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Doc: HPV is not related to canker sores

Keith Roach
To Your Health

Dear Dr. Roach: I have a history of squamous cell cancer of the tongue. About six weeks ago, a PET scan highlighted activity on my tongue for the second time in 28 months. The biopsy pathology came back as type 16 positive, associated with the HPV virus. I am scheduled to have surgery to robotically extract the tumor. My question is about HPV. Is this the same virus that causes canker sores? I have had two large canker sores on the back-right side of my tongue, and later, two more on the front-right side. Now the sores have cleared up, but my tongue is still numb on the right side.

J.K.

Dear J.K.: Human papilloma virus is becoming a leading risk factor for developing cancer of the mouth and pharynx. Type 16 is the most common cancer cause — in the head and neck, as well as cervical cancer.

HPV most commonly appears as a wart, but it can have multiple appearances. However, they are an outgrowth from the skin, whereas a canker sore is an ulcer, a hole in the lining of the mouth or tongue. Canker sores (properly called “aphthous ulcers”) are not thought to be related to viral infections, but are thought to be more autoimmune related. They can be related to irritants, such as sodium lauryl sulfate, a component of many toothpastes.

Dear Dr. Roach: My husband (82) had prostate cancer surgery 11 years ago. His PSA goes down due to a Lupron shot. Does a higher PSA level mean cancer cells are present in the body? If so, how does lowering the PSA count treat cancer cells?

D.L.

Dear D.L.: After prostate surgery, there usually are no more normal prostate cancer cells. This is confirmed when the PSA level goes to zero after surgery. Since only prostate and prostate cancer cells make PSA, any PSA in the blood probably is coming from prostate cancer. The higher the PSA level, the more cancer cells in the body. If the Lupron (which blocks testosterone, a hormone that helps prostate cancer cells grow) cuts PSA, it means it is effective at treating prostate cancer cells. Sometimes we can’t cure the prostate cancer, but can keep its growth controlled for a prolonged time with treatment.

Email questions to ToYourGoodHealth@med.cornell.edu.