Eight out of ten people will be infected with the human papillomavirus (HPV) at least once in their lifetime.
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In most cases, your body will clear it up on its own, but this one virus can also cause six cancers. That is why, after girls, boys now also receive an invitation to be vaccinated against HPV. The letters will be on the mat from the beginning of February. In North Brabant, the first jabs are put in at the beginning of March.
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Jos Faro (61) from Asten used to like to have one. An HPV infection led him to penile cancer: “Half of my penis was removed to prevent dangerous cancer cells from remaining behind.”
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HPV is very common and highly contagious; 80% of people who are sexually active will become infected at some point. The body often clears the virus itself within two years, but sometimes it remains in the cells for longer. Then a precancerous stage of cancer or even a malignant tumor can develop. The latter happened to Jos: “I was in my early thirties when I started to suffer from a skin rash on my penis. The doctor prescribed an ointment, but the blisters did not go away and it continued to hurt a lot. I got another ointment, later another one and so on. I have been using for many years to no avail to get rid of my so-called eczema and fungal infections. In the hope that it would alleviate the symptoms, I was then circumcised. The operation only caused more misery. The skin on my penis was completely broken and my wife and I almost stopped having sex because of the pain. It took more than fifteen years before the doctors found out that it was penile cancer. The diagnosis is extremely difficult to make. Of course it also gave a certain clarity, but at the same time my world collapsed.”
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Whether or not a person develops cancer from HPV depends on many different factors. It has to do with, among other things, the place where the cells grow and the extent to which the cells deviate. There are more than 100 types of HPV, including high-risk variants of cancer. HPV types 16 and 18 are the most dangerous and can cause cancer of the penis, anus, vagina, cervix, labia, and oral and pharynx. The time between HPV infection and the onset of cancer is usually more than fifteen years. An HPV infection itself does not affect fertility. However, the possible consequences can influence the birth of children, for example due to the development of a certain form of cancer and its treatment.
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Jos has since been declared cured, but found it difficult to feel ‘man’ after his operation: “It was very drastic, but I also found people’s ignorance difficult. ‘You had prostate cancer, didn’t you, Jos?’ customers asked when I went back to work. Penile cancer is much less known and something completely different. The urologist suspected that the cancer was deep in my penis and wanted to prevent dangerous cancer cells from remaining behind. That’s why I lost half my penis. That had a huge impact on my life and on my self-image. It only got better after a good plastic surgeon could help me by putting a piece on my penis, but I never really became myself again. I am cancer free, but always afraid that the disease will come back. You don’t wish your worst enemy the route I went through, which is why I’m so happy that boys now also get the chance to get vaccinated. And because the age limit goes down, HPV cancer is less likely to spread. Young people who do not get vaccinated run the risk of becoming as sick as I am or they could infect someone else. If I could travel back in time, I would definitely have gotten that shot!”
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Every year in the Netherlands, almost four hundred men get a form of HPV cancer, 80% of which can be prevented if boys are vaccinated. In addition, about 1,100 women develop cancer from HPV, about 75% of which can be prevented with the HPV vaccination. In the Netherlands, a vaccine is used that protects against HPV types 16 and 18. After vaccination, the body makes antibodies so that the virus is quickly recognized and cleared after an infection. The vaccine protects for at least ten years and works best before an HPV infection is present. HPV can be transmitted during sex, but the infection can also happen through fingers or the mouth. Using a condom offers protection, but it never completely prevents the transmission of HPV.
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In a number of European countries – Germany, Belgium, Ireland, Luxembourg and Norway – boys are also vaccinated against HPV in addition to girls. Many other countries have just started, are about to start or are considering HPV vaccination for boys. Oscar Brouwer, urologist at the Antoni van Leeuwenhoek Hospital, thinks this is a good development: “Penis cancer is a rare disease, most people don’t even know it exists. It is quite a taboo subject and shame also plays a role. Yet it is diagnosed in at least one hundred and fifty men every year. And it’s not just an old man’s disease, the number of men over the age of 30 with penile cancer is increasing and about half of the cases start with an HPV infection. That is why it is good that boys can also be vaccinated. As far as I’m concerned, there are few arguments not to opt for an HPV vaccination, all studies show that any side effects are mild and not permanent. We also now know for sure that vaccinating young is better, preferably before someone is sexually active. There have been major scientific breakthroughs recently: studies show that the HPV vaccination really protects well and that cervical cancer is much less common after vaccination. That is very good news, isn’t it?”
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The vaccination against HPV is part of the National Vaccination Program that is coordinated by the National Institute for Public Health and the Environment (RIVM). The vaccine used was launched in 2007 and will be used in the Dutch vaccination program from 2010 onwards. In the first ten years, about 800,000 girls were fully vaccinated against HPV. From 2022, the HPV vaccine will also be offered to boys after a recommendation from the Health Council. At the same time, the vaccination age will be lowered from thirteen to ten years. All children receive the invitation in the year they turn ten. In 2022 and 2023, all 12- to 18-year-olds who have not yet been vaccinated against HPV will also receive an invitation to protect themselves against HPV cancer. Whether or not to vaccinate is a personal choice and therefore not mandatory.
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