HPV And Cervical Cancer
- Elizabeth Ham, 34, was diagnosed with cervical cancer without having any symptoms. Her cancer was caught early thanks to a regular check-up, and her treatment was successful. Now, she’s advocating for others to prioritize routine screenings like she did.
- Cervical cancer begins in the cells lining the cervix the lower part of the womb (uterus). Treatment options for cervical cancer include surgery, chemotherapy and/or radiation therapy. HPV (human papillomavirus), a sexually-transmitted virus, causes more than 70% of cervical cancer cases.
- Nearly all cases of cervical cancer are caused by HPV, but people should also be aware that HPV puts both men and women at risk of developing several other cancers as well including cancers of the vagina, penis, anus and throat. Thankfully, we have HPV vaccines.
- Nearly every sexually-active person will get the human papillomavirus (HPV) infection at some point in their lives.
When Ham, 34, went to her routine check-up in November 2020, she wasn’t suspecting that anything could be wrong.
Read MoreLLETZ, or large loop excision of the transformation zone, is a procedure that removes abnormal cells from your cervix that’s often done at the same time as your colposcopy. Her colposcopy appointment confirmed that high risk cells had been found, but it wasn’t until she an MRI, blood test and chest X-ray that her cervical adenocarcinoma was confirmed.
“It all happened very fast, I was seen at different hospitals,” she said. “When I received my diagnosis, I was then referred to the Liverpool Women's Hospital for my treatment plan and pre-op.”
She underwent a radical hysterectomy an operation to remove the uterus, cervix, part of the vagina and sometimes the ovaries, fallopian tubes and nearby lymph nodes in January 2021. Today, she’s felling “grateful” that she’s still here.
“The operation was a success, a week later I received the all clear and I now attend the women's every four months for a check up,” she said. “I would urge everyone to attend for screening… you never know what is going on inside your own body.”
Understanding Cervical Cancer
Cervical cancer begins in the cells lining the cervix the lower part of the womb (uterus). Treatment options for cervical cancer include surgery, chemotherapy and/or radiation therapy. We don’t know the cause of Ham’s cancer, but HPV (human papillomavirus), a sexually-transmitted virus, causes more than 70% of cervical cancer cases. It's important to note, however, that other risk factors like smoking can make you about twice as likely to get cervical cancer as those who don't smoke.
The American Cancer Society estimates that the United States will see about 14,100 new cases of invasive cervical cancer in 2022. Cervical cancer screening is critically important because an earlier diagnosis can mean a better prognosis with broader treatment options.
The American Cancer Society recommends that cervical cancer screening begins at age 25, and people aged 25 to 65 should have a primary HPV test, an HPV test done by itself for screening, every 5 years. If primary HPV testing is not available, however, screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every 5 years or a Pap test alone every 3 years.
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The most common symptoms of cervical cancer can include:
- Abnormal vaginal bleeding, such as bleeding after vaginal sex, bleeding after menopause, after douching, bleeding and spotting in between periods or having heavier or longer (menstrual) periods than usual.
- Unusual discharge from the vagina that may contain some blood and may occur between your periods or after menopause.
- Pain during sex.
- Pain in the pelvic region.
What Is HPV?
Nearly every sexually-active person will get HPV at some point in their lives, but most people with the infection do not know they have it and never develop symptoms or health problems from it. The virus is spread via sexual activity and can manifest as warts on your genitals or mouth.
Get the Facts: HPV Can Cause Cancer in Men Too
When people talk about HPV and cancer risk, they tend to focus on cervical cancer. And while it's true that nearly all cases of cervical cancer are caused by HPV, people should also be aware that HPV puts both men and women at risk of developing several other cancers as well including cancers of the vagina, penis, anus and throat.
Oral and throat cancers, for example, are both on the rise in young, non-smoking adults, and Dr. Allen S. Ho, an oncologist at Cedars-Sinai Medical Center, says HPV is the cause.
"The fastest-growing segment of the people developing oral cancers are young non-smokers," Dr. Ho told SurvivorNet in a previous interview. "HPV, a very common virus, one responsible for the vast majority of cervical cancers, is now identified as a cause of this rapid rise of oral cancers."
Learning about the HPV Vaccines
Thankfully, we have three types of HPV vaccines Gardasil 9, Gardasil and Cervarix. All three went through years of extensive safety testing before being approved by the U.S. Food and Drug Administration (FDA), and the CDC reports that HPV vaccination has the potential to prevent more than 90 percent of HPV-attributable cancers.
The HPV vaccines, like other immunizations that guard against viral infection, stimulate the body to produce antibodies that attack if they encounter the HPV infection by binding to the virus and preventing it from infecting cells. HPV vaccines do not prevent other sexually transmitted diseases or treat existing HPV infections/HPV-caused disease, but their implementation can reduce the rates of certain cancers.
And while Dr. Susan Vadaparampil, the associate center director of community outreach, engagement and equity at Moffitt Cancer Center, previously told SurvivorNet there are few medical strategies that totally prevent against getting cancer in the first place, she emphasized that data from countries with high rates of vaccine coverages shows decreases in HPV-related pre-cancer and cancer particularly so in the case of cervical cancer.
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"We have a safe and effective vaccine to prevent HPV-related cancer," Dr. Vadaparampil told SurvivorNet. "It is widely available, and costs are typically covered by private or public insurance."
Eileen Duffey-Lind, a pediatric nurse practitioner at Dana-Farber Cancer Institute/Boston Children's Hospital, echoed Dr. Vadaparampil's sentiment.
"No one should die of a preventable cancer like those tied to HPV, especially since we have a highly effective and safe vaccine available," Duffey-Lind previously told SurvivorNet.
Who Should Get the HPV Vaccine?
According to the CDC, the HPV vaccine is recommended for all preteens (both girls and boys) 11 to 12 years old in two doses administered between six and 12 months apart. The series of shots can also be started as early as 9 years old.
That being said, the CDC also says that teens and young adults through age 26 who didn't start or finish the HPV vaccine series also need the vaccine. And people with weakened immune systems or teens and young adults who start the series between the ages of 15 and 26 should get three doses instead of two.
Additionally, the HPV vaccine is sometimes administered in adults up to 45 years old, but it is not recommended for everyone older than 26. Still, a person older than 26 might decide to get vaccinated after talking to their doctor about possible benefits even though it is less effective in this age range since more people have already been exposed to HPV by this time.
What Are The Possible Side Effects?
With more than 120 million doses of HPV vaccines distributed in the United States, there is plenty of data showing the safety of HPV vaccines. But, like any vaccine, there are possible side effects.
According to the CDC, the most common side effects are pain, redness or swelling in the arm where the vaccine was given, dizziness, fainting (which is more common among adolescents after receiving any vaccine), nausea and headache. With the exception of fainting, there have been no confirmed adverse HPV vaccination side effects occurring at higher than expected rates.
Anaphylaxis, a serious allergic reaction, occurs very rarely after any vaccine including HPV vaccines. The CDC says that anaphylaxis following vaccination in the U.S. has a reported rate of three cases per one million doses administered.
HPV Vaccine Hesitancy
Doctors say the benefit of having your child get the HPV vaccine outweighs any possible concerns, but timing is important. Duffey-Lind says the immune response is "significantly stronger" in those vaccinated before age 15.
"The greatest benefits for HPV vaccination occur when adolescents are vaccinated at younger ages," Dr. Vadaparampil previously told SurvivorNet. "Their immune response is better, and they are less likely to have been exposed to the virus. Also, two doses are required if the vaccine series is started at age 14 or before, compared to three doses required after that age. Thus, waiting for a child to be older, may lead to missed opportunity to be maximally protected."
So why are people hesitant to protect themselves and their children? One reason may be that there is a myth that that the HPV vaccine can cause autism.
Don't be Swayed by Myths: The HPV Vaccine Is Completely Safe
"The HPV vaccines do not cause autism, there's always a risk of some vaccine-related side effects … local site injection pain, some redness, some swelling," says Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic Cancer Center. "There are no syndromes such as autism or other neurologic symptoms that have been linked to the HPV vaccines."
Dr. Geiger also wants people to remember that, although you might not want to think about it, your children will likely participate in sexual activities at some point in their lives. Refusing to vaccinate your children denies them available protection from HPV-linked diseases, and that should be more important than not wanting to think about your kids ever having sex.
"The fact is that the majority of us are going to participate in sexual activity at some point in our lives," Dr. Geiger said. "It's unreasonable to think that just because your child isn't engaging in sexual activity now that they won't later in life."
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