Preventing Cervical Cancer

Pencils? Check. Bookbag? Check. Lunch money? Check. Life-saving cervical cancer prevention vaccine? Maybe not.

In the bustle of the back-to-school season, mothers clock record hours helping their daughters get ready for a happy and healthy school year. However, in preparing their daughters for another successful year, many mothers overlook the importance of preventative medicine, specifically where sexually transmitted diseases are concerned. This, says Dr. Charles Johnson of the Chattanooga Ob/Gyn Center, is a serious mistake. HPV, or the Human Papillomavirus, is the number one sexually transmitted disease in women and, in some cases, will lead to cervical cancer.

One Girl at a Time

By Lindsay Goble-Jordan

Understanding HPV

According to the Center for Disease Control, HPV is defined as a virus “infecting the skin and mucous membranes… [of] the vulva, anus, the linings of the vagina, cervix, and rectum, and the skin of the penis.” The virus is predominantly found in women and, in most cases, has no signs or symptoms. Recent studies have found a direct link between certain types of HPV and cervical cancer.

The virus, says Johnson, is tricky to get around. Practicing “safe sex,” for instance, does not greatly decrease the odds of contracting HPV. “During intercourse,” says Johnson, “parts of the testicles can still come into contact with infected parts of the vagina, and vice versa. Using a condom really doesn’t do any good against HPV.”

“HPV is a virus that acts like bacteria. It doesn’t live long on surfaces, and, in most cases, a healthy immune system will kick the virus long before a woman realizes she’s had it,” says Johnson. “The problem I run into is that women do not realize that HPV can lie dormant for years. You can have normal pap smears for several years, even if you caught HPV in high school.”

 Detection and Treatment

A yearly pap smear will detect the presence of abnormal cells. According to Johnson, a lab will then detect if the abnormal cells are any one of the 66-90 strains of HPV and if that strain is cancerous. Even cancerous HPV cells, says Johnson, do not immediately implicate cervical cancer. Recent studies have found that cancerous strains of HPV in women in their teens and late twenties will spontaneously regress.

Many doctors, however, will treat the cancerous cells with a procedure called a LEEP, or a loop electrosurgical excision procedure. A LEEP is simply a small loop that emits an electrical current when placed inside the cervix. The procedure is routinely used to scrape away abnormal cells and requires only local anesthetic and mild pain medication.

In some cases, however, cancerous HPV cells can penetrate deeper into the cervix and cause cervical cancer. The American Cancer Society estimates that this year alone 11,070 women will be diagnosed with cervical cancer. Prevention, says Johnson, is truly the only way to bring down those numbers.

 Gardasil

Currently, Gardasil is the only vaccine for cervical cancer caused by HPV and is issued in a three-shot regimen – one, two, and six months apart. Gardasil works by stimulating the immune system to produce antibodies that will fight off certain types of HPV. The four strains of HPV the vaccine is designed to fight – types 6, 11, 16 and 18 – have been proven to cause 70 percent of cervical cancer and 90 percent of genital warts cases.

According to the doctor, the vaccine carries virtually no risks. While Gardasil claims that some women may experience skin irritation at the injection site, nausea, fainting, dizziness, vomiting, and fever, Johnson says his patients have experienced none of that.

“The only complaint I’ve really heard is that some women don’t like having to come to the office for three separate visits,” says Johnson. “Most of my patients are glad to be taking measures that may protect them from cancer down the road. It’s the wave of the future. Gardasil gives us another way to prevent cancer.”

In addition to having few side effects and risks, the cost of the Gardasil vaccine is covered by most insurance companies. For those without coverage, the cost ranges from $150 to$175. Gardasil also does not interfere with oral contraceptives or antibiotics. There is a modified version available for pregnant women, and there are no risks to nursing mothers. The only women advised not to take Gardasil are those allergic to the ingredients in the vaccine. Gardasil is currently not recommended for men.

 Reducing Cervical Cancer

As far as an immediate reduction of cervical cancer, Johnson believes it may take years to see any results. Because the vaccine is currently recommended only for women between the ages of 9 and 29, many women at risk for cervical cancer may have already contracted cancerous forms of HPV.

“It’s similar to the Rubella vaccinations in the 70s,” says Johnson. “Even though children were being vaccinated, there were still many cases throughout the 70s and 80s. It wasn’t until much later that we really stopped seeing that virus.”

Even so, Johnson believes a domino effect is in HPV’s immediate future. According the doctor, young women who are vaccinated now will neither contract cancerous HPV nor pass it on. Eventually, men who have contracted HPV will have no one else to pass the virus onto, and it will just die out.

Prevention, says Johnson, is a means to an end. He believes it is extremely important for young women to be vaccinated before they become sexually active. This is particularly important for young, school-aged girls, says Johnson. The Center for Disease Control is likely to agree. They estimate that 20 million people are living with HPV in the United States today, and in 2008, 6.2 million more will be infected.

Johnson is optimistic about the vaccination. According to the doctor, Gardasil actually does more than it can claim. He believes the vaccination treats HPV strains other than the main four. He also believes that women who have already been diagnosed with HPV should still take advantage of the immunities the shot provides against other strains. A complete antiviral vaccine and childhood immunization, he believes, is just around the corner.

“It’s a new modality,” says Johnson. “We can prevent cervical cancer and run almost no risks. Any woman who can be vaccinated for HPV should be vaccinated.”

For more information regarding HPV and Gardasil, contact your general physician or the Hamilton County Health Department at (423) 209-8218.

 Lindsay Goble-Jordan currently resides in St. Elmo and works as a Public Relations Support Specialist with Derryberry Public Relations. A native of Oklahoma, Lindsay moved to the Scenic City in 2001 and recently received her Bachelor’s degree in Communication from the University of Tennessee at Chattanooga.

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