relationship because if this is my destiny I can face it and live with its consequences despite how hard it is and not to harm anyone because of me.
Kind regards


Hellom

Please be assured that you can continue your routine sexual life as a normal man. Please do not panic about it. You are a normal person and you are not responsible for anal cancer in your female sexual partner whom you had met 9 months ago as per your email. Be assured that HPV has other means of transmission and I AM NOT BLAMING YOUR PARTNER FOR HPV INFECTION ALSO. There may be other reasons for her malignancy OTHER THAN HPV and SEXUAL TRANSMISSION. SO PLEASE DONT DOUBT YOUR PARTNER BASED ON THIS NOTION ONLY.

Answering specifically for your queries

1. I will try to get illustrated examples for making you understand HPV infection which will be easy for non medical person. However there are innumerable websites explaining the same in internet. Eg. http://www.cancer.gov

2. Whether circumcised or not, any male will have HPV infection. Circumcision reduces the transmission but does not completely eliminate it. So you don't have to really be concerned over it. Please be informed that you are at reduced risk of HPV transmission.

3. You can follow normal sexual practices (vaginal intercourse) than anal. The reason I advised your partner for 3 yearly Pap smear is , as a general recommendation for any female in reproductive age group. There are recommendations even to do Pap smear for Unmarried females starting age 21 as per WHO guidelines. This is part of routine recommendation issued by WHO. I AM MAKING IT CLEAR AGAIN AND AGAIN THAT NORMAL SEXUAL LIFE CAN BE CONTINUED WITHOUT ANY CONCERN.

Hope I clarified your queries. Please let me know if not clear.


Patient replied :

Thank you for you kind response and care.

For more clarification in point 1, please I will be waiting for this clarification as soon as you can.
But now I want to understand

1- if we did anal sex for only 9 months and hpv "cannot" be the reason of her anal cancer because the life cycle of hpv to be processed to cancer "must" take at least several years, the question is: can anal sex by itself without hpv infection can be a reason of anal cancer for any other reason rather than hpv infection and in only 9 months?

2- for Pap smear can be this done to virgin women or this may cause lost of virginity while doing this test?

3- I am not doubting any of your words but I can see from your kind responses that you can understand how I am panicked totally and feeling cursed! Really that's a very kind feeling to sense your patient and address his needs. So, can you refer me to another big oncologist whom you personally trust very mush to take a second opinion. For me this is the case of my life.

Thank you again and kind regards


Hello,

1. Anal sex alone cannot cause anal cancer. Do not worry about this at all
2. No virginity is not likely to be affected
3. I can do direct referral , but in that case my current country of practice is India. So I am not sure whether this will work out for you

Hope this helps
Feel free to ask followups

Thank you


Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

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