Dear Dr. Eva,

Can you get Hodgkin’s lymphoma from a person that has it by swallowing their semen? He didn’t tell me until later, and I heard it was caused by a virus. And that would be just about my luck!

Worried

Dear Worried,

Hodgkin's Lymphoma is not an infectious condition. A person cannot get it from contact with the body fluids (semen or blood) of a person who has it.

The reason this question comes up is that some cancers are triggered by specific viruses. Some (not all) cases of Hodgkin’s lymphoma, and several other kinds of lymphoma as well, are triggered by the Epstein Barr virus (EB). EB is an extremely common virus -- 90% of adults have antibodies to EB virus in their blood, meaning they have been infected with EBV. Many of these infections occur in young childhood and are completely without symptoms- the child may not feel ill at all, or may have a minor illness that seems just like the other minor viral illnesses of childhood.  When a person is not infected in childhood, and becomes infected in adolescence or adulthood EB virus can cause mononucleosis ("mono"), a disease characterized by fever, prolonged sore throat, severe fatigue, and sometimes liver and spleen enlargement.  Mononucleosis is usually a disease of adolescents and young adults. It is contagious through saliva and is sometimes called the kissing disease.

Hodgkin’s lymphoma occurs more often in people who have had mononucleosis. So it seems that becoming infected with the EB virus at an older age (adolescence or older) makes a person more likely to have a later reactivation of the virus causing lymphoma. Some researchers have suggested that EBV associated Hodgkin’s lymphoma could be eliminated by making sure everyone is exposed to the EB virus in early childhood.

However, very few people who have mononucleosis will develop lymphoma. So it seems that other factors are involved. Inborn genetic vulnerability can be a predisposing factor.  So can acquired immunodeficiency such as occurs in people with AIDS.

This brings me back to your original question. No, you cannot get Hodgkin’s lymphoma from a person that has it by swallowing their semen. But you might get any number of other things, including HIV! Unprotected oral sex is a common cause of oral syphilis, throat gonorrhea, lip herpes, and warts on the lips or tongue. It’s less common to catch HIV from oral sex, but it happens. For your health's sake, please use a condom for oral sex or do without it.

Dr. Eva

Dear Dr. Eva,

I have noticed bumps under my arms that come and go. Could these be signs of cancer? I stay really clean and shave under my arms every day, so I’m sure it couldn’t be an infection. Should I get a mammogram?

35 years old

Dear 35,

If you are sure the bumps come and go, that is a very good sign. Cancer related bumps (lymph nodes) don’t come and go – they come and stay.

I suggest you see your primary care medical provider for an exam and discussion.

Regular shaving does not decrease the chance of infections – it actually increases the risk. Consider not shaving, or using hair removal cream or waxing instead. If you feel you must shave, use a new disposable razor every time and wash well with antibacterial soap before shaving.

A mammogram is not likely to be helpful. In women under 40, the breast tissue is denser, and mammograms often cannot show a clear image. As a result, unnecessary biopsies are done which cause scarring that makes future mammograms harder to interpret, resulting in more unnecessary biopsies and scarring.

Dr. Eva