Archives for: November 2006, 17
I think Sante_j's blog today about abortion and breast cancer is extremely important information. I have read some of the statistics before, but I've never seen the evidence presented in such a concise manner as it is in her blog.
There is another disease killing women that has also been hushed up because of political correctness - cervical cancer. I'm attaching an edited article from the October 7, 2006 World Magazine. It prompted a very frank conversation between my honorable husband, my darling daughter, and myself. This blog and Sante_j's blog will probably be too much to process in one sitting. Read one today and one tomorrow, but read them both.
Stalking a silent killer
by Lynde Langdon
Eva PerÃ³n never knew what killed her. In the early 1950s, before patients' bills of rights and managed care, doctors and families commonly kept cancer diagnoses a secret from those afflicted. But Argentinian president Juan PerÃ³n went to great lengths to hide his wife's diagnosis of cervical cancer from her. He never told his wife before her death in 1952 that an American specialist performed her hysterectomy in place of her local doctor. Historians have speculated that the deception was part political maneuvering and part denial; President PerÃ³n did not want the country to learn of his misfortune in an election year, and his wife did not want to know.
But there was something neither PerÃ³n nor the public knew about Evita, even after a Broadway musical memorialized the story of her populism and humanitarianism. Her cancer was caused by a sexually transmitted virus that she most likely caught from her husband, whose first wife also died of cervical cancer.
The CDC estimates that 80 percent of women under 50 have had human papillomavirus (HPV), the virus that causes cervical cancer. Doctors have known about the disease for at least 20 years, but until recently it remained as much a mystery to the public as it did to Juan and Eva PerÃ³n. T
The release of an HPV vaccine in June finally gave women a reason to talk to their doctors and each other about the disease. The facts of HPV challenge what they thought they knew about sex and sexually transmitted diseases (STDs). As with all STDs, abstinence until marriage will prevent HPV, but it has to be abstinence from all genital contact, and on the part of both spouses. HPV can occur in monogamous relationships if one of the people in the relationship has had previous genital contact with someone else.
HPV is similar to HIV, the virus that causes AIDS, only in that both can be transmitted sexually. But statistically speaking, the population that exposes itself to HPV is much larger than the one that exposes itself to HIV. About 40,000 new U.S. cases of HIV occur every year, while there are over 6.2 million new cases of HPV.
There are more than 100 kinds of Human papillomaviruses, all of which cause changes to skin cells. The majority of types cause the common skin wart; about 40 kinds of HPV are transmitted through genital contact. Most HPV infections clear up on their own with no symptoms. Some types of HPV cause genital warts in men and women, while a handful of strains change the cells of the cervix into pre-cancerous cells. The cells will develop into cancer if not detected and removed. Men can carry the kinds of HPV that cause cervical cancer, but they rarely experience any symptoms from it. Doctors now believe HPV is the sole cause of all cervical cancer.
With 6.2 million new cases of HPV every yearâ€”more than gonorrhea, chlamydia, and syphilis combinedâ€”the Centers for Disease Control predict that if every American ages 14 to 49 took an HPV test on the same day, 15 percentâ€”20 million peopleâ€”would be infected. More than half of sexually active men and women get HPV at some point in their lives; and, the CDC says, by age 50, 80 percent of women have had HPV. A recent study showed people who use condoms were 70 percent less likely to get HPV than those who do not, but condoms are not 100 percent effective at preventing the virus.
Gynecologists now use HPV testing as a follow-up to an abnormal Pap test, which analyzes cervical cells for early signs of cancer. But HPV has a long, unpredictable latency, so a woman can contract the virus early in her adult life and have it for years before it affects the cells in her cervix. A man can also carry the virus for a long time and never experience symptoms. Without abstinence, both may give the disease to others in the meantime.
Connie Mao, a gynecologist at the Harborview Women's Clinic in Seattle, said most of her patients with HPV had never heard of the virus before she diagnosed them with it. "They want to treat it, they want to know it's gone, and they want to know who gave it to them," said Mao, who is also on the faculty at the University of Washington, the country's leading HPV research center. "All of those questions with HPV are very hard. You could have had it for 10 years, and I can't treat it."
"We do not routinely test the cancers for HPV because it does not affect treatment and they are all positive," said Liz Swisher, a gynecological oncologist at the University of Washington.
FDA approval of the HPV vaccine Gardasil, which provides immunity from two kinds of HPV that cause 70 percent of cervical cancer, has sparked increased interest in the virus from women and the media. The vaccine's maker, pharmaceutical company Merck, has started a national ad campaign to promote HPV awareness. Commercials show women talking about "cancer caused by a virus" and direct viewers to the website www.tell-someone.com. The women in the commercial appear surprised to hear that HPV causes cervical cancer.
The Pap test helped doctors in the United States bring cervical cancer rates under control. Between 1955 and 1992, the number of U.S. cervical cancer deaths dropped by 74 percent, according to the American Cancer Society. Dr. Anna Giuliano, a researcher at the H. Lee Moffitt Cancer Center and Research Institute in Florida, has studied HPV and cervical cancer since completing her Ph.D. in 1990. "Ultimately, as long as people participate in a Pap smear screening program, their risk for cancer is going to be very low," Giuliano said.
"There have been studies looking at how women feel once they have been given an HPV test diagnosis," Giuliano said. "It's almost akin to having been diagnosed with one of the classic STDs. . . . Women don't know if they can have sex again or not. It does create a lot of anxiety even when they don't develop cervical cancer."
Cervical cancer ranks 11th on the list of common cancers in American women, according to the American Social Health Association. But worldwide, it is the second deadliest cancer, next to breast cancer, in women because developing countries lack Pap test screening programs. The World Health Organization reports that 80 percent of the world's cervical cancers occur in developing countries in Asia, Africa, and Central America. In Central America and the Caribbean, cervical cancer is more common than breast cancer.
In the United States, the Gardasil vaccine is already for sale for $120 a dose, more expensive than any other vaccine on a price list published in August by the Centers for Disease Control. Since it takes three doses to develop full immunity, American women can expect to pay $360 for full protection against HPV. Some private insurance companies have already agreed to cover the cost. So did the federal Vaccines for Children program, which provides free immunizations to uninsured or underinsured children. Since Pap testing, which usually costs less than $50 a test, has successfully kept U.S. cervical cancer at bay, Giuliano does not expect rates of the disease to drop significantly lower because of the vaccine. Rather, she predicted, the incidence of abnormal Pap tests and genital warts will decrease.
To develop immunity to HPV, women must receive the vaccine before they expose themselves to the disease. That puts the responsibility on parents to estimate when daughters will become sexually active and to decide whether and when a girl should get the HPV vaccine. The CDC recommended the vaccine for girls as young as 9, stirring a controversy similar to the debate over sex education in schools. States chose not to include the vaccine on their lists of shots required for school attendance.
Conservative family groups that oppose mandatory sex education and condom distribution at schools have said they support the use of the vaccine as long as parents, not schools, choose whether their children receive it. The Family Research Council issued the following statement: "While we welcome medical advances such as an HPV vaccine, it remains clear that practicing abstinence until marriage and fidelity within marriage is the single best way of preventing the full range of sexually transmitted diseases, unwanted pregnancies, and negative psychological and emotional consequences that can result from sexual activity outside marriage."
Mao witnesses those consequences at the Harborview Women's Clinic, where every day she explains HPV to another patient who has never heard of it. "I've taken care of a lot of young women with fairly significant disease who end up getting procedures done to remove abnormal cells," Mao said. "I've had people tell me, 'I wish someone would have told me about HPV before I had sex with people, and maybe I would have had fewer partners or thought about it a little.' People don't understand the risk of having boyfriends when 15 or 16 years old other than just getting pregnant."
Copyright Â© 2006 WORLD Magazine
October 07, 2006, Vol. 21, No. 38