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  • Dr Jonathan Gui

The Unpleasant Growth

Updated: May 4, 2021


HPV looking like Cancer

Prologue:

HPV and warts may affect or is already affecting you. HPV causes anal, penile, vaginal, oral, vulvar cancers and unsightly warts at the private parts. This will surely reduce your self-esteem and your overall health. This story may relate to you deeply and you may be able to find solutions to this “WARTY SITUATION”. This is a fictional story which may be coincidental or may reflect real-life occurrences.


The Beginning:

In early May 2019 I had a patient who visited my clinic who rushed into my consultation room and forgot to register at the registration counter in his haste to see me. I chuckled a bit with his little antics. Clearly he was anxious, scared and worried with frown lines drawn from temple to temple. “Have a seat”, as I dismissed the formalities of Mr. or Sir. Clearly he was younger than me by a decade. Before I could introduce myself, he had already whipped out his penis to show me the lesion saying “Doctor see! Look at this bump. Is it cancer?.” “Calm down. I have not even registered you in the system. After I register you then we can discuss regarding your problem. Can I have your Identity Card?”. “Sorry. Sorry”, he said and he tucked away his shaft. I politely gave him a squirt of hand sanitizer liquid before I took his Identity Card.


Bumps on the Penis

His name is Yong. I looked at Yong thoughtfully, he is still twenty-three years old and he has good features; fair, small framed, with the typical Korean-like double eye-lid and high nose bridge. “Yong, before I proceed to see any part of your body, I will need to ask you a few questions.” He almost braced himself when I said that I will ask him a few questions. Clearly this case is not just some supposedly simple skin cancer. In my years of experience, I can easily spot a guy who has done something which he is not comfortable talking about. He makes me feel like I am looking a Bambi from Walt Disney. There was a scene when Bambi was trying to walk as he was wobbling, that was the perfect description. “Ok”, Yong said as he shifted his position uncomfortably.


“Yong, how long did you have the bump?” I asked. “Ummm… about 3 months but it is not painful or itchy,” he replied with a straight face. “Are you single or have a partner or may be a girlfriend or boyfriend?” as I smiled. I gazed at me with his wide eyes and said in a single word “Boyfriend.” His response told he a lot and as my lecturer always said the ‘diagnosis is always in the details’. “You and your boyfriend had any sort of ‘fun’ together?” Yong just nodded quietly, as ‘fun’ meant Sex.


I asked a few more questions and it was evident that based on the time of growth, speed of growth, location of the lesion and finally his sexual history seemed to point towards warts which is usually caused by Human Papillomavirus (HPV). Yong was surprised that we could get HPV and warts because he heard and assumed that HPV affects only women. Furthermore you can get HPV from skin to skin contact like touching and kissing.


HPV and Warts do not just affect females, it affects both male and females. It is a misconception due to the programs of Malaysian Ministry of Health which only targets young girls to be vaccinated against HPV (http://www.lppkn.gov.my/index.php/en/archive-news-events/50-soalan-lazim/964-faq-pvhpv.html).


HPV diseases in both men (grey side) and women (white side)

Most of the time men have little to no symptoms but they can act as carriers of the disease to others. So in the recent developments and awareness of HPV affecting boys and girls, many developed countries have started vaccinating both sexes (https://www.cdc.gov/vaccines/parents/diseases/teen/hpv-indepth-color.pdf). There are about 100 subtypes of HPV and about 40 subtypes causes disease to the human body. Studies has shown a reduction of anal, cervical, vulva, penile, oral cancers and warts from 70-95%. Control of Diseases Center (CDC) also advocates for anyone who is sexually active and especially men to men sex requires to be vaccinated for Hepatitis A, Hepatitis B (https://www.cdc.gov/hepatitis/populations/msm.htm) and HPV (https://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm).


Now back to Yong’s story: I examined him and told his that I will remove his lesion and send it to the pathologist to review. It is unlikely to be cancer but to be sure the sample needs to be sent for biopsy. He received the news well but still he was worried that he had other forms of Sexually Transmitted Disease which was not tested on routine blood test. After a long 40-minute consult and addressing his issues, we proceeded to have a few of his warts removed and sent for sampling. There were a few peanut sized warts over his foreskin and over the head of his penis but I did not totally remove all the warts as I would like to see his report before proceeding further. After the procedure he felt a slight tingle as the wart removal left a small wound which usually heals about 5-7 days. He was overall overjoyed that his penis has become more normal again.


Alas! Good news for Yong. His skin lesion was a viral wart and not a cancerous lesion. However, I cannot stress enough that HPV can always cause Anal cancers, Oral cancers, Vaginal cancers, Vulva Cancers and even Penile cancers.


He was given his first HPV vaccine despite having possibly acquired HPV already but the vaccine can still be used to prevent other subtypes of HPV. In short, the newer recommendation of HPV vaccination can be given from the age of 9 years old onwards till about 45 years old. Always ask your doctor if you are above the age of 45 years old or if you are unsure you can always inquire with me Dr. Jonathan Gui (+60128077720 – mobile / WhatsApp) or/and via Facebook (AMD clinic) or/and Website (https://www.amdclinicmy.com/). I am ready to help but kindly give me some time to reply.


Nevertheless it is important to be vaccinated as early as possible and before being sexual active. View the video below for more information.



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