January is Cervical Cancer Month. So it is time to look at what has been accomplished recently in control of this disease.
Getting treatment for advanced cervical cancer is challenging. Patients often have pelvic pain, sometimes with blockage of intestines and the urinary tract. Regrettably many patients have fistulas (holes) develop where they leak urine or stool through the skin, vagina or bladder. These are cruel consequences of failed cancer control. About 13,000 women will develop cervical cancer every year, and tragically 4,000 will die of the illness.
In 2014, the FDA approved a new treatment for advanced cervical cancer. Bevacizumab, an antibody that targets blood vessels in cancers and has been useful in colon, lung and brain tumors, gave better control of patients with advanced cervical cancer when used in combination with chemotherapy. For over eight years, oncologists have been helping patients by using combinations of paclitaxel plus cisplatin chemotherapy, or paclitaxel plus topotecan chemotherapy. The addition of bevacizumab has extended the length of time chemotherapy helps patients. Combining chemotherapy with radiation treatment has also markedly helped in the control of this cancer.
The cause of cervical cancer is usually infection with human papilloma virus, or HPV. Screening for cervical cancer with pap smear testing has been extended to include HPV testing, resulting in better prevention of invasive cervical cancer by diagnosing early abnormalities that lead to the cancer. After treatments of those early abnormalities by minor surgical approaches, cure rates are high and more extensive surgeries have been avoided. Results have shown that 69 percent of sexually-active people will have genital HPV infections during their lives, and 10 percent of men and 4 percent of women even have oral HPV positivity when tested.
Since vaccination with FDA-approved HPV vaccines can reduce HPV infections and reduce the likelihood of ever getting cervical cancer, it is important to know if people and their physicians are using the vaccines. In 2014, results of the 2013 National Immunization Survey were announced. In adolescents and young adults ages 13 to 17, HPV vaccinations have now been given to 57 percent of girls and 35 percent of boys. This is an amazing medical accomplishment, but it still leaves room for improvement.
Here are my tips for you and your family.
• Get pap screening tests with HPV virus testing as well if you are a woman and sexually active. If you are getting older, discuss with your doctor when you can stop having pap testing. If any abnormalities are seen, discuss with your doctor how you are going to cure them. If your doctor is uncertain get a second opinion with another gynecologist or gynecological oncologist. Never let abnormalities fester and become invasive or advanced cancer.
• Encourage women in your family to get their screening tests for cervical cancer.
• Be certain that all adolescents and young adults in your family have had their HPV vaccinations. Called Gardasil and Cervarix, these two HPV vaccines are given as three shots over a period of six months to both females and males between the ages of 11 and 26. Over the age of 26, if someone still tests negative for HPV infection, they can still receive the vaccines.
• If someone is having a difficult time affording the HPV vaccines, the VFC program (Vaccines For Children) can help in reducing the costs so everyone regardless of financial status can get immunized.
• Remember, HPV can vaccines not only prevent cervical cancer, but also other HPV illnesses and cancers. These include cancers of the vagina and labia in women and penis in men (surgeries to cure these diseases are so damaging to tissues that they interfere with sexual function, and no one ever wants to have to undergo these operations), and head and neck cancers (such as tongue, throat, larynx and tonsil cancers). Even disfiguring genital warts (condyloma accuminata) can be prevented by HPV vaccines.
• Always discuss even the rare side effects of HPV or other vaccines with your doctor. Although previously some people feared neurological illnesses after HPV, this was found to be false. A recent 2015 article has shown that in 789,000 women vaccinated, neurological complications were no higher than in over 3 million women who had not had the HPV vaccine. These vaccines appear to be very safe and prevent mutilating and fatal cancers.
As I emphasize in my book Surviving American Medicine, preventing illness is important in avoiding poor quality of life and early death, and is better than trying to battle advanced cancer. Let January, Cervical Cancer Month, be a reminder for you to get vaccinated and screened.