Stuff You Should Know - HPV and You
Episode Date: July 18, 2024Human papilloma virus, HPV, is an unusually common bug among humans. Most of the time it’s benign and your body manages to overcome the infection. Sometimes it can linger and cause warts.  But in t...he worst cases, HPV infections can actually cause cancer.See omnystudio.com/listener for privacy information.
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For so many people living with an autoimmune condition like myasthenia gravis or chronic
inflammatory demyelinating polyneuropathy, the emotional toll can be as real as the physical
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Welcome to Stuff You Should Know, a production of iHeartRadio.
Hey, and welcome to the podcast.
I'm Josh and there's Chuck.
And Jerry's here too.
And this is Stuff You Should Know.
And I've got an intro for this, Chuck. You ready? Chuck and Jerry's here too. And this is Stuff You Should Know.
And I've got an intro for this, Chuck, you ready? Yeah, let's hear it.
Dearly beloved, we are gathered here today
to talk about this thing called human papillomavirus.
What do you think?
That's good.
I hear the beat starting in the background.
Such a good album.
We gotta add some kind of good spin to this.
Sure. Well, we're talking about HPV, like you mentioned, and we should say right out of the gate, HPV is a very, very, very, very common sexually transmitted infection. If you have HPV or have had it, you may have not even known about it,
perhaps, because your body just took care of it. But if you have it and you know about it,
or have had it and knew you had it, it's no big deal for the most part. It's nothing to be ashamed
of. It is very, very common. It is. The problem is this. Like, that would be the end of the episode if HPV wasn't a virus, actually the first
virus found to cause cancer.
That is rare in and of itself compared to all of the HPV infections that are running
around the world at any given time.
There's a lot.
And there's a lot of different types of HPV.
But because it causes cancer, it's's a lot of different types of HPV. But because
it causes cancer, it's drawn a lot of interest from the biomedical community. And luckily,
what we're finding is that HPV is super treatable if your body doesn't clear it up on its own.
And in fact, there's an amazing vaccine out there that is one of the better, more effective
vaccines on the market today for anything.
That's right. And if people get this vaccine, they're potentially looking at eradicating
at least HPV-caused cervical cancer.
Yeah. Just getting rid of it. So long, goodbye cervical cancer. You're a thing of the past.
And because we brought up the vaccine so early, I believe I heard the sound of 100,000 people
skipping to the next episode or maybe finding a new podcast altogether.
Come on.
So the other thing that you might think about
when you hear of HPV, besides cervical cancer,
is genital warts.
Maybe the last few remain people have tuned out now.
Right.
But we're gonna dig into this,
because those including talk of genital warts
and cervical cancer, but HPV itself, we should say, is a larger name, an umbrella term, basically,
for many, many different viruses.
But there are a handful that are pretty key to our story here, and they are, you'll hear,
say, various numbers like HPV11, HPV16. That's how they have them labeled.
Yeah, and one of the stars, the villain, I guess,
is HPV16.
It's the strain that causes the most kind of cancers.
And it's actually, it's really ancient.
Like, the reason they call it human papillomavirus
is because it is specific to humans.
Like, you can give it to your dog all day long,
and your dog's not going to get it.
Your dog has papi—
Here, have some.
Right. Your dog and other animals have
papioma viruses. Apparently, cotton-tailed rabbits
get warts very easily from their papioma virus.
And we can't get it from them. So it's very, very specific.
And HPV-16, which is a kind of human papillomavirus that causes
cervical cancer among others, they believe that humans, us, modern homo sapiens, got
it from Neanderthals and Denisovans when we used to have sex with them and them with us.
You know what you gotta do before you try and give your dog HPV though.
What?
You gotta make him sit.
I don't get it.
What?
You gotta make your dog sit before you give it HPV.
All right, I'm just gonna scoot right on past that one.
Okay.
So we're talking a little bit of history.
We'll see, we'll do a poll
of people who get that joke and don't I want to hear
Is it?
Okay, all right. Well you explain it later and I'll see if I if I'm guessing it right, all right
Now I get chastised for explaining jokes. So I'm not even gonna do that this time. We'll let the people speak
Wait, why don't you do it next time? I really want to know this
I'll tell you after okay, so
Looking at our history of human beings, people have long suspected that warts that you see, like you got a wart on your nose or a wart on your elbow, that there was an
infection that was responsible for that happening.
Finally, we proved that in the
middle of the 19th century or so when they people there were scientists that
were intentionally trying to give themselves warts. Yeah. And it worked by
infecting their skin. So like, all right, we figure that out. With wart extracts. Yeah, gross.
It's trying to point that out. So it took a little while for that to go downstairs
and apply to genital warts because people thought
for a very long time, hey, if you have genital warts,
that's just a symptom of syphilis or something.
And we eventually learned that that's not the case at all.
Yeah, there was a 1917 German paper
that purposefully infected a virgin girl to prove that genital
warts exist outside of STIs, that it's its own thing.
And they did, they proved it.
So there's another thread going on at the same time back in the 19th century.
They figured out that cervical cancer
was a strange conundrum, scientifically speaking,
because if you took a group of nuns
and you took a group of married women
and put them together, the incidence of breast cancer
would probably be about the same.
The incidence of lung cancer, probably about the same.
The one that diverged is cervical cancer,
and they couldn't figure out why,
because it didn't really make sense, except the only way that did make sense
is that cervical cancer somehow developed
from a sexually transmitted infection.
I wonder if, like, one person knew it,
and they were sharing with other scientists,
and they were like, I don't know, and they were like,
what do nuns not do that other married ladies might do?
Drink wine? No, no, what's something ladies might do? Uh, drink wine?
No, no, what's something they might do in the bedroom, maybe?
Uh, watch TV?
I don't know, just tell me.
Oh, there's a good sketch in there somewhere, I think.
Sure.
So, uh, they figured all this out,
they put it all together, and they finally realized,
thanks to a German virologist, another one, uh one named Harald Zürhaußen, great name, in 1983 he
found that if you took a specimen of cervical cancer, a biopsy, and studied it closely,
you would actually find a papioma virus inside.
And specifically, it turned out to be what we now know as HPV16.
The chances are there's going to be some form of HPV16 found in that biopsy, in that cancerous
cell taken from a cervical cancer patient.
That's right.
And like you said, that was in 1983, flash forward to 2008, when Zerhausen gets a Nobel Prize in
Physiology or Medicine for his continued work
developing that HPV vaccine that we mentioned.
Right.
It's a nice work, Zerhausen.
Yeah, way to go.
I think he deserved it because he found this is the
first virus that we've ever shown to cause cancer.
It's like this whole field of medicine
that's starting to kind of wrap its head around
the role that viruses play in all sorts of diseases.
I know there's a hypothesis that schizophrenia
might actually be triggered by a dormant virus
that comes to life later on around your teenage years.
So this is the first time we point it to it.
And that's one of the things that makes HPV so fascinating.
There's not a lot of viruses running around that cause cancer, and this one definitely does.
Yeah, so we mentioned that it's a lot of viruses, over 200 if you want to get a little more exact.
And they generally divide these into a couple of different groups, the cutaneous and the mucosal types.
Cutaneous HPVs
are, this is where you think of the warts. They infect the skin if you have like
plantar warts on your feet or you have warts on your hands or something like
that. It's because of the cutaneous type of HPV. The mucosal type, and it's a
little grosser here because we have to say the word moist, but they specifically infect moist parts of the body. This is where you get warts on
genitals, your throat maybe, your nose, your anus, your cervix of course, and
your inner eyelids which can't be comfortable. Yeah and because all of
those or a lot of those are sexy parts, the inside of your eyelid notwithstanding,
it goes to show that HPV infection can be transmitted sexually.
It's not all the time, like the other kind, the cutaneous type that causes plantar warts,
you can get that from walking around a pool deck where there's HPV hanging out.
But it's a different kind of HPV.
HPV-16 that can cause cancer,
that is a sexually transmitted HPV, it's mucosal,
and it's also in a subcategory of mucosal HPV
called high risk.
There's high risk and there's low risk.
And as you may guess just from the names,
high risk typically leads to cancer or can.
The low risk almost never does.
Yeah, that's right. If you think, hey, can I use a condom to get around this?
That helps. But HPV, the mucosal type, it doesn't require bodily fluids for transmission. So,
if you are sexually active as a person and you have been so for a few years, then chances
are you've probably had HPV and maybe not even known it.
Yeah, and that's a really big point that you don't have to exchange body fluids.
And also similarly, Chuck, I want to make sure it's totally clear, genital warts doesn't
cause cancer.
It's a different type of HPV.
So you actually can give
somebody genital warts from sexual contact, but that's almost certainly not
going to lead to any kind of cancer. They're just different types, even though
they can be passed along similarly through skin-to-skin contact.
That's right.
So, yeah, I think you said just from being sexually active, you're probably going to pick up some
form of HPV or another. About 14 million Americans, yeah just Americans alone, get
a new infection every year. There's at least 80 million Americans running around
with an HPV infection right now. And if you do the math, here in America we have
a pretty pretty close
replacement rate where we have just a few more hundred thousand births than
deaths every year right so let's just say that's a wash at 14 million new
infections every year that means everything's staying exactly the same
as it is now in 24 years every single American will be infected with HPV and
we already said with HPV.
And we already said that HPV-16 we got from Neanderthals. So it's been around a really long time.
So it makes you wonder, well, why this sudden surge in infections.
And apparently a lot of the incidences of HPV or this rise in incidents can be traced
to changes in sexual mores and behaviors that have occurred over the last few decades.
Mm.
Should we just put a pin in that?
Sure.
OK.
We'll reveal what that might mean later on.
Maybe we should take a break, yeah?
Yes.
Pretty good intro, and we'll talk about gender awards
when we get back.
For so many people living with an autoimmune condition, the emotional toll
is as real as the physical symptoms. Starting this May, join host
Martine Hackett,
for season three of Untold Stories,
Life with a Severe Autoimmune Condition,
a Ruby Studio production, and partnership with Arginics.
From myasthenia gravis, or MG,
to chronic inflammatory demyelinating polyneuropathy,
also known as CIDP,
Untold Stories highlights the realities
of navigating life with these conditions conditions from challenges to triumphs.
In this season, Martine and her guests discuss the range of emotions that accompany each stage of the journey.
Whether it's the anxiety of misdiagnosis or the relief of finding support in community, nothing is off limits.
And while each story is unique, the hope they inspire is shared by all.
Listen to Untold Stories, Life with a Severe Autoimmune Condition on the iHeartRadio app
Apple Podcasts or wherever you get your podcasts.
Welcome to Good Game with Sarah Spain, your one-stop shop for the biggest stories in women's
sports.
Every day I'm bringing you the stakes, stats, stars, and stories to keep you up to date.
If you're new to women's sports, welcome.
Can't wait to show you around.
And if you've been around, let's make things nice
and comfy for our new friends.
We want good game to be just like women's sports.
The best of the competition, teamwork,
and rivalries that we love,
minus the toxic masculinity and drunken brawls.
Where else but women's sports?
Do we see a player passing her ex-wife on the WNBA's all-time leading scorer list,
and then watch her new fiancé, teammate, and MVP candidate talk about it afterward
on SportsCenter?
Shout out to DeWanna Bonner and Alyssa Thomas.
The tea, y'all.
The tea is so good.
Good Game is where we go to celebrate, debate, and dissect those stories and all aspects of women's sports.
Join us.
Let's have some fun.
Listen to Good Game with Sarah Spain
on the iHeart radio app, Apple Podcasts,
or wherever you get your podcasts.
Late on the evening of March 8th, 1971,
a group of anti-war activists did something insane.
Holy s***, we are really here.
This is really happening.
They weren't professional criminals.
They were ordinary citizens.
But they needed to know the truth about the FBI.
Burglars forged blackmail letters and threats of violence were used to try to stop anti-war
marches.
Even if that meant risking everything.
I just felt like I was living in the heart of the dragon
and it was just my job to stop the fire.
I'm Ed Helms, host of Snafu,
season two, Medburg,
the story of a daring heist
that exposed J. Edgar Hoover's secret FBI.
If it meant some risks that were involved, well, that's what citizens
sometimes have to do.
Listen to season two of snafu on the iHeartRadio app, Apple podcasts or
wherever you get your podcasts.
Tom Slick, February 14th, 1958.
We just heard it.
The proof.
Owen Wilson is Tom Slick, mystery hunter.
To track the Yeti is an expedition of life and death, Mr. Slick.
It's a mystery that does not want to be solved.
That's why I'm here.
We're gonna die.
Nellis, when she's dead, Mr. Slick. It's a mystery that does not want to be solved. That's why I'm here.
We're gonna die!
Nellis, when chance arrives, act!
God, I need my blood pressure checked after that.
Mom, you don't have to listen to this if it's too much.
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Listen to my show, Tom Slick, Mystery Hunter,
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or wherever you get your most thrilling adventure stories.
All right, so we're back. We promised more talk, that is, of genital warts.
I believe you mentioned the low-risk mucosal type, usually 6 and 11 HPV are the ones that
cause these warts or other moist membranes, mucous membranes. They don't generally cause a lot of health problems,
or any really.
They can be painful sometimes, they can be itchy.
Obviously, there's a lot of embarrassment that surrounds
genital warts, just saying those words together
isn't something you're probably going to advertise to people.
No, you don't say like, just disregard my genital warts.
Yeah, I mean, well, I'm sure plenty of people have said that, but who knows where...
It doesn't always work.
It doesn't always work.
But it's nothing to be ashamed of because it is quite common and they can be removed.
Sometimes medication can do it.
Sometimes they'll do the old freeze with liquid nitrogen routine.
I used to get that. I got warts on my elbows and I used to get it burned off with liquid nitrogen routine. I used to get that.
I got warts on my elbows and I used to get it burned off with liquid nitrogen pretty regularly.
I think I remember that.
It's not pleasant.
Yeah.
I feel like I've had that done with, I think I had planner warts that they did that to
when I was in college.
Yeah.
I mean, you can get rid of warts that way.
Yeah.
There's also lasers these days that can handle that.
Different methods to get rid of those genital warts in due time.
So don't worry about it if you have those people.
Just keep soldiering on. You'll be okay.
Yes. So there are some types of HPV infections that lead to warts, mucosal warts, that can
be a problem. There's one in particular, respiratory papiomatosis, is a condition that's caused
by warts in the airways. And it typically happens in kids and it's treatable, but it
can narrow the airway in that in and of itself is problematic. They think that it's treatable, but it can narrow the airway in that, in and of itself, is problematic.
They think that it's transferred,
that HPV infection is transferred during birth
or from the amniotic fluid inside the womb,
but it's pretty rare.
It's one of the rare ones that, okay,
this actually could be a bit of a health problem from warts.
Yeah, for sure, but that is only in young children.
It's usually you see it between the ages of two and six.
It can occur in adults, but I think it's even more rare.
But again, you can remove these surgically.
So you can get that taken care of as well.
Yeah, plus you get to go back to school in the fall
and be like, yeah, they shot lasers down my throat.
What did you do this summer?
That's right to get rid of my warts. Yeah
There's also infections with the high-risk kinds of APV
That don't clear up on their own and these are the ones that could eventually lead to cancer
Yeah, so
This is a very very long process, but essentially this HPV infection
that can, is akin to causing warts, just causes, hijacks a cell, just like any other virus, causes
it to multiply and multiply and multiply, and then as these cells rupture, they release more viruses
into the extracellular membrane, and they get into more cells,
and it just gets worse and worse.
The difference between an HPV infection
and other types of infections from viruses
is that they're not systemic.
They stay very, very localized,
and so they form a very recognizable lesion.
Yeah, but it isn't just cervical cancer, though,
that we should point out.
I believe there are six kinds of cancer.
I think the data that we got, was this Livia? Did she help us with this?
Yeah, hats off.
I could tell. In a good way.
I was like, oh, geez, I could tell.
All the dirty jokes that we can't see? 2021 is when we got the latest CDC data with more than 37,000 cases of cancer associated
per year of HPV, that are associated with HPV, 22,000 in women, 16,000 in men, and the
six kinds of cancer, or I guess the five besides cervical, are anal cancer, penile
cancer, vaginal cancer, vulvar cancer, cancer?
Vulvar cancer.
Man, that's hard to say.
It is.
That's a good pre-stage warmup.
Okay.
So if you hear me backstage saying that.
Good Lord.
And then finally, oropharyngeal cancer, which is the base of the tongue, the back of the
throat, tonsils.
You can also get that through tobacco use, not surprisingly.
So you should also not be surprised to learn that as tobacco use has gone down, so have
incidences of non-HPV oropharyngeal cancer.
But incidence of oropharyngeal cancer overall has increased
because there's been a rise in HPV infections.
Right.
And I think I made it pretty clear HPV16 is one of the big baddies of this episode.
So is HPV18. Those are the two most common cancer-causing types of HPV.
They're responsible, HPV-16 is responsible for 90%
of HPV-related oropharyngeal cancers,
half of all cervical cancers,
and all the other cancers that are related to HPV,
it makes up a significant portion of them, just 16 alone.
Yeah, and I think 18 causes 20% of cervical cancer.
So between those two, you know, you're looking at 70%.
So let's talk cervical cancer, shall we?
Because it is a, it's really important.
It's become, I guess, how do you put it?
It's really emerged as a condition that's gotten a lot of attention
because there's so much potential
for getting rid of it altogether.
Yeah, and it's a situation where here in the United States,
due to early detection and treatment,
it is really, really lowered.
I think it's gone down by more than 50%
from the mid-70s to the mid-2000s,
and only, and of course, 4,000 people is a lot of people,
but when you're talking about what the rates could
and would have been in the past,
4,000 Americans dying of cervical cancer each year
is a lot of progress has been made.
Yeah, and overall, I think there's 350,000 deaths
from cervical cancer worldwide every year.
Yeah.
And I mean, Americans make up a decent portion of the world population, but not a good portion
of the cervical cancer death population.
The reason why is because America has a really robust screening process that is easily accessed
by American women to search for cervical cancer and catch it early on.
And it's not nearly as robust
in some other developing parts of the world.
Yeah, because in America, once you turn 21,
if you're a woman, generally from about 21 to 65,
you're gonna be getting a Pap test about every three years, or 65, you're going to be getting a PAP test about every three
years, or at least you're supposed to.
And the U.S. Preventative Services Task Force, the USPSTF, says if you're under 30, they
don't recommend that you get tested for HPV unless you have some pretty obvious risk factors.
Why?
Well, because generally by then you have probably gotten it and it has probably cleared up on its
own and that also means that you have some kind of immunity, sometimes very long-lasting immunity.
Yes, so they say don't bother with the HPV test, but definitely do get your pap test
Pap by the way isn't short for papioma. It's short for the guy who came up with the test Georgios Papa Nicolaou
Pap I guess to his friends and family sure
So that's looking for abnormal cells in your cervix if they find that then you test for HPV to see what kind of HPV
Infection you might have that could account for those abnormal cells.
And then the American Cancer Society says,
forget that, just start at 25, forget the Pap smear,
start with an HPV test.
Like if you have to prioritize one, do that.
And you might say, well I'm confused.
The Preventative Services Task Force says 30,
and focus on the Pap test in the meantime.
The ACS says, throw the PAP test out,
focus on the HPV test starting at 25.
Which one should I choose?
And you don't have to worry if you're an American
because your insurance company will choose for you
and that'll probably be neither.
That's right.
If during your screening you happen to see what's a pre-cancer or dysplasia,
then what they're probably going to do next is to examine the cervix.
It's not a pleasant process.
It's done using an instrument called a colposcope.
You may get a biopsy performed,
but a lot of times it's a minor thing that's going to go away on its own.
And so what they might do is say, hey, let's just monitor this thing instead of removing it and just sort of get you tested more regularly to see what's happening with that.
Hey, welcome to your year of anxiety.
Yeah, true.
Until your next test. It sucks.
Yeah, but the next test. It sucks. Yeah, but the answer with you. Yeah, yeah, for sure.
Because we've got this early screening, because they are, have like a lot of telltale signatures.
They might, they may also do a biopsy.
If it does seem like it's a big deal, they may do more invasive surgery.
But for the most part, we'll set cervical cancer aside for
a second until we get to the vaccine. If you go get a Pap test and you do some form of
HPV testing if needed, you're probably going to catch it early enough for it to be treated.
That's right. That's the great news with cervical cancer.
Unfortunately, the other kinds of cancers,
the other five that we mentioned, caused by HPV,
there isn't a routine screening for those
or preventative treatments for those.
And that is one of the reasons why you mentioned
oropharyngeal cancer is growing,
even though tobacco use and tobacco-caused oropharyngeal cancer is growing even though tobacco use and tobacco caused
oropharyngeal cancer is falling. Yeah because people stopped using tobacco as
much but they replaced tobacco use with oral sex which is one of the it's
actually the biggest risk factor now for developing oropharyngeal cancer and
the more oral sex partners you've had, the greater your risk of developing oropharyngeal
cancer a few decades later is, as a matter of fact.
So that's what I was saying earlier when I was saying that there's been a change in sexual
mores in behavior.
Oral sex has become much more prevalent since the 60s and 70s than before.
And a lot of those men in particular are starting to age into that point in their life where
that HPV infection is developing into a cancer and is developing into oropharyngeal cancer.
Right.
And we're talking specifically about oral sex performed on women.
So I guess the idea is that you can get that HPV and many, many years later,
when you're, like you said, in your 50s or 60s, that's when it might rear its ugly head.
Yeah, do you remember when Michael Douglas said that he had oral cancer, throat cancer, I think, and he's like, it's from oral sex.
Yeah, and everyone laughs.
Yeah, that's exactly what he was talking about.
And he's right in that age group of boomers that were like, you know, let me try this
back in the day.
So we don't have a good handle on really anything besides cervical cancer. So the oropharyngeal cancer field, like the researchers and doctors who study this
kind of stuff are like, okay, it's go time for us because, you know, we thought
everything was just ducky with the tobacco use going down and now we've got
this, we've got to figure this one out.
That's right. Good time for a second break?
I think so.
All right, great.
We're going to take a break.
And we talked about the vaccine a couple of times.
We're going to come back and put all our vaccine cards
on the table right after this. For so many people living with an autoimmune condition, the emotional toll is as real as
the physical symptoms.
Starting this May, join host, Martine Hackett for Season 3 of Untold Stories, Life with
a Severe Autoimmune Condition,
a Ruby Studio Production, and Partnership with Arginics.
From myasthenia gravis, or MG,
to chronic inflammatory demyelinating polyneuropathy,
also known as CIDP, Untold Stories highlights
the realities of navigating life with these conditions,
from challenges to triumphs.
This season, MartÃn and her guests discuss the range of emotions that accompany each
stage of the journey. Whether it's the anxiety of misdiagnosis or the relief of finding support
community, nothing is off limits. And while each story is unique, the hope they inspire
is shared by all. Listen to Untold Stories, Life with a Severe Autoimmune Condition on
the iHeartRadio app, Apple Podcasts, or wherever you get
your podcasts.
Late on the evening of March 8th, 1971, a group of anti-war activists did something
insane.
Holy s***, we are really here.
This is really happening.
They weren't professional criminals.
They were ordinary citizens, but they needed to know the truth about the FBI.
Burglars forged blackmail letters and threats of violence were used to try to stop anti-war
marches.
Even if that meant risking everything.
I just felt like I was living in the heart of the dragon and it was just my job to stop
the fire.
I'm Ed Helms, host of Snafu, season two, Medburg.
The story of a daring heist
that exposed J. Edgar Hoover's secret FBI.
If it meant some risks that were involved,
well, that's what citizens sometimes have to do.
Listen to season two of Snafu on the iHeartRadio app,
Apple podcasts, or wherever you get your podcasts.
Welcome to Good Game with Sarah Spain, your one-stop shop for the biggest stories in women's sports.
Every day I'm bringing you the stakes, stats, stars, and stories to keep you up to date.
If you're new to women's sports, welcome. Can't wait to show you around.
And if you've been around, let's make things nice and comfy for our new friends.
We want Good Game to be just like women's sports.
The best of the competition, teamwork, and rivalries that we love, minus the toxic masculinity
in drunken brawls.
Where else but women's sports?
Do we see a player passing her ex-wife on the WNBA's all-time leading scorer list
and then watch her new fiance, teammate, and MVP candidate
talk about it afterward on SportsCenter?
Shout out to Duana Bonner and Alyssa Thomas.
The tea, y'all, the tea is so good.
Good Game is where we go to celebrate, debate,
and dissect those stories and all aspects of women's sports.
Join us, let's have some fun.
Listen to Good Game with Sarah Spain
on the iHeartRadio app, Apple Podcasts,
or wherever you get your podcasts.
Tom Slick, February 14th, 1958. We just heard it, the proof.
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Listen to my show, Tom Slick, Mystery Hunter, on the iHeartRadio app, Apple Podcast, or
wherever you get your most thrilling adventure stories. Um, Chuck, before we move on to the vaccines, which I agree we should do, post-haste, we do want to mention that
the other kinds of high-risk HPV mucosal cancers include, I think like you said, anal cancer,
vulvar cancer, penile cancer, and vaginal cancer. And they start to get much more rare,
starting with anal cancer down to vaginal cancer, as far as cancer cases go caused by HPV.
Hopefully we'll be able to figure this out
and there won't be any of those cases,
but that's another reason why cervical cancer
got so much attention because it was much more prevalent
in addition to much more treatable.
That's right, I'm glad you said that stuff.
So now we can talk about the vaccine, okay?
Yeah, let's do it.
There were two guys, Jean Jow and Ian Fraser.
They both worked at the University of Queensland.
I believe Ian Fraser ran the lab in Jean J, and his partner worked for Ian Fraser,
and together they started studying HPV,
specifically HPV-16,
and they figured out that you could take HPV-16
and isolate proteins from it,
and you could use those proteins ostensibly in a vaccine.
And in very short order, within a few, well, a decade or so,
a vaccine finally did come out.
Apparently, the drug companies took some pep talks, I guess,
about how much money they could make on this.
And they finally saw the light.
And we ended up with a HPV vaccine in 2006.
The first one was called Gardasil.
And I remember when this came out,
because from the outset, it came out essentially
in the midst of the firestorm
of the vaccines cause autism stuff
that was going on at the same time.
Merck was like, hey, we got a new one, everybody.
Come check this one out.
That's right.
It's meant for girls and women between 9 and 26 years old.
There's a group called the ACIP, the Advisory Committee on Immunization and Practices,
that said, you know, this stuff's good to go.
Let's get it out there.
And it protected against HPV 16 and 18,
which is the most common high-risk types we talked
about, and then 6 and 11, which more readily caused the genital wart.
So it basically kind of took care of the four bad guys.
Yeah.
And after this thing was released, they started launching studies on the, like, real-world
studies on people who had gotten it, and they found like, this is actually pretty good at protecting people
against those four HPV strains.
And in fact, they also figured out that it could protect men against genital warts and
anal cancer, because anal cancer, or HPV that causes anal cancer, I think 16 or probably 18 as well, can be transmitted from anal intercourse.
I can't remember. Receptive anal intercourse, that's the word.
And so you can transmit it like that. And they found that if men got this vaccine, it protected them against that,
which was pretty surprising because at the beginning they were like, yeah, we just need to give this to little girls.
And then they were like, no, we need to give it to little boys too.
That's right.
So that was in 2009 when the FDA licensed it for for boys and men from nine to 26.
And again, a couple of years after that is when the ACIP said, yep, we should get it going in that population.
Yeah, so at the same time, GlaxoSmithKline said,
us too, we wanna make some money off of this too,
and they released Cerverix,
which I guess just never really picked up steam
against Gardasil because in 2014,
Merck released Gardasil 9,
and that is essentially the de facto HPV vaccine in
most of the developed world.
It protects against, as you might have guessed from the name, nine different strains of HPV,
not just the common ones, but also some less common ones that are still high risk.
And they also found, again, through more clinical trials and more real-world studies, that these
things were really, really effective at protecting kids if you gave them this vaccine before
they became sexually active.
Right.
Because one of the really big keys here is once you're infected with a strain of HPV,
that vaccine won't protect you against that strain.
It'll protect you against the other strains that you haven't gotten yet,
but it apparently won't do anything.
It doesn't cure any HPV infections.
It just defends against them from getting infected with them.
Yeah, and that's why they went from down to nine years old.
It's two shots, six months to a year apart. If you're older than 15, I believe you have three
shots over a six-month period. And if you're like, well, wait a minute, at the time, like you're like,
well, I'm older now and this stuff just came out. And they're like, sucks for you. Yeah, well,
they, you know, you're not going to get the full benefit necessarily from that vaccination,
but they said it still may be worth getting if you weren't vaccinated as a kid.
Especially if you had fewer sexual partners.
So less sex, the older you are, the likelier the vaccine is to protect you against it later
in life
Right and if you were a 40 year old virgin then they made a movie about you
Steve Carell pretty good movie, too. Yeah, I like that one
So like I said, this thing was released in the midst of the vaccine
Vaccines cause autism firestorm
And so it was controversial right out of the gate
But Rick Perry who was governor of Texas of the gate. But Rick Perry, who
was governor of Texas at the time, did not help things at all. He did something
that seems extraordinarily bizarre today in retrospect. He was the Republican
governor of Texas who ended up serving as Department of Energy secretary under
Trump. And he mandated as governor that every girl entering sixth grade who
lived in Texas had to get the Gardasil vaccine in 2007 a year after it got FDA
approval and that did not sit well with a lot of parents. No a lot of parents
were either just you know sort of like stuff you hear about today,
like, you know, parents' rights groups saying that we want to make those decisions.
Some of them were part of the anti-vaccine movement.
And some of them also, and just people in general, I think, were like, well, wait a
minute, Perry, you've got, you're cozied up to these lobbyists for Merck.
Like, is that what's going
on here?
So it was, it was a big deal.
And like you said, in retrospect is, it's very odd to see a Texas Republican governor
mandating vaccines for anybody.
Yeah.
And Rick Perry had big time ties to Merck.
That was the only HPV vaccine on the market at the time.
So it's not like he could choose from a different type, but just those ties
made the whole thing smell fishy.
There was another really big thing
that parents came out against.
There was a lot of fear that when you vaccinated
your kid with a HPV vaccine, they were gonna run right out
and start having receptive anal sex
because now they were protected.
They were gonna have intercourse
or you have oral sex starting at age nine
because you just gave them this license
to go have sex because you vaccinated them
against HPV.
And that was the one that the most
vocal opponents
sounded the alarm about.
But it turns out
from studies, follow-up studies about
hesitation, HPV vaccine hesitancy among
parents, that's almost like not even on the charts.
Like very few parents are actually worried about
that.
They're more worried about things like whether it's
safe or they think that their kid actually doesn't
need it because my kid's ugly.
Like there's a whole other cadre of reasons and that
one apparently didn't pan out.
And studies that looked at it, that possibility found that girls who had been given the HPV
vaccine pre-teen compared to girls from the same cohort had no more incidences of seeking
birth control, of pregnancies, or of any other things that indicated they had more sex
than the girls who weren't vaccinated with the HPV vaccine.
Yeah, and I bet one reason is because parents
probably didn't say, all right, you're going to the doctor
and you're getting this vaccine,
and you know what that means.
Ear, ear, ear.
So the other, one of the other things that popped up
was the idea that
Whether or not you need to vaccinate boys
In 2011 there was a story in the New York Times
That that basically kind of suggested that the biggest benefit for male vaccination was either
protecting female partners because well was protecting female partners because the only way to, if you're gonna get it as a man or a boy, is to have, like you
said, have that receptive anal sex. And so we've learned since then that straight
men are also at risk, especially for that oropharyngeal cancer. So that was sort of,
I mean, I was about to say quickly quash
But also it wasn't because people got up in arms about it
Yeah, because I mean they HPV 16 causes 70% of oral cancers, right?
So if you give a boy the vaccine against HPV 16
You're going to take a big bite out of that possibility of them developing oropharyngeal cancer later in life.
It just makes sense. So it does make sense for boys and girls to both get the vaccine, and yet
thanks to the anti-vax movement, thanks to Rick Perry and his Merck ties, thanks to that study that
linked autism with vaccines, there's still today just a lot of hesitancy
in mandating HPV as part of a required vaccine schedule
among boys and girls in America.
I think Delaware, Rhode Island, Hawaii, Virginia, and DC
are the only ones that require vaccines for students.
They require it for boys and girls.
But even with that hesitancy among states,
among individuals, the cases of cervical cancer
and deaths from cervical cancer have fallen dramatically
since 2006 when we started vaccinating kids against HPV.
Yeah, I mean, that's the one takeaway is that
this is a vaccine that really seems to work.
Yeah.
There was a study in 2021 that found that among women who had been vaccinated between 12 and 13,
there were 87% fewer cases of cervical cancer.
Yeah, that's nuts.
Johns Hopkins came up with a model that said that because of vaccination rates among men,
there should be 1,000 fewer cases of oropharyngeal cancer by 2045.
You might be like, that's it? That doesn't seem like that much.
The reason why is because only 20 to 30 percent of boys aged 13 to 17 are getting that vaccine.
If you increase that percentage to like what girls are getting, which is more like the 60 to 70% range, it would take an even bigger bite out of oropharyngeal
cancer in the future because those kids will eventually age and if they got the vaccine,
they won't have contracted that strain of HPV.
That's right.
How many people are getting this vaccine? vaccine, more and more. In 2022, 57% of kids between the ages of 15 and 17 had gotten at
least one dose. If you are from a family that has parents that are college-educated and
maybe a little more money, you're more likely to be vaccinated against it, statistics show.
And you know, public education is one of the big reasons
that people are more aware of it and more inclined to get it.
Yep.
So I guess that's it, Chuck.
HPV.
Yeah, if you wanna know more about HPV,
there's a lot to go read out there and educate yourself on.
Same with the HPV vaccines that are available.
You should probably read up on anything like that first.
But make sure that you are getting your info
from trusted sources.
And since I said that, of course,
it's time for Listener Mail.
This is good because it ties into an episode on whistling
and something we both love, which is?
Whistling.
The Scorpions.
Oh yeah, I love this one.
Hey guys, listening to the show about Whistling
and got to the part of the episode about popular songs
and as I hoped, you guys did mention
the classic Wind of Change by Scorpions.
Side note, he says, it's just scorpions, not thee.
Oh, sorry.
Didn't know that.
Kind of like eagles and indigo girls. And Edie Brichel in New Bohemians. note he says it's just scorpions not the oh sorry didn't know that and like
Eagles and Indigo girls and Edie Braquel and new bohemians yeah and Edie
Braquel and new bohemians yeah that's right yeah know what you said yeah yeah
brand new bohemians and brand new heavies that's right oh god how you still
love that man and new pornographers.
Oh, well, you know I still love them.
Uh, who else? Jethro Tull.
Okay, I look Jethro Tull too.
Oh my god.
He whistled through his flute.
Um, however, guys, uh, I was half expecting one of you to mention this crazy fact and you passed over it.
To state it briefly, there exists a conspiracy theory that the song Wind of change was written or partially written by the CIA as
A mode of propaganda to help bring an end to the Cold War. Hmm. I had never heard this at you
No, but it really rang true because I remember when the song came out and what it what the sentiments were like
Oh, sure down to Gawky Park
The song was written and released just months before the Berlin Wall was brought down and became hugely popular
Throughout the Soviet Union at the time it kept a political leaning song was very out of character for scorpions. I
Just can't say it. Yeah, I just picture a bunch of scorpions
Yeah, it doesn't quite sit right. It's not like Jethro Tull
No, very out of character for The Scorpions.
And the band claims that the song was written by lead singer Klaus Meine,
who typically never wrote music for the group.
I didn't know that either.
Their manager Doc McGee somehow weaseled out of a large drug case
with a mysterious deal from the US government.
The Scorpions claim the song was inspired during a rock festival
called the Moscow Music Peace Festival,
where the bands were surrounded by CIA and KGB handlers.
The interesting wrinkles go on from there.
Probably not doing it justice,
but highly recommend the podcast,
Wind of Change, by Patrick Radon-Keefe,
which chases down a number of these connections and threads.
If nothing else, it's a pretty amusing story about the 80s hairband. They were more than a hairband.
Yeah, they were a political hairband.
Yeah, that's right. I hope this email finds you guys well. Have been a huge fan for years.
Glad I could share this with you. That is Jimmy from Spokane, Washington.
Nice. And Jimmy, I want to just follow up, and Josh,
with a recommendation of my own.
If you're a fan of scorpions,
I recommend that you go look immediately
at the video for the song from 1978,
Sails of Charon.
Charon, like the river sticks boat keeper? Yeah, Charon, Sails of Charon. Charon? Like the river sticks boat keeper?
Yeah, Charon.
Sails of Charon.
C-H-A-R-O-N.
Yeah.
If you only know the scorpions from like the early 80s, then check out this gem from
1978, because it's awesome.
All right, well we've got a couple minutes left before we hit 45, so I am going to tell
you about a movie that I watched last night from 1979 called Tourist Trap. Have you ever seen it?
I don't think so. It is the definition of camp without intentionally being camp,
without being annoying camp. It's one of the best schlocky late 70s horror movies I've ever seen in my life.
It is really good.
All right, what year, 1970?
79.
You can stream it online somewhere.
I'm looking it up right now.
You don't even have to pay for it.
Please watch it.
It's a really good one.
It's like a highly watchable, enjoyable movie.
And there's some surprising little, like,
directorial bits in there that you're like,
wow, that seems sophisticated for this movie.
Tonya Roberts and Chuck Connors are in it,
that's enough for me.
That's all you need right there, yep.
90 minutes, also perfect.
Yep, so go forth, look up,
Sales of Charan video by Scorpions.
Yeah, you need to watch that one,
you're gonna love it.
I still need to watch your whistling video that you watch that I know I feel like a jerk I'm
sorry all right you got you got work to do I do well I'll well while I do that
you guys go out and send us a listener mail you can send it off to stuff
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