06/20/2013 10:55 am ET Updated Dec 06, 2017

What Do You Think About the Controversial Revelations of Michael Douglas About His Cancer?

This question originally appeared on Quora.
Answer by David Chan, MD, Oncologist

I've always liked Michael Douglas as an actor. Now I like him even more for doing a public service. It takes some guts to talk about this kind of thing. HPV infections and the related cancers it can cause are a big public health problem that most people know little about.


Mr. Douglas was treated for a head and neck cancer that lots of people probably thought was related to smoking or drinking. But that's not necessarily the case.


Head and neck cancers related to HPV are on the rise. HPV related cancers can be confirmed by HPV testing on the biopsy.


So how does someone get HPV infection of the mouth and throat? It's most likely from oral sex. HPV is transmitted by direct contact. Most people that have HPV infection won't get cancer. But it's also associated with a number of other cancers including cancer of the cervix, vulva, and anus in women and penis and anus in men.


"HPV is a common virus that is easily spread by skin-to-skin contact during sexual activity with another person. It is possible to have HPV without knowing it, so it is possible to unknowingly spread HPV to another person."


"HPV vaccine is a strong weapon in prevention. These safe, effective vaccines are available to protect females and males against some of the most common HPV types and the health problems that the virus can cause."




This stuff is all preventable by vaccination. It's recommended for the following:


"Cervarix and Gardasil are licensed, safe, and effective for females ages 9 through 26 years. CDC recommends that all 11 or 12 year old girls get the 3 doses (shots) of either brand of HPV vaccine to protect against cervical cancer. Gardasil also protects against most genital warts, as well as some cancers of the vulva, vagina, and anus. Girls and young women ages 13 through 26 should get HPV vaccine if they have not received any or all doses when they were younger."


"Gardasil is also licensed, safe, and effective for males ages 9 through 26 years. CDC recommends Gardasil for all boys aged 11 or 12 years, and for males aged 13 through 21 years, who did not get any or all of the three recommended doses when they were younger. All men may receive the vaccine through age 26, and should speak with their doctor to find out if getting vaccinated is right for them."


So what's the problem? Only about 30% of girls in America are getting vaccinated. And for boys, it's even lower than that. The vaccination seems to be more effective when given younger rather than waiting to late teens or twenties.


Why don't kids get the vaccine? For some, it's the expense. For others, parents have expressed concern that it could promote sexual activity. That's puzzling.


We have a vaccine that can prevent cancer and some parents won't get their kid vaccinated because getting the vaccine could promote sexual activity? We give vaccines for all sorts of infections without discussion about the social implications. HPV should be no different. We don't discuss the social implications of getting a tetanus shot or MMR. HPV should be no different.


STUDY: The HPV Vaccine Is 33 Percent More Effective When Given To Younger Girls

This answer is not a substitute for professional medical advice. This answer is for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Quora users who provide responses to health-related questions are intended third party beneficiaries with certain rights under Quora's Terms of Service (

More questions on Cancer: