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Warts or Cancer.. Which is it?

Hey Doc,

I am at my nerves end. If you could please answer me these few questions, it would be greatly appreciated.

I have Genital warts that I am currently getting treated with cryotherapy. I was first under the influence that visible warts are a symptom of Low-Risk HPV types and I had read off the CDC webpage that very same fact. I was mildly relieved by this information. But, in the past few hours I have been reading from other websites that High-Risk HPV(mostly 16) can also cause visible FLAT warts. This has caused me a great deal of anxiety, because my warts are small and flat. Can you clarify this for me?

Next, what are the symptoms of HPV in the mouth? Can it cause symptoms similar to Geographic Tongue. I have geographic tongue and it seems worsened now. I also experience what seems to be inflamed taste buds, that become white, protruding, and hard, though they seem to go away within a few days. Could this be symptoms of oral HPV?

Thank-you, Amaninneed

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239123 tn?1267647614
MEDICAL PROFESSIONAL
Flat warts are pretty much invisible; if that's what you had, you would never have known it.

Stop worrying about this.  You're concerned about outcomes that are less likely than a lightning strike.
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Avatar universal
I say flat because they are smooth, some very small, and hard to notice. I am thinking of going to get a biopsy. So what constitutes a "flat" wart? Because I don't get that cauliflower look to em'...
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome back to the forum.

Since your warts were obviously visible, i.e. not "flat" warts, you can be confident they were caused by the usual "low risk" HPV types, probably HPV-6 or 11 (which cause 90% of genital warts).  But even if due to a high risk type, you really shouldn't be worried about cancer.  The high risk HPV types, like HPV-16 and others, progress to cancer in well under one of every 1,000 infected persons -- maybe only one in hundreds of thousands. And when that happens, it's typically 20-50 years later.

Look at it this way:  every year in the US there are hundreds of thousands (maybe millions?) of men new infections with the high-risk, cancer-causing strains of HPV.  But how many cases are there each year of penile or oral cancer?  Have you ever known anybody with these cancers?  They are very, very rare -- far less common than lung, prostate, breast, and other cancers.

Dr. Hook attempted to reassure you about oral HPV in your thread a few weeks ago.  As he advised you, this is an irrational worry.  HPV doesn't cause geographic tongue or any of the other symptoms you mention.  Even when it causes throat cancer, it's typically after age 50 and only in people who are smokers who also abuse alchohol -- and even with these factors, it remains a rare cancer.

If your oral symptoms continue, of course you should not rely on a distant online forum; see a health professional.  But from all you say, I cannot imagine that you have anything to worry about in regard to your recent HPV infection.

Regards--  HHH, MD
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