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Private Practice - Talking about HPV on TV


Updated February 03, 2014

Private Practice Episode 2x19: What Women Want

When an old patient of Dr. Cooper's comes back to the practice complaining of a minor illness, things turn out to be not precisely what they seem.

Medical dramas like to stay up to date by covering current issues in healthcare. Not surprisingly, this means that they occaisionally end up discussing STDs. In recent years, for example, HPV-related scientific discoveries have been constantly in the news, and fiction refuses to be left behind. In March 2009, the TV show Private Practice decided to tackle one of the thornier issues head on.

In episode 2x19, What Women Want, a former pediatric patient of Cooper's -- who used to be so sick all the time that his mother called him "her lemon" and who had gone through massively disfiguring facial surgeries -- is now handsome and healthy and happy. He now talks, where he didn't before, and he has a beautiful girlfriend. Unfortunately, when he comes in to see Dr. Bennett about a sore throat, it isn't just a simple case of strep. A strange lump is present, and he has to have it biopsied.

When the biopsy turns out to be cancerous, the young man questions how he could have cancer at age 22, when he doesn't smoke or have any other risk factors. The answer? The tumor is positive for HPV. He's confused. "Isn't that an STD?" he asks. It is... and his girlfriend is horrified because she has it and feels responsible for his cancer.

It turns out that the tumor is advanced -- stage 4 -- and the cancer has spread to the bone of the patient's jaw. Dr. Bennett wants to remove part of his jaw in order to give him the best prognosis, but Cooper wants to just offer radiation and chemo in order to give him hope and a better quality of life.

When push comes to shove, radiation and chemo aren't an option. Emergency surgery becomes necessary to remove the fast-growing tumor before it kills the patient. He doesn't want more surgery, but it's the only way to save his life.

Unfortunately, the girlfriend can't handle it. Between guilt from feeling like she's caused the cancer and inability to cope with the potential disfigurement, she decides to dump him. Although the patient initially tries to convince his doctors that he can keep his jaw and his girlfriend, eventually they convince him that surgery is the only option... and that he needs to find someone worthy of him who will stick around when things get tough.

What the episode got right:

  • HPV can cause oral cancer in both men and women.
  • Oral sex can put people at risk of sexually transmitted oral and throat cancers, although, due to the anatomy involved, these types of cancers are slightly more common in people who practice oral sex on men.
What the episode got wrong:
  • I don't know how likely it is that a private practice doctor would actually have an oral cancer biopsy tested for HPV DNA.
What you need to know:
  • There is little use in trying to have your throat tested for HPV. Even if such a test were commonly available, which it is not, a positive test does not imply that you are going to develop cancer and a negative test does not clearly show that you will not.
  • Using barriers for cunnilingus or fellatio can reduce the likelihood of acquiring HPV from oral sex.

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