Is Oral Sex Safe?

We all know that having unprotected sex can give you STDs

like herpes or gonorrhoea.

But there's also one that can give you cancer - HPV -

human papillomavirus.

You can even get it through oral sex,

which can then lead to oral cancer.

It's still rare, but the numbers are rising

and it's happening more in younger patients.

I'm Jaime Winstone,

and I know what it's like to watch someone close to me fight cancer.

My good friend Paul had colon cancer and recently died.

He was only 27.

He used to DJ here.

You know, he was such a big ball of energy.

He was amazing. You'd meet him and just be blown away by this person.

# Your back's against the wall There's no-one home to call

# You're forgetting who you are You can't stop crying. #

Just knowing that we're not going to hear his tunes

and we're not going to hear...

I'm not going to get Paul,

you know? And, um...it's just...

It's really sad.

It's really hit home.

You know, his cancer couldn't be beaten.

It was colon cancer, and there's not really a way to prevent it.

But cancer from HPV, the human papillomavirus, can be prevented.

A simple vaccination can stop it, that's all it takes,

but it's only being given to girls.

Why isn't the jab being offered

to young boys as well as young girls?

Why isn't there...

Just, you know, I want an explanation. I want to know why.

I vaguely heard about HPV through having my smear tests

and I thought it was something that girls could get

that could cause cervical cancer.

I'd never, ever made the connection in my head between HPV and sex,

let alone oral sex, which... even saying it sounds unbelievable.

Also, that it's something that doesn't just affect women,

it affects men, too.

I'm a sexually active person.

I want to know at what risk I'm putting myself by having sex.

I don't know much about HPV,

but now I know that it's something that could cause cancer,

I want to find out as much as I possibly can.

OK, so I'm on my way to New Haven to meet a guy who's in his 30s

who's got oral cancer that's linked to HPV.

This, for me, is making it very real.

It'll be good to talk to someone about the actual effects

and how it's affected their lives.

Darren is 31 years old and lives on the East Sussex coast.

He's been with his girlfriend since he was 17.

Last year, his world fell apart when he was diagnosed with oral cancer,

caused by HPV.

-Hi, Darren.

-Hiya.

-How are you?

-How are you?

Thanks for coming to talk to me.

-No worries.

-Well, letting me talk to you.

-No worries.

-How's it all going?

-Yeah, good.

-Yeah?

-Yes.

-Darren, how did you first realise when you got cancer?

I just had a sore throat.

It wasn't painful, my tonsils were inflamed.

A gland was up on my neck.

I thought nothing of it. I thought,

sore throat, blah, blah, blah.

My partner said, keep on going down to the doctors.

I went all the way down to the doctors said she said,

"It's got to be something serious", and that was it.

That was when I got told - in May time, when I went for the biopsy -

-that it was cancerous.

-That obviously was a really massive shock to you?

Yeah, I just shut down. I had my tonsils out.

In between your tonsils, there's a gland.

I had the gland out as well.

I've got a big scar inside my throat that goes all the way down.

The chemo side of it, the three months, I felt really bad.

I lost all my hair, the whole lot, top-to-bottom.

I just felt sick all the time. Tired every ten minutes.

That's kind of the main side effect?

-That's it.

-So, you just felt yourself go quite down?

I went really down. I just wanted to give up.

Did you think of anything that might have caused it?

Were you aware of...

Personally, I thought it was smoking.

And how many do you smoke a day, just for curiosity?

Seven, eight a day, roll-ups. I'd smoke half of it and just flick it.

And what did your doctor say when you said,

"Is it because of smoking?"

I asked him, actually. I said, "Is it due to smoking?"

And he sat me down and said, "It's due to sex." So, yeah.

Due to oral sex? That's quite...

I didn't believe him at first.

You find it quite unbelievable. I found it quite unbelievable.

It is. I mentioned it to my mates, and they go,

"How many people have you done it to?"

Only one. You know. And they go, "No!"

But it is, I swear, it's only one.

It just goes to show that this HPV thing is in us, is out there.

That's it, yeah.

You don't necessarily need to be sleeping around.

You've been with the same woman. You know, you start questioning things.

Personally, I kept it all to myself.

I didn't want to tell anyone it was due to sex.

-Everybody looks at you funny, going, "That's dirty!"

-Yeah.

-It's not that.

Everybody takes the wrong end of the stick and thinks, ugh...

-But it's not.

-Does it affect your relationship at all?

-Sex wise?

-Yeah.

Yeah. I was a bit scared.

Is it going to come back, if, you know, anything happens again?

If we get intimate, is going to come...?

-A bit of pressure on it.

-Three, four months, five months, no nothing.

I just didn't want to.

It's really cool that, you know,

you've sat here and talked to me about that stuff today.

It's not easy to talk about that.

You've been through quite a lot,

-so thank you so much.

-No worries, thank you.

I'm looking forward to meeting your wife - your girlfriend!

-Maybe to be?

-Yes!

Most oral cancers are caused by smoking and drinking

and are seen more in older people.

Darren's HPV cancer is rare, but is diagnosed more in younger patients.

We used to live in a flat exactly like this.

-There was always loads of kids.

-Yeah.

That's the best bit.

I want to find out what impact Darren's cancer has had

on his other half, Karen.

You're taking me back down memory lane a little bit.

-That's good.

-This one here?

-Just this door here, yeah.

-OK.

-Hi, Karen.

-Hiya. You all right?

-I'm Jaime.

-Hi, Jaime.

-Nice to meet you.

-How you doing? Come on in.

-Thank you, very much.

-How have you been, you all right?

I'm very well, thank you. We've just been having a nice little chat.

Well, thank you, Kaz and Daz, for having me here.

-I noticed you've got matching tattoos.

-Yeah.

Is that a bit of an addiction of yours going on?

Yeah, I've got Daz.

You've got one, to help you with your cancer, wasn't it?

Have you? Can I have a look?

-I don't mind.

-You sure?

It's on his back, so it's like, strip!

Strip!

Sorry, I come into your house and make you strip.

We'll let you off!

-You all right there?

-Yeah, fine.

Oh, wow, you've really got loads. That's a really cool one as well.

Oh, cool.

"I look to the sky and what do I see?

"A castle, a rainbow and dreams for me.

"And end to this battle that I must fight,

"to rid my feelings of depression and fright.

"An end to cancer is not far away, it will be there some day."

That's gorgeous. That's really lovely.

That's really, really nice.

-It's really special.

-It's the only way I could...

It's a way of getting away with it?

Obviously, that really helped you getting through.

What about you, Karen?

I kept a written diary.

Obviously, he had me to offload onto but I didn't have anyone else.

I was like, you know, "Having a bad day, blah, blah, blah,

"beep, beep, beep!", and I just stuck it all in there.

I also took, going through your radiotherapy,

I took a lot of photos.

-Too many.

-So you documented it?

-Shut up. Definitely.

-He hated it.

-It was too many!

-Can I see the pictures?

-Yeah, they're in here.

So this is how you documented it?

You can see the change in his neck.

What's that?

It's just burns from the radiotherapy.

-And that's really painful?

-It was really sore, yeah.

-I can imagine it. Really?

-And then the changes were starting.

-It started to blister?

-It didn't blister, you just lost your skin.

Your skin was dying.

Oh, it looks so painful.

-And this is the usual side-effects of radiotherapy?

-Yeah.

There's the mask, there, that he had to wear through his radiotherapy.

-Have you got that?

-Yeah, I do.

-I can show you.

-This is just..

And you'd have to wear this?

These were on the sides.

You get strapped to the bed.

All this gets locked in.

Feel it, it's just so hard.

And then it was just zapped through that?

Yeah. All them... That's where they line you up with the laser.

All these, that's where they were zapping.

Wow. This is all really shocking, to be honest.

How do you deal with that, Karen?

Did you know... Were you aware of what HPV was?

I wasn't.

Cancer doesn't happen to us.

It was like, you never think it's going to happen to you,

especially at our age.

So when he was seeing the oncology,

he said it was through sex. We just looked at each other.

I was like, "What? What you mean?"

We didn't really ask him many questions.

He just said it was about that.

I was like that. He was like, "So you gave me that, then?"

I was like, "If you want to blame me, blame me, it doesn't matter."

It was still a shock, that I probably gave it to him.

I just think that it was all my fault.

What sort of pressure - that must have put

immense pressure on you two, really?

I didn't, you know... It was water off a duck's back and it's happened.

I didn't do it on purpose.

I couldn't have done anything different to stop it.

It's really weird, because before you have children,

you know, you're obviously...

That experimental period.

You like to get a bit fruity, as you've got the time.

I think with having kids, it's not something...

Oral sex isn't the sort of thing you have time to do.

You know, it's not... You can't do it and then kiss your kids.

It just doesn't seem right.

It's not something that we did on a regular basis after we had the kids.

It's, like, a while back.

Tia's 12 and Leo's seven.

You know, and when they're saying about oral sex, you think,

"God, that could have been years back."

It's just scary, the fact that what I've passed to him has created

inside him a cancer that could have been from years ago,

when we were able to have some more time.

-Fun.

-Fun, yeah.

-Fun, yeah!

-Naughty, cheeky, harmless fun.

It's just insane. It really is insane.

Yeah, definitely, that it's just sitting inside

like a time bomb, sort of thing.

It's just sitting there, festering.

And then, you just pass on the virus and it just triggers it off.

It's just mental.

Daz is such a sweet person.

He's got through the worst of his cancer

but the risk of it coming back still hangs over him.

It's always in the back of my mind that it could come back.

Touch wood it won't, never.

Who can tell?

Sometimes, I don't speak to Karen for a whole day.

Sometimes, I just go out for a walk somewhere.

That's how I can deal with it.

I still can't get my head around the fact that Daz caught a virus

through oral sex, which caused his cancer.

It makes me think, what exactly is this human papillomavirus?

Today, were travelling to Cambridge University

to meet Professor Margaret Stanley,

who's the queen bee of HPV.

I think she's going to fill in the gaps for me about this

vaccine and answer a load of questions I have about that.

I'm quite excited to meet her,

-because I hear she's pretty intelligent, pretty amazing.

Margaret is a Fellow at Christ's College.

She's dedicated her life to HPV research

and has even been awarded an OBE for it.

Pretty impressive stuff.

I suppose the first thing I want to ask is, how do you get the virus?

And what it is?

HPV is a little virus that lives in the skin.

You've got to remember, the skin just doesn't cover your outside.

There's a skin like covering in your mouth, your throat, your vagina,

the anus, that's the back passage.

This virus lives in all those places.

It's a virus that doesn't get into the bloodstream.

It only lives in the skin.

You get it, basically, from sex.

So, if you have vaginal sex, you get it in the cervix and the vagina.

If you have anal sex, or on the outside of the anus,

you get it in the anus.

If you have oral sex, you get it in the mouth.

So, oral sex isn't safe?

-In a word, no.

-No.

Lots of teens, particularly, have oral sex

because they won't get pregnant.

I have to tell them, that's the only thing they won't get.

I mean, oral sex is sex, and so you get transmission of

whatever you've got on your genitalia, OK? That includes HPV.

Interestingly, it's easier for a guy to acquire HPV

from his female partner than for a woman to get HPV from a man.

So, if a guy is having oral sex with a girl,

he's more likely to acquire HPV in his mouth than

the woman is likely to acquire HPV, if she's doing a blow job on the guy.

I always blame Clinton and Lewinsky.

Nobody knew what oral sex was before then.

And frankly, babes in their cradles do it now.

Say if a guy was watching this now

and he's had more than five sexual partners,

or performed oral sex with five or more women or men,

what would your advice be to him,

to not send him into a panic of, "Oh, my God, I've got HPV"?

First of all, it's a very common virus.

You and I will have had it.

You're likely to get it, I'll certainly have had it.

Just about everybody acquires this virus.

Nearly all of us get rid of it.

But there are about, oh, one in ten people

who don't manage to get rid of the virus.

Because their immune systems, for one reason or another, can't handle it.

The likelihood is, you're fine.

So, don't worry. As they say in Dad's Army, don't panic.

-Don't panic.

-Don't panic.

But there's a serious side to this.

Because in the last couple of years,

there's been a lot of information come out.

It shows that cancer, caused by HPV in the mouth,

is higher than we thought.

More concerningly, it's going up at a very steep rate.

HPV, the human papillomavirus, is very common.

80% of the sexually active population has it.

It's usually spread through vaginal, anal and oral sex.

Which, in some people, could lead to cervical, anal, and oral cancer.

Cervical cancer kills over 1,000 women a year.

So, in 2008, the NHS started to give the HPV vaccine to all schoolgirls.

Boys weren't seen as a priority.

The theory was, if the girls got the jab,

they couldn't pass the virus on to the boys anyway.

But as Margaret says, HPV oral cancer is rising.

And even though it's still rare,

new research says that men get it five times more than women.

So, surely HPV is something guys really need to be up on?

What I want to know today is, if teenage boys are even aware of HPV,

especially as they're the ones that aren't offered the jab against it.

Are they even aware that there's a virus

you can catch through oral sex which can lead to cancer?

And, you know,

even if they were offered the jab, would they have it anyway?

TRIBAL-INFLUENCED DANCE MUSIC

This dance crew is all 18 and under.

The boys have different levels of sexual experience.

But how clued-up are they on the risks of having sex?

Woo! That was awesome. I want to see it again.

You're a joker.

He cracks me up with his faces.

That was wicked, man. Thank you very much.

And you've been working on that for like two months?

-Two months, yeah.

-Good. Nice one.

I think we're going to sit down

and have a chat about some things now, if that's OK? Yeah?

So, if I go round and ask you

what sexually-transmitted diseases you are aware of...

Um, herpes, Chlamydia, um, crabs.

-Gonorrhoea and herpes.

-Yeah.

-Not for me.

-Not for you?

Not for anyone. Hopefully!

Yeah, syphilis. And hep... I don't know how to pronounce it.

Hepatitis. And do you know of any risks

that you can have with oral sex?

Are you aware of anything like that?

-I haven't got a clue.

-No?

How many of you think that oral sex is safe?

When you're having sex, half of your mind is on pregnancy.

Oral sex, you know they're not going to get pregnant,

so I think they are less worried about having oral.

I think they think it's safer.

50% is all about pregnancy.

As I said, you're not getting...

pregnant from oral, are you?

So that's like the main concern, really, in young guys.

That can change your life.

Once you get the person pregnant, your life's over.

There's a sexually transmitted disease

that you may not have heard about called HPV.

What does it stand for?

-Human papillomavirus, basically.

-Human...popa...

Hopalopola!

Human papillomavirus.

How many of you know what HPV is?

Never heard of it.

Never heard of it?

I haven't heard about it much, I've just heard it from girls in college

saying that is why they are getting an injection that day.

That's pretty much it.

And do you know what it was for? Do you know why? Was you told why?

They just told me it's like a new virus that girls can catch.

So... I thought, OK, cool.

Did it raise any bells in your head, make you think, well...?

If I'm talking to females about a jab

that they are supposed to be getting for cervical cancer,

they haven't actually described it

as something that males should take as well as females.

So we kind of took it like, OK, it's only for females, sort of thing.

Males don't even need it at all.

Well, HPV is basically a virus you can catch through oral sex,

through oral contact, by going down on your girlfriend, basically.

Stuff like that. Something that boys and girls can carry as well.

How does that make you feel,

that girls are getting offered this jab in school and not boys?

That is unfair. I don't know why they can give it to girls

and not boys. That's stupid.

They've come to my college and done it with girls, but I think

they should have come with boys and educate us about it.

We just see girls getting jabs, we haven't got a clue what's going on.

Yeah, I agree with Moses.

It's kind of disrespectful.

We should be able to learn about the virus

so we won't be able to catch it and also like, give us an opportunity

to get a jab if we want it as well.

These guys are pretty switched on,

but they say no-one's given them the facts about HPV.

They want to know about it and they want to protect themselves.

So, if this cancer from oral sex is on the rise,

exactly how big is the problem going to get?

OK, so today we're off to Coventry.

I'm going to meet a leading head and neck surgeon

at University College Hospital.

He has the latest research on oral cancer and HPV.

I'm quite nervous.

I've been invited to watch a full-on face operation.

It's a real first for me.

Mr Hisham Mehanna is the director

of the Institute of Head and Neck Studies and Education

at the University Hospital, Coventry.

He spent the last 18 months doing major research

into how big a problem HPV-related oral cancer really is.

The day starts early in theatre.

So, you can scrub on that side.

Put your hands under there and just wet them.

Just make sure you don't touch anything with your hands.

Have you had much breakfast this morning?

No, I decided not to eat.

-That's probably wise.

-Yeah.

You've not done...

Anything like this.

I've done theatre, but a different kind of theatre.

Right, OK. Fair enough! That's it.

I'm actually quite excited.

I'm going to find out exactly where in the mouth HPV cancer attacks.

Excellent, wow. Like a pro.

I just have to hold it together.

SHE SIGHS

Can I have some big swabs, please? Thanks.

Eight years ago, this patient had one tonsil removed

in an operation for oropharyngeal cancer.

But this poor guy's radiotherapy has made his jaw crumble,

so the surgical team

are going to take the bone from his arm to rebuild his jaw.

It's all very intense.

And detailed.

I can't really believe what I'm watching, to be honest. It's insane.

Can I have a swab, please?

Normally, surgeons treat HPV oral cancer with chemo and radiotherapy.

This operation is the worst case scenario for a patient,

when things haven't gone to plan.

-Are you all right?

-Yeah, I'm fine.

OK. Tell me if at any point here you're concerned, OK?

You can see the beginning of the bone.

And then you're going to work round to where it's...

crumbled, if that's the word.

That's right.

-OK, if you give me a tongue retractor, please.

-So, where would...

I mean, the HPV related cancer site, would this be the area?

HPV related cancers tend to affect two places.

The tonsil, and the back of the tongue, most commonly.

And you can just about see it there.

But it is a very difficult area to see.

But also, even in the clinic, just trying to screen, see the tonsils,

the back of the tongue, is not an easy thing to do

without specialised equipment, basically.

You wouldn't be able to discover this

with self-examination?

No, that's exactly right.

It's a hard area to examine on your own, and that's why people often

will come to us after the tumour has spread to the neck.

-Until this point of operation.

-Yeah.

They only come... They don't often come when it's very small.

They often come when it's much bigger because

they then see things on the outside, like a lump in the neck or whatever.

So what we're going to do now is we are going to divide the jawbone.

-Are you all right?

-Yeah.

-Are you sure?

-Yeah, I'm fine.

OK. You're doing really well.

Why is it that area in particular that is affected by HPV?

Well, you know, this is a very good question.

We really don't know why that is the case.

We have theories,

and one of the theories is that that area, the tonsil and

the back of the tongue, has a lot of lymphoid tissue, immune tissue,

and it seems that the HPV virus favours that area and enters it.

I'm completely in shock, basically.

A bit of someone's jaw has just been taken away.

I don't know how I got through that, to be honest.

I got a bit wobbly. I'm feeling, like, really emotional now.

It kind of makes me a little bit angry.

When you just think of something so simple, like a jab,

like a vaccination,

that people are just blissfully unaware of, you know?

Why isn't this pushed further to stop a virus that can then obviously

turn into...is proven to turn into something so cancerous

and such a heavy procedure?

For me, it's a non-brainer.

So exactly what is the scale of the HPV cancer problem?

Hisham is the man who knows.

Recently, we've seen reports in some studies suggesting that

the percentage of oropharyngeal cancers that are caused by HPV

has risen sharply. So, patients who were

diagnosed in the year 2000 and before the year 2000,

only about a third of them had HPV oropharyngeal cancer.

But looking at the most recent group, in the last five years,

this has gone up to 70%.

So that's pretty much more than double.

And we're now seeing one of two patients a week in my clinic

who have that type of disease.

Whereas in the past, oropharyngeal cancer only ten years ago

was very rare, and you'd go a couple of months without seeing a patient.

So there is a significant increase.

And it's only been in the last five years

that we really started becoming quite aware of it.

I met a guy, a 31-year-old guy, who's had HPV-related cancer.

He's been with the same sexual partner since the age of 17.

What are the chances of it coming back?

Is it something that they are going to have to constantly worry about?

Out patients actually respond to chemo and radiotherapy

and to the treatments really well.

And so the chance of it coming back is low.

There is a about a 10-15% chance of it coming back over five years.

And that is higher if the patient has been or is a smoker,

as well as having HPV oropharyngeal cancer.

So there is a chance that it can come back,

but it's not as high as other types of head and neck cancer.

What would be his situation

when coming to having oral sex with his partner?

-Would he be able to have it?

-That's a really good question.

And the honest answer is, we don't know for sure what the risk is.

And this is definitely at the very forefront of science.

It's too early to know

whether people should change their sexual practices

once they've got HPV-related oropharyngeal cancer,

or even an HPV oral infection.

Does anybody actually understand?

I mean, do we know why the virus can turn cancerous?

Well, we know a little bit about how the virus causes cancer.

What we don't know is why certain people, when they're infected,

develop the cancer, whilst most other people,

when they're infected, don't develop the cancer.

That is one of the really important questions

that we are trying to work on at this moment in time.

Hisham's research says the number of HPV oral cancer are rising

at a faster rate than mouth cancer, caused by smoking and drinking.

His new figures show there are now around 700 cases every year,

of which at least 600 are men.

And with no jab available to them on the NHS,

it's the guys who are left unprotected.

So, what's the deal for the boys?

They could visit a private clinic like this one.

But they'd better be feeling flush,

because they'd have to fork out between £300 and £400.

-Hello, Jaime.

-Nice to meet you. Thanks for seeing me.

'Richard Dawood is a doctor in the vaccination business

'and today he's giving his 13-year-old son, Jamie, the HPV jab.'

-Hi, Jamie.

-Hi.

Nice to meet you. I'm Jaime too.

Thanks for letting me sit in today.

-And you're going to have the vaccination.

-That's right.

Very exciting. Are you excited? Are you all right?

Well, I don't want to get neck or mouth cancer, so...

So you are aware of it? That's good. How much do you know about it?

I know that the actual injection is to fight against cervix cancer,

but it also stops neck and mouth cancer in boys.

-Why don't you have a seat here?

-OK, cool.

I'll just go and get the vaccine from the fridge.

You're quite educated in it. I wish I was that educated when I was 13.

Obviously, you wanted to ask why you're having the vaccine.

Two reasons. One, I know that girls have a cervix and boys don't,

so I was wondering why I was getting the cervix jab.

And two, cos my cousin, when she had to have her cervix jab,

she had to be restrained because she has a phobia of needles.

She said it was horrible. "Argh!"

I don't think it's just the phobia of needles.

I think she's paranoid that it's going to hurt. Jabs don't hurt.

Right, Jamie, are you all set?

-No air bubbles?

-No air bubbles.

Just hitch up the sleeve.

OK. It just takes two seconds to do.

Ready, steady, go.

-Done.

-Seriously?

-That's it.

-Cool.

-OK.

-Thank you, Jamie.

Thank you very much.

I mean, obviously if you're some sort of doctor and you get a reduced price in terms of the vaccination,

maybe not a lot, maybe not full price, but if you're just like

the general public or parent, would you still fork out £400 for this jab?

That's a difficult question. Clearly I have chosen to do it because I'm deeply involved in vaccines.

It's still an expensive vaccine and I could have done something else

with the money instead of spending it on this.

But at the end of the day, it's for each parent to prioritise their choices.

We get many parents who come here and do decide to offer it to their girls and boys.

But if they can't afford it, then they...

may have better things to do with £400.

How did you explain to Jamie, your son, about this jab?

I find it would be a tricky subject to kind of mention to your son.

I don't see this vaccine as being part of a discussion about sex

or how HPV is necessarily transmitted.

It was simply a matter of me and my wife explaining that this HPV virus

is linked to head and neck cancer, and he was very accepting of it.

So there was never any detailed discussion about it.

Certainly if he'd asked,

or wanted to know more about it, I would have explained.

Thank you. One more question, can I have a lollipop?

-Absolutely.

-Thanks!

I've been staring at them.

Thank you very much, Richard, for seeing me.

Thank you for coming.

The Government is banking on boys not catching HPV,

because vaccinated girls can't pass it on.

Giving us a wonderful HPV-free world.

Something called herd immunity.

Not much comfort if you're gay.

And there's another problem.

Right now, as it stands, it's down to the girls to protect the boys,

as they're the only ones being offered the jab.

But the older girls, the 16 to 18-year-old girls,

aren't having it for some reason.

So what I want to know is, are they aware of not only are they

not protecting themselves, but they are also not protecting

the men, or the boys?

It'll be quite interesting to talk to these girls and find out what's at the bottom of this.

'I've come to a sixth-form college in Hammersmith, West London.'

-Hi, girls.

-Hi.

-Hi, I'm Jaime. Nice to meet you.

'These girls are between 16 and 18 and if they want the jab,

'they can get it free from their GP.'

OK, let's just talk frankly.

First thing I really want to know is,

why have you girls not had the jab?

-I don't like testing new injections because even though...

-The needles and stuff?

No, I don't even mind the needles, but I prefer to have more research

on it than just to go in straight away because it's a new injection,

and then find out five years down the line that there's a few side effects,

you could die, or you could develop some sort of disease, anything like that.

Even if it's now been proven to stop cervical cancer?

Well, my mum was talking to me about smear tests because she told me about

smear tests before, but I never knew it was for cervical cancer.

So she said that if you get regular smear tests,

then if you do develop the cancer, it can be quickly counteracted.

So I thought if my mum can manage that, my nan can manage that, then why can't I?

-And what about you, girlies?

-I heard about it from my GP.

He didn't really give me much information on it.

He just kind of assumed I knew what it was for.

But I'm not sexually active, so I thought, there's no point.

Are you waiting to become sexually active to have the jab? Where do you stand with the vaccination?

I may not know when I'm going to become sexually active.

-So you're questioning it now?

-Yeah. Like, what do you do first.

The jab, or sex?

HPV is basically a virus that kind of 80% of us carry, and that can turn cancerous,

-and which you can get through oral sex.

-I didn't know that.

-You didn't know that?

-No.

-Did you know that boys can get HPV too?

-No.

And did you know that you could actually give a partner or a boy HPV

by receiving oral sex?

I just thought that boys transmitted it to girls.

I didn't know that we could give it to them.

Boys aren't being offered this jab.

Only girls.

How does that make you feel?

To be honest, we're in the same position, both boys and girls.

So it's a bit stupid and ignorant that they wouldn't give them the jabs too.

I also think that schools and colleges don't do enough.

The first time I heard about cervical cancer was during Jade Goody's death.

I didn't know it existed before that.

So I don't think schools and colleges

are playing their part fully in educating everyone about it.

Now I've told you that boys can get HPV also,

does that make you feel like a certain responsibility factor,

even if you don't feel like it's necessary to get HPV vaccination?

Yeah, I think it changes my mind slightly, because I think that

I'm kind of responsible for what happens as well,

and I don't want to like have my partner's life risked

over anything that might happen between us.

So I would consider it, but because of the kind of lifestyle I want to lead, because I want

to wait until I'm a married to like have sex and stuff,

you don't really think about those kind of things.

It makes me feel like I have more of a weight on my shoulders,

because if it was me that was getting something passed on to me,

like if I was in the male's position, I would feel cheated

and disgusted really, because if you had the knowledge that

you could pass this on, and then you still didn't do anything

to prevent it, it's a bit selfish.

So I think maybe I'd consider getting it.

OK, so the girls I met today all had valid reasons

for not having the vaccination. But for me, it just feels like

they are missing out on a golden opportunity to have the free jab,

a jab that can protect them against cervical cancer,

and their partners against HPV cancers.

So I want to know,

can I get the vaccination? You know, I'm already sexually active.

Is it worth it for women like me, or that are older?

The Margaret Pyke Centre has specialised in women's health issues for over 50 years.

Dr Anne Szarewski is looking closely into how HPV vaccines

can be used in older women, even if they've already got the virus.

I've been thinking on my journey throughout making this film,

I've been thinking,

"God, have I missed the chance to get the vaccine?

"Would there be a point me getting it now?"

I think it's a myth that's kind of grown up that you can't have it if you're over 16 or something.

And in actual fact, women of any age can have the vaccine.

Obviously the earlier you have it, the better,

and the ideal is to have it before you've ever had sex.

But even if you have had sex,

it's still on an individual level worth having the vaccine,

because research that has been done all around the world is now showing

that the vaccine will stop you getting it again.

So it can actually stop you from being re-infected?

-Yes, it does appear to do that.

-Wow.

That is really promising, isn't it?

-So you would strongly recommend it?

-Absolutely.

The problem is that on a national level,

it would be so expensive to vaccinate absolutely everybody.

But on an individual level, if a woman actually has the money,

which now works out at about £300 for the vaccination course, if she's got

the money and she wants to spend that money on protecting herself against

cervical cancer, rather than perhaps buying a new handbag this season,

then why shouldn't she?

And it will certainly give her benefits.

If you can't afford it, there is a screening programme, which will still protect you

against getting cervical cancer, so it's not like there's nothing for those who can't get vaccinated.

How would an older man, approach this and say, "I'm concerned."

Is it the same as for older women?

At the moment, of course, the vaccine isn't being given to boys at all,

which I do think is a shame.

If we gave it to boys, it would increase the herd immunity, so it would help women as well.

But also, of course, for men who have sex with men,

they are at higher risk of getting things like genital warts,

anal cancer, probably oral cancer, all these other HPV-related diseases.

And they're not going to get protected at all without a sort of vaccination programme for boys.

I do think the earlier they could get vaccinated, the better it would be.

Even though most of us have HPV, only two out of the 143 strains,

HPV 16 and HPV 18, are most likely to cause cancer.

But given what's at stake, I'm not hedging my bets.

OK, so that was actually really cool.

Now I feel really reassured about getting the jab, the vaccination.

I'm not so panicked. I don't feel like I've missed the boat at all.

So yeah, I'm definitely going to have the jab.

For sure.

'The jab is given in three doses spread over six months.'

Any problems whenever you have injections or anything?

-Are you OK with injections?

-Yep, that I know of.

So, it will just be uncomfortable for a little minute.

OK. If you could just turn round to the side a little bit more.

That's absolutely fine.

There's just going to be a little jab here. And that's it.

-OK? All done. Is it stinging?

-Yes.

-If you just want to press on your arm there.

-OK.

That's absolutely fine.

I'll just pop a little plaster on.

You just need to keep it on for about ten, 15 minutes.

Right. That's your vaccination all done.

Awesome. Oh, God! Oh!

No, it wasn't bad at all.

A little bit flushed, though.

It's all very intense for a second.

Having vaccinations is never a pleasant experience.

Yeah. It's erm...

Oh, that did hurt.

You might find, for the rest of the day,

that it feels slightly uncomfortable.

'I'm really happy I got my jab.'

It already feels like a huge relief.

And my course of injections will cost around £300,

which I'm really lucky I can afford.

But where does that leave everybody who can't afford it?

You know, in times like these,

there's not a lot of people with £300 to spare in their back pocket.

And I don't know Darren and Karen's money situation,

and I don't know if they'll be able to afford to vaccinate

their young son, Leo, you know?

If it was free on the NHS, it would solve a huge problem.

So it makes me think, you know, why isn't it?

'To find out, I've got to psych myself up to meet

'an important man at the Department of Health,

'in this pretty daunting building at the heart of Whitehall.'

Professor David Salisbury is the man with the answers.

He's the director of immunisation and he advises the Government on

what vaccinations should be given on the NHS.

So, doing this documentary, I've met someone who had suffered from

HPV cancer and he has a daughter and a son,

and I find it quite unfair that

he could get his daughter vaccinated with this jab, but his son couldn't,

especially as they were in nowhere near a position to afford it.

How does that make you feel?

What position does that put you in?

What we do not have enough evidence for yet is,

is it going to be cost-effective?

Is it good use of money to vaccinate males?

And it's not just one or two that might want it,

we would have to vaccinate all of the males.

That's 300,000 boys every year.

And we have to know that doing that is in their interests.

If I spend money irresponsibly,

then other parts of health will suffer, but we have to

make our decisions on the basis of the benefit to the individual

and the benefit to the community.

One of the people I've met during this documentary, his research shows

that HPV-related oral cancer is rising, especially in men.

Would that maybe change your opinion?

That's a very important piece of the debate.

What we need to know is,

how many of those oropharyngeal mouth and throat cancers

are caused by the viruses that we can block with the vaccine?

What would be the percentage of people with HPV-related cancer...

to bring in the vaccination for males?

I just can't answer that. It's just such a complicated question.

What we would have to do is run these extraordinarily

laborious computerised models that we do, where we put in

what if the proportion was this, what if the proportion was that.

Lots and lots of computerised models of what if.

I simply cannot tell you what 30,000 runs of a computer model will reveal.

And if the what ifs come out to say the probability is good, that this

would be cost-effective, then that's what makes us change our policy.

So, the Government have to decide what treatments to offer.

And whether it's a good use of our money.

To give all boys the HPV jab, it has to work out cheaper

than to treat just the ones who would otherwise fall ill.

But since 2008, boys have missed out because at the time, experts only

had limited research showing low figures.

Now, new research shows a sharp rise

in the proportion of oral cancers with HPV.

So, the Government will now have to decide if the figures add up.

'I'm back with Daz, Kaz and their two children.'

'Seven-year-old Leo and 12-year-old Tia.'

It's been tough with Daz off work for over a year,

but they've really held it together as a family.

'Back home, I put them in the picture about what I've found out.'

When I did meet the man from the Department of Health,

the situation is, basically, the numbers aren't high enough

with this rare cancer. Your daughter Tia will be offered the jab,

but they're still not going to be offering it to boys, to Leo.

How does that make you feel?

Well, wrong. Really wrong.

There are plenty of young men that need it.

Oral sex is a two-way street.

It's not just us girls doing it.

Men are doing it too. Do you know what I mean?

It's wrong.

Tia has just had her first jab,

I think it's just wrong that Leo is not going to be offered the same type of vaccine

that my daughter is being offered.

It's just wrong. It's really sexist.

You can get the jab for your son, Leo, at the price of around £300 to £400.

Is that something that you would look into? Or could you?

A year off of work is a no-go at the moment.

Our financial situation at the moment, with Darren, is still recovering, I guess.

To be able to afford £300, £400, £500 for the vaccine...

It's a lot of money. It's a lot of money.

You want to give your kids the best.

But under circumstances... You just can't do it.

And it's like penalising people that can't afford to do it.

Obviously, people with money can be like, "Yeah, we can give it to our son straight away."

And how does this make you feel about your son in the future?

Really angry. Really angry.

-Touch wood, we won't be sitting here helping him through it.

-That's it.

That's one thing I don't want.

The other option is to say, "Let's not have oral sex again,"

which is unrealistic and totally unfair as well.

It's like saying, "Don't drink till you're 18."

-"Don't put sugar with your tea."

-Yeah.

Loads of people have sugar in their tea.

You think of when you were young and you were experimenting. It's all part of growing up.

We don't want to teach him not to go play.

We can't follow him everywhere around the streets, you know?

"Don't go out and have oral sex, son." It's just not going to happen.

It's not. Not at all.

"No female sweets for you, mate."

Thank you so much guys for having me here again.

It's been a pleasure meeting you both.

You're fantastically inspirational.

-Well, we just got through, didn't we?

-Yeah. Had to.

To go through something like that... It is a massive deal, so, yeah.

-It was just nice to come out the other end.

-Yeah.

He still gets tired though, he'll have a lie down later.

I think I will too. It's been a long day!

THEY LAUGH

When I first started making this film,

a good friend of mine, Paul, was suffering from cancer.

And then a few weeks later he died.

There was nothing that could be done for his type of cancer.

There was no cure,

there was no way it could have been prevented.

But HPV cancer can be prevented with a simple vaccination.

And it just makes me so angry to think that it boils down to money.

Meanwhile, more and more young men are getting HPV oral cancer.

But maybe there is hope.

The more that young people learn about the virus, how you catch it

and how it can be prevented,

the more they can make their own decision about what to do about it.

And, hopefully, Darren's son Leo

will never have to suffer the way his dad has.

Subtitles by Red Bee Media Ltd

E-mail [email protected]