Diagnosis and Treatment of conditions caused by HPV

Human papilloma virus (HPV) or the genital warts virus causes warts and sometimes cancers of the sexual organs.{{more}} Last week, I said that the virus is actually a group of viruses and that explains why some persons get warts and others get cancer. That is, certain viruses cause warts and others cause cancer, but they belong to the same group of viruses. Most patients who have warts do not have cancer and vice versa. Patients who have warts and cancer usually have concurrent infection with more than one type of the HPV, the wart-forming and the cancer-forming types. Obviously, there are exceptions to these rules, but then again these are exceptions, hence they are rare.

This week we will deal with the diagnosis and treatment of the conditions caused by the HPV. We know that we have warts because we see and feel them. Warts are usually not painful, so most of them are discovered incidentally, as little lumps on the penile shaft or head (glans penis). If they are looked at closely or under a magnifying glass, they look like little finger like processes or fronds clumped closely together. Rarely, they can affect the urine passage and cause difficulty passing urine and burning on urination. Warts can also occur on the female external genitalia (vaginal lips and the vaginal canal itself), where they can become large. The woman will notice the growths on her vaginal lips or may experience slight discomfort or bleeding on sexual intercourse. Sexually transmitted warts can also occur on the lips, mouth and throat (pharynx) in accordance with the patient’s sexual preference. The warts usually occur weeks to months after the initial exposure to the virus and, unlike herpes, gonorrhea and chlamydia, there are no symptoms that occur when you “catch” the warts virus. You just notice the warts weeks to months after and, remember the episode of unprotected sex, the new partner or the multiple partners. You may not even know whom you got it from as the warts may occasionally arise years after the contact. Remember there are no symptoms of catching the warts virus.

Cancers can occur on the penile foreskin, head and shaft or on the vaginal lips, inside the vaginal passage or on the cervix. The problem is the cancer develops years after the initial exposure to the virus, so like warts, you may not remember whom you got the infection from. You say “infection?” yes, infection! The HPV virus is the cause of the penile, cervical and vaginal cancers 90% of the time. You would have gotten the infection years before, but not develop the cancer until years after. You most likely would not have remembered when you caught the virus, unless you contracted another sexually transmitted infection at the same time.

Penile cancer starts as a painless ulcer on the shaft or foreskin of the penis. It only becomes painful in the late stages when it begins to spread, at which time it also becomes very smelly and malodorous. The scent can be repulsive! Sometimes, it occurs in the urine passage and presents as a tightness in the passageway, with burning and blood on urination. Fortunately, this is not the most common cause of these symptoms. Like penile cancer, vaginal cancer may occur as a lump or ulcer on the vaginal lips. The ulcer does not heal and tends to spread and get larger. Cancers inside the vaginal canal and on the cervix are difficult to diagnose and usually only produce symptoms when they are advanced. That’s why it is important for women to have regular gynecological checks and PAP smears. Pre-cancerous cervical lesions and early and hence curable cervical cancers can be detected using the PAP smear years before the woman “knows” that she has cancer. In the later stage vaginal and cervical cancer she may notice abnormal bleeding, painful intercourse or a smelly discharge from the vagina. Next week, we look at the treatment of warts of the genital tract.

For comments or question contact:

Dr. Rohan Deshong

Tel: (784) 456-2785

email: deshong@vincysurf.com