COVID-19 update

THE number of people infected with COVID-19 has risen to almost 17 million, with nearly 98,000 new cases in 24 hours worldwide, and about 660,000 deaths. There are almost 4.5 million cases in the United States, with about 16,000 new cases in one day, and about 152,000 deaths, 400 of which was last Monday, July 27. Brazil has the second highest total, with almost 2.5 million cases and 88,000 deaths, and almost 3,000 new cases. The Philippines has about 83,700 cases and almost 2,000 deaths (1,680 new cases).

In our column in March, we warned about the probability of a second or third wave of COVID-19 in the U.S., which would be caused by people’s protests and demand for their civil rights and lack of self-discipline and reckless behavior. The recent increases in the number of cases in California (466,835, with 8,549 deaths) and Florida (441,977, with 6,119 deaths) are a testament to people’s non-compliance to socially distance and wear face covers. The massive testing and high positive results are not to blame for the spikes in the number of cases. If people were more compliant and disciplined, the number of positives would be enormously less. More people tested positive because they were careless and exposed to those infected. Social distancing and facemasks have been proven very effective, together with discipline and personal hygiene. It’s time we learned!

Oral sex

The rate of throat cancer in the United States has not declined, compared to most head and neck malignancies. I suspect that the statistics could also be true, when extrapolated, for other countries like the Philippines since most Filipinos are westernized in their lifestyle, habits, and behaviors.

The most logical explanation why cancer of the throat has not diminished has been attributed to the Human Papilloma virus (HPV), a bug that causes a sexually-transmitted disease. HPV is popularly known to cause genital warts and most cancer of the cervix (mouth of the womb). It has only been fairly recently when scientists discovered and identified HPV transmission through oral sex as an etiology of throat cancer.

M.D. Anderson Cancer Center in Houston reported that its research team found “the incidence of throat cancer (in the United States) to be stagnant and even rising in some populations, defying a downward trend in other head and neck cancers linked more closely with smoking.”

The American Cancer Society reports that the greatest risk factors in head and neck cancers are smoking and drinking alcoholic beverages (90% of them either smokers or tobacco-chewers and about 80% of them imbibed a lot of alcohol). The good news is that a trend analysis in head and neck cancers in the United States shows a decline the past twenty years, trailing a decrease in smoking prevalence, which started in the 1970s, by 10 to 15 years.

The bad news is that oro-pharyngeal cancers (which include the tonsils, base of the tongue and soft palate, and side and back of the throat) have gone up in some populations in the United States, and probably among people in other parts of the world who practice oral sex, where HPV takes its toll.

A vaccine, Gardasil, which is genetically engineered, blocks infection caused by two of the more than 100 types of Human Papilloma Virus (HPV), strains 16 and 18. These two sexually-transmitted viruses are responsible for about 70% of cervical cancers. HPV, in one form or the other, afflicts about 20 million Americans. The other strains of the virus cause painful genital warts, and sometimes, cervical cancers too.

How prevalent is cervical cancer?

In the Philippines, there are about 5,000 new cases of cervical cancer each year. However, more alarming than that is the fact that there are between 10,000 to 25,000 women walking around (not seen by physician) who have undiagnosed pre-invasive lesions in their cervix. If diagnosed early, these women could be saved. For every four survivors of breasts cancer, there are less than 3 women who survive cervical cancer, which shows how virulent cervical cancer is.

What causes cervical cancer?

Human Papilloma Virus (HPV, also known as genital herpes virus) accounts for most cervical cancers. At least 50% of sexually active men and women are infected with genital HPV, especially those with multiple partners. There are about 20 million American men and women infected with HPV, many linked with abnormal pap tests, genital warts and cervical cancer. It is estimated that at least 10,000 new cases of cervical cancers are discovered annually. Between half a million to a million Americans have genital warts, transmitted through sexual contact.

Is the cure for cervical cancer?

Better than the cure! A vaccine (Gardasil) that prevents cervical cancer, vulvar and vaginal cancer that was approved by the US-FDA in 2006 was found to be “effective 100%, in the short term, at blocking the cancer and lesions likely to turn to cancer” (like the pre-invasive lesions), according to Gardasil manufacturer, Merck & Co. “To have 100 percent efficacy is something that you have very rarely,” Dr. Eliav Barr, Merck’s head of clinical development for Gardasil, told The Associated Press. The UK’s version of the vaccine is known as Cervarix.

How early should the vaccine be given?

Students in grammar school, middle school and high school should be vaccinated before they become sexually active because once they catch HPV infection there is no cure; herpes is for life. This is the recommendation of Dr. Gloria Bachmann, director of The Women’s Health Institute at Robert Wood Johnson Medical School in Brunswick, NJ., who said this vaccine is a “phenomenal breakthrough.” Prophylaxis Gardasil vaccination comprehensively eliminates HPV 16 and 18 associated non-invasive and invasive cervical cancer. The vaccine also cuts down infection with HPV 6 and 11, the causes of 90% of genital warts.

How about throat cancers?

Of the 45,000 head and neck cancers in the U.S. each year, about 10,000 of them are oro-pharyngeal cancers, and tongue cancers among young adults have also increased. The evident conclusion is that the cause is the HPV virus.

“Over the last five years, 35% of the throat cancer patients treated at the M.D. Anderson Cancer Center had no history of smoking, and that close to 90% of patients who had never smoked showed evidence of oral infection with HPV,” says Dr. Sturgis on Web MD.

Vaccination against HPV among young girls and boys have been proven to be of great benefit in preventing the infection and the related potential malignancy. The use of cling plastic wrap used in the kitchen, placed over the woman (groin to groin), has been advocated by some to prevent HPV transmission when oral sex is performed. Mouth, tongue, and other throat cancers could be as grave and deadly as most other forms of cancers.

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Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, a Health Advocate, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites: philipSchua.com and FUN8888.com; Email: [email protected].

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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