Human Papillomavirus (HPV)
In Episode 703, "Superfreak," our doctors treat Jerry Adams, a man who tragically suffers from the "Tree Man" disease in which he develops severe bark-like growths over a large portion of his body. His wife Tess brings Jerry to Seattle Grace-Mercy West Hospital in hopes that they can find some way to help him look like a normal person again. Four years ago, when the warts were smaller, Jerry had some of them removed. But when they grew back after only a couple of years, Jerry preferred to stay inside and live a solitary life. But as Dr. Mark Sloan says, if Jerry does not do something about his condition, the warts will completely disable him.
So, what exactly caused Jerry to look like this?
Jerry (as well as the couple of real-life Treemen) suffers from a type of Human Papillomavirus (HPV). The virus has more than 100-200 reported different types, and they each affect specific parts of the body. The virus is a "papillomavirus" because particular types can cause warts, or papillomas, which are noncancerous tumors. For example, HPV 1 and 2 cause warts to grow on the hands and feet—entirely separate from the form of the virus that causes growths in the throat or genital area.
Researchers agree that Treemen probably suffer from Type 2, which many people in the world actually have, just not to this severe extent. These Treemen possess an immunodeficiency to the virus, which leads to the extreme rate and size of their growths.
Luckily, these "horns" that form from the warts do not cause the patients any pain. Even though the warts continue to grow new cells, there's nothing inside of the horns (no nerves exist). And usually, one's immune system would kick in at this constant production of new cells, but when an immunodeficiency is present, nothing can fight off this proliferation of cells.
What about the other types of HPV?
When many people think about HPV, they associate the virus with HPV 6 and 11—the form that causes warts to appear in the genital area. These types are considered to be a sexually transmitted disease and are known to increase the risk of some cancers. Many HPV infections do go away on their own without causing any type of abnormality. However, infection with high-risk HPV types can increase the chances that abnormalities can develop and progress even to cervical cancer. Or, if the HPV infection occurs within the mouth, it may increase the risk of developing oropharyngeal cancer—cancer that forms in tissues of the oropharynx, the middle part of the throat and includes the soft palate, the base of the tongue, and the tonsils.
How can HPV infection be prevented?
Well, regarding genital HPV infection, the best way to prevent contracting the disease is to refrain from any genital contact with another individual. And for those who are sexually active, the best strategy obviously is to maintain relationships with uninfected partners. The degree of protection from HPV provided by condoms is actually unknown; however, condom use has been associated with a lower rate of cervical cancer. How common is HPV infection? According to the CDC, 50% of all sexually active men and women will contract genital HPV at some point in their lives.
In 2006, the US FDA did approve Gardasil, a vaccine highly effective in preventing HPV Types 16 and 18, two "high-risk" HPVs that may cause cervical cancers, as well as Types 6 and 11 which generally cause genital warts.
Is there a cure for Jerry?
Unfortunately, researchers still need to narrow down the specific diagnosis for these Treemen. They know that their condition is related to a form of HPV Type II, but they need to process further information (such as the make-up of the patients' gene pools) before being able to announce a definitive cure. Until then, for patients like Jerry, surgeons can remove the warts and perform skin grafts in order to improve their appearance and function of their hands and feet.
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