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Tell Someone: HPV & Cancer

dogmelissa
November 9th, 2006, 12:33 PM
Tell Someone (http://www.tellsomeone.ca)

I have recently been informed that I have HPV--one of the kinds that causes cancer, and yet my gynecologist does not feel the urge to check me more than once a year. I have had to take matters into my own hands and schedule myself pap tests with my family doctor. As a patient, it is my right to request treatment and monitoring, and no doctor in their right mind would refuse, as they get paid everytime I walk in the door.

I wanted to pass this link on, and also this article:

Should girls get a vaccine for cervical cancer?

Dr. Peter Nieman, For The Calgary Herald
Published: Thursday, November 09, 2006

Q: I read recently that there is a new vaccine available to prevent cervical cancer and that it is recommended for patients between the ages of nine and 26 years. Why should my daughter get such a vaccine if she is not sexually active?

A: Cervical cancer is associated with a virus known as the Human Papilloma Virus. This form of cancer carries a heavy burden and is relatively preventable.

Although HPV is transmitted during sexual intercourse, even if a teenage girl is not sexually active, experts recommend that vaccination start in the teen years, or as early as nine years of age, in order to protect her from the probable future risks of cervical cancer.

This past summer, a vaccine against HPV, known as Gardasil, was approved in Canada.

The new vaccine can prevent 70 per cent of all cases of cervical cancer; it may also prevent some forms of vulvar and vaginal cancers associated with HPV.

At a recent international papilloma conference in Prague, one of the conference organizers, Dr. V. Vonka, was quoted as saying, "This is one of the best vaccines ever developed."

A senior medical specialist at the Public Health Agency of Canada, Dr. Shelly Deeks, echoed this opinion.

There are more than 150 types of HPV and 15 types are associated with a high risk of cervical cancer. The Gardasil vaccine, made by Merck, protects against four HPV types.

Do Condoms Protect Against HPV?

The question of how and if condoms protect against HPV remains difficult to answer.

According to a recent North American survey of teens, more sexually active teenagers are using condoms (63 per cent in 2006 versus 46 per cent in 1991).

However, the protection of condoms against this virus remains uncertain -- at least there is agreement that whatever protection may exist, it may not be as high as previously thought. Thus the excitement over the vaccine.

Children are heavily influenced by media when they decide to become sexually active during the teen years, according to a study published in

Pediatrics in April (for a free abstract of this study, Sexy Media Matter, see Pediatrics.org (http://Pediatrics.org)).

Other disturbing data from a recent survey monitoringthefuture.org (http://monitoringthefuture.org)) showed that about 23 per cent of sexually active teens used alcohol or other drugs before their sexual encounters. The point is that, even though some teens plan not to be sexually active, they often engage in such behaviour under the influence of drugs or alcohol.

But what if a girl is not sexually active and remains that way until she gets married? This is where things get complicated: she may be a virgin when she gets married, but unless her future husband also is a virgin, she may be at risk of contracting HPV from him.

How likely is it that her future husband would have HPV if he is not a virgin when they get married?

Nobody knows for sure, but experts estimate that at least 50 per cent of sexually active people will get genital HPV and at least 75 per cent of sexually active men and women will be exposed to HPV at some point.

There is also some suggestion that the younger a girl is when she gets the vaccine, the higher her protection levels will be later in life. Current evidence shows there is no sign of waning immunity five years after vaccination.

As is the case with most new vaccines, there are still some big questions which need to be addressed, such as:

- Should boys also be vaccinated?

- When will a booster dose be required?

- What protection exists with incomplete dose administration?

How is the vaccine is given?

The vaccine is injected in the arm or thigh, and three dosages are required to give maximum protection.

After the first dose, a second dose is given two months later and the third dose is given six months after the first dose.

Studies have not shown any interaction between the vaccine and products such as anti-inflammatory medication, antibiotics, analgesics, herbs, some foods or vitamin supplements.

The vaccine is quite expensive and is not covered at this time by any province in Canada.

In order to have a Canadian perspective, the Canadian National Advisory Committee on Immunizations (NACI) will provide for Canadian physicians, toward the end of this year, more recommendations on how to utilize and promote this vaccine.

Corporate research of both physicians and consumers done in 22 countries between 2001 and 2005 came up with data showing there is much room for improvement around awareness of HPV:

- Only four per cent of Canadian pediatricians said they were very or extremely knowledgeable about HPV;

- Twenty-five per cent of Canadian family physicians said they were very knowledgeable;

- Consumer surveys showed there is a general lack of knowledge about HPV; when told HPV is a sexually transmitted disease that can cause cervical cancer, many expressed shock, fear or anxiety.

Where can I learn more?

Currently, there is a public awareness effort under way in Canada to address this deficiency. On the net, go to: tellsomeone.ca (http://tellsomeone.ca).

More information, independent of industry-sponsored sites, can be found on the Society of Obstetricians and Gynecologists of Canada's website, www.hpvinfo.ca (http://www.hpvinfo.ca).

The Mayo Clinic website (http://www.mayoclinic.com/health/cervical-cancer-vaccine/W000120), also provides very detailed and extremely useful information.

Calgary pediatrician Dr. Peter Nieman is a part-time faculty member at the University of Calgary and host of healthykids.ca (http://healthykids.ca). His column appears monthly in the Herald.
The Calgary Herald 2006


I hope this helps even one person. If you haven't already been checked for it, ask to be checked (women only). If you don't have HPV, or have teenage girls, please consider getting vaccinated. It costs ~$50 per injection.... but if $150 investment will save your life and the life of your child, isn't it worth it?? It's too late for me; once you have HPV, there is no point in vaccination, but if even one person is saved because of this, it'll make me feel better.

Thanks for reading.
Melissa

jawert1
November 9th, 2006, 12:40 PM
Just a note dogmelissa, cervical cancer caused by HPV is extraordinarily slow growing, meaning a yearly checkup and PAP smear is all you really need. They can give you anti-viral medicines in the interim to help supress the virus, which will also decrease your chance of having it mutate into cancer. Don't put yourself through unnecessary PAP tests if you don't have to - it's a pain for you (no pun intended), especially since the vaccine is coming and there are other, less invasive options available.

Hunter's_owner
November 9th, 2006, 12:41 PM
I second that motion:thumbs up

I work doing health research. One of my co-workers is in the process of a masters thesis in medicine and her topic is hpv and cervical cancer. She was recently at this conference in Pragues that is mentioned in the above article.

Being informed of this is necessary, as cervical cancer is one of the very few cancers that they actually know what causes it, and therefore, they have a way of prevetning it. But the prevention only works if people get the vaccine. If you are the parent of a young girl, please vaccinate against this as you would measles, smallpox, etc. It is definetly worth it, and you don't have to look at it as prevention od an std, you can look at it as prevention of that type of cancer.

Melissa,
Sorry to hear about you having HPV, but atleast you took your health into your own hands and are tested regularly. That way if anything abnormal shows up (hopefully it won't as there are many types of hpv that cause no ill effects), atleast then you can act early.
In the meantime, keep checking to see if the hpv is still active in your body, as there is a type that your body will rid itself of on its own. Hopefully that is the one that you have.

dogmelissa
November 9th, 2006, 12:59 PM
Just a note dogmelissa, cervical cancer caused by HPV is extraordinarily slow growing, meaning a yearly checkup and PAP smear is all you really need. They can give you anti-viral medicines in the interim to help supress the virus, which will also decrease your chance of having it mutate into cancer. Don't put yourself through unnecessary PAP tests if you don't have to - it's a strain on the healthcare system and a pain for you (no pun intended), especially since the vaccine is coming and there are other, less invasive options available.

jawert,
Thank you, this is information I already knew. However, after discussing the situation with my doctor, she agreed that common practice is to have pap smears every 4-6 months, a colposcopy once a year, and if the abnormal cells go away, then I continue with this routine for a full 2 years. After that time, if everything is still normal, then I go back to once-yearly pap smears.
My gynecologist did *not* recommend treatment to remove the abnormal cells.
Please note that not ALL women experience slow-growing cervical cancer: Only some women with pre-cancerous changes of the cervix will develop cancer. This process usually takes several years but sometimes can happen in less than a year. For most women, pre-cancerous cells will remain unchanged and go away without any treatment. But if these precancers are treated, almost all true cancers can be prevented

Maybe it's just me, but I'd rather be a strain on the health care system now with my pap smears every 6 months and a (hopefully) one-time treatment to remove my abnormal cells, than to be a huge burden on the system with multiple surgeries, radiation &/or chemotherapy treatments and extended hospital stays, when I develop cancer. I pay my Health Care premiums, and I don't go to the doctor for anything other than prescriptions for birth control and my pap smears. I am not a burden on the health care system, and I would never call a person who was attempting to prevent a serious disease by asking for treatment or monitoring a burden.

The vaccine is already here, and not available to girls/women who already have or have previously had HPV in any form.

Anti-viral medications? There is no anti-viral treatment at this time for HPV

I appreciate your position, but this is my personal health, and when I can *do* something to protect it, I'm going to, whether or not someone feels that I'm being a burden to the system. When you have an abnormal pap smear, are told that you have HPV that causes cancer and then get blown off by doctors, I'm sure you'd understand my perspective.

Melissa

jawert1
November 9th, 2006, 01:06 PM
Not to be too personal, but I was one of the 4% of women in America who had a form of cervical cancer totally unrelated to HPV, and it grew really darn fast. I have to go every 3 months for the rest of my life for PAPs and colposcopys, it's not fun, so no offense, but I have a better perspective than you do about cervical cancer treatments. While I respect that this is a relatively easy disease to treat, it's not the end of the world for someone to have HPV - 74% of Americans have it and not all develop cancer, which you pointed out. I'm glad you take your condition seriously, health is not to be taken lightly by any means, and the vaccine SHOULD be given as STANDARD to ANYONE age 9 and older, if for no other reason than it's easily treatable. Kudos to you for getting out the information, and I'm sorry you took my post as confrontational.

Hunter's_owner
November 9th, 2006, 01:07 PM
When abnormal cells are found in addition to the presence of HPV, the usual course of action involves what Melissa is going through.

An anti-viral medicine will not work in this case, and the vaccine is no good once the virus is contracted. The vaccine is only out to prevent the hpv from occurring in the first place.

dogmelissa
November 9th, 2006, 01:20 PM
and there are other, less invasive options available.

Just curious: What other options?

Melissa

Prin
November 9th, 2006, 01:54 PM
There's also a DNA test for HPV. In Qc you have to pay for it (reimbursable by private insurance), but it is more accurate than a PAP. HPV can be dormant in your system for YEARS before starting to wreak havoc with things. I kept having abnormal paps with normal followups, so my gyne sent me to get the DNA test.

I was negative, and she called me "the chosen one" because nearly everybody who goes for the DNA test has some form of the virus. She also called it the "fidelity test" because nearly anybody who has sex nowadays gets it.:rolleyes:

Hunter's_owner
November 9th, 2006, 01:56 PM
There's also a DNA test for HPV. In Qc you have to pay for it (reimbursable by private insurance), but it is more accurate than a PAP. HPV can be dormant in your system for YEARS before starting to wreak havoc with things. I kept having abnormal paps with normal followups, so my gyne sent me to get the DNA test.

I was negative, and she called me "the chosen one" because nearly everybody who goes for the DNA test has some form of the virus. She also called it the "fidelity test" because nearly anybody who has sex nowadays gets it.:rolleyes:

Yes there are many different forms of hpv and it is VERY common.
An abnormal pap without hpv usually means that the abnormal cells are not harmful. So it can save someone a lot of pain and trouble of having to go through a colposcopy.

Prin
November 9th, 2006, 01:59 PM
An abnormal pap without hpv usually means that the abnormal cells are not harmful. So it can save someone a lot of pain and trouble of having to go through a colposcopy.Yep. Or it can indicate a simple bacterial or fungal infection. :shrug: That's why they culture the cells after an abnormal pap (you go back and they take more) to see what's growing and why there are white blood cells (if that's the case) there.

It is very scary to get an abnormal pap the first time, but you get used to it. :shrug:
(by "it" I mean the constant gynecological bad news)

dtbmnec
November 9th, 2006, 03:09 PM
I suppose I've been lucky and never had a "bad pap" or bad results....nothing's ever been wrong with me....well ok every other part of my body is going to explode soon but not my cervix! Go MEGAN!

I plan on getting the vaccine....I just don't know where/if I can get it yet....

Megan

Prin
November 9th, 2006, 03:12 PM
I assume that if you've already been sexually active, the safest way to go is to get the DNA test first and then the vaccine. If you vaccinate when you already have HPV, it might compromise your immune system or stir up something...

dogmelissa
November 9th, 2006, 03:12 PM
I also read an article that said there is a possibility (no one is really sure) that you can get HPV from an infected person even if you don't actually have sex, just sexual contact, and that condoms may not protect you from it, either. So yeah, I really think that young girls should all be vaccinated, it shouldn't even be something that you consider, it just gets done, the same way polio and such get done in gr 9 (but maybe HPV vaccine should be sooner).

I guess my doctor is a bit abnormal. She's a great doctor, but you have to be informed when you go to her, because she's often likely to prescribe antibiotics for just about everything. When I sprained my thumb & got a cat scratch and went to her for the thumb, she prescribed antibiotics for the scratch. Didn't matter that I had a cat at home, and had been working at the Humane Society for 2 years so I knew how to clean a cat scratch. But in this case, she found the abnormal cells in a routine pap, did her "panic" routine and sent me to the gyno right away. I had a colposcopy right away, and they tested the samples they took during that for HPV. Didn't bother to tell *me* that, though. I didn't even know they'd checked for it, and didn't know I had it until I asked my doctor about it, when I went back to her after the second colposcopy.

Well... thanks for the support guys!
Melissa

Prin
November 9th, 2006, 03:14 PM
and that condoms may not protect you from it, either
Yeah, that's in the text you posted:
The question of how and if condoms protect against HPV remains difficult to answer.

According to a recent North American survey of teens, more sexually active teenagers are using condoms (63 per cent in 2006 versus 46 per cent in 1991).

However, the protection of condoms against this virus remains uncertain -- at least there is agreement that whatever protection may exist, it may not be as high as previously thought. Thus the excitement over the vaccine.

Prin
November 9th, 2006, 03:15 PM
Oh and the main protest against the vaccine is from people who think that vaccinating girls against some cervical cancers will MAKE them sexually active.:rolleyes:

dogmelissa
November 9th, 2006, 03:32 PM
Oh and the main protest against the vaccine is from people who think that vaccinating girls against some cervical cancers will MAKE them sexually active.:rolleyes:

That sounds like an argument from the same people who think that listening to violent music automatically makes you a serial killer. :rolleyes: If only those people heard some of the music that *I* listen to, and the way that my bf and I "insult" each other. :P We're always calling each other bad names or telling the other to F off. We mean it in jest, though people who heard us say it probably wouldn't be able to tell.
I lost my virginity young, my bf even younger (he was 13!!!!), and I honestly doubt that a cancer vaccine would have made me sexually active any younger. I think most of those arguments that "this will encourage teens to have sex" or smoke or whatever they're saying are excuses from parents who want to blame others for their mistakes and failures as parents.

:offtopic: On the news a little while ago I heard a report that said if you tell teens not to smoke, they're more likely to do it. So I figure we should probably figure out which kids do exactly what they're told NOT to do and tell them to *please* have sex and smoke, and the rest of them we tell NOT to. What's the worst that can happen? Most of them are smoking, drinking and having sex way too young anyways.

Melissa

dtbmnec
November 9th, 2006, 04:08 PM
I assume that if you've already been sexually active, the safest way to go is to get the DNA test first and then the vaccine. If you vaccinate when you already have HPV, it might compromise your immune system or stir up something...

That I didn't know...

Hmmm well whatever happens I shall have to see how it turns out...

Unfortunately, I have a few things I need to take care of before I'm able to get checked out like that...:(

Megan

LM1313
November 9th, 2006, 09:43 PM
Oh and the main protest against the vaccine is from people who think that vaccinating girls against some cervical cancers will MAKE them sexually active.:rolleyes:

Yep, because that's what all the kids are afraid of these days. :rolleyes:

"Did you see Billy? I think he was flirting with me . . . *giggle* He's sooo dreamy!"

"Ohmigod, Tiffany, just don't sleep with him, you might get CERVICAL CANCER!"

" . . . or, um, AIDS? Or, like, herpes?"

"Oh, yeah, I guess, like whatever, but I'm talking about CERVICAL CANCER, okay?? Totally!"

Prin
November 9th, 2006, 09:44 PM
Yeah, no kidding. People my age still don't know about HPV. What are the odds a 9 year old will?

dtbmnec
November 10th, 2006, 02:31 AM
Yep, because that's what all the kids are afraid of these days. :rolleyes:

"Did you see Billy? I think he was flirting with me . . . *giggle* He's sooo dreamy!"

"Ohmigod, Tiffany, just don't sleep with him, you might get CERVICAL CANCER!"

" . . . or, um, AIDS? Or, like, herpes?"

"Oh, yeah, I guess, like whatever, but I'm talking about CERVICAL CANCER, okay?? Totally!"

I think its supposed to go like this:

"Did you see Billy? I think he was flirting with me...*giggle* He's sooo dreamy!"

"Oh well you should get the Cervical Cancer vaccine and you'll be able to have all the sex with Billy you want! It protects against EVERYTHING I swear!"

"But Beth it only protects against the cancer not anything else"

"Yeah whatever."


Gah....All I know is that I would have jumped at the chance for it to be earlier...then I wouldn't have had to worry I had it :)

Oh and it may have just been me, but I was terrified of sex until I was about 17/18. I actually had it in my head at one point that if you had sex you would end up with a kid nine months later, regardless of contraception and just the general nature of human beings (not being perfect). Oh and being told that extramarital sex was evil on one hand but pretty darn ok on the other hand (thanks 'rents) didn't help things either. Oh I was a messed up teen....

Megan

mona_b
November 10th, 2006, 09:22 AM
This is a topic that is close to me..

I'll have to make this quick as I'm heading for work...Will continue when I get back.

9 years ago I had cervical cancer.It was on the top and lower part of my cervix...I had it removed and a biopsy done.I had one treatment(chymo..sp?)and said that's it...They started another treatment with freezing(hurt like hell)..I went every 6 months to get checked and then every year.I still go every year as it can come back.

My mom had it when she had me.She had a historectomy after I was born.

This is just not a sexual disease.And it bugs the hell out of me when I hear it is.Cancer is also hereditary.And that's how I got it.I was not sexually active when I was younger.There is cancer in my family.My mom had both her breasts remove to breast cancer and I get screened.And she also has cancer throught her body.

Frenchy
November 10th, 2006, 11:14 AM
9 years ago I had cervical cancer.It was on the top and lower part of my cervix...I had it removed and a biopsy done.I had one treatment(chymo..sp?)and said that's it...They started another treatment with freezing(hurt like hell)..I went every 6 months to get checked and then every year.I still go every year as it can come back.



Me too, sorry, I just don't see what's the big deal. After seing my father died of cancer when I was 13, if it's the only cancer I get, I will be really glad and count myself as a lucky one.:shrug:

dogmelissa
November 12th, 2006, 03:52 PM
Mona, very sorry to hear about your mom and your cancer situations. I also knew a girl who's mom died of breast cancer when she was very young and she was always very concerned about it.

Frenchy, sorry to hear about your father's death. I honestly can't describe how lucky I count myself that both my parents are alive and well and still married. I honestly hope that you don't blow off the very real risk of death with cervical cancer due to the death of your father from another form.

That being said, I've read numerous pages about cervical cancer, and oncologists world-wide do not believe that cervical cancer is hereditary, and that higher family rates of this type of cancer are probably related to environmental factors, rather than genetics. I'm not saying that you shouldn't be worried about your daughters, but I would suggest that such a worry would be a darn good reason to get your daughter(s) vaccinated for HPV regardless of health care coverage for the vaccine.

Edited to add: Recent studies suggest that women whose mother or sister has had cervical cancer are more likely to get the disease themselves. This could be because they are less able to fight off HPV than other women.

Melissa

Frenchy
November 12th, 2006, 03:58 PM
Thanks Dogmelissa ( I don't have any kids tough) the very important thing is to get a pap test EVERY year. :thumbs up

Prin
November 12th, 2006, 11:46 PM
Umm... not to stir up the pot or anything, but it could also have to do with sexual activity... For example, they say young moms' kids are likely to have sex younger too, so maybe uhh... some of the views on sex are also passed on between family members... :shrug: You know what I mean?:o

mona_b
November 13th, 2006, 08:16 AM
Thank you dogmelissa.

Mom is 69 and still with us.She still has cancer and is now in the first stages of Alzheimers(sp)...She went through Chymo(sp),MANY years ago but decided not to continue.Her decision.

My gyno explained to me that we are all born with cancer cells.And I believe that as a friends baby was born with cancer in one of her eyes and ended up loosing it.This is a baby.Imagine that.

As for it not being hereditatary,well my gyno thinks differently.My parents met young in Europe.Neither had been with anyone else before they married.So how did Mom get it if she was not sexually active?And neither was Dad?And this was 40 years ago when she had it.:shrug:

I have a 19 year old.Do I worry about her being sexually active?Of course.BUT she is a pretty smart young woman...She's is not sexually active and is not ready to be....:highfive:

birdy
November 15th, 2006, 01:34 PM
Just curious: What other options?

Melissa

well as a friend back then from SAIT, i am really sorry to hear this whole cancer thread. Hope that you still remember who i am. This is Keith and i saw you on the news last week. Hope to hear from you soon.

heidiho
November 15th, 2006, 01:45 PM
If i ever have a daughter no doubt about it she will get the vaccine,becasue like it or not kids at young ages {not all kids} are having sex.There is no debate in my mind about having say a 12 year old get the vaccine.