Wednesday, 20 February 2019 20:08

Mexican scientist cures HPV (kind of)

Mexican researchers had a major breakthrough in treating HPV (Human Papillomavirus), the most common sexually transmitted disease. In fact, the CDC states that almost 80 million Americans are infected with HPV with approximately 14 million people becoming newly infected per year. Those are just the numbers in the U.S. alone.

 

What exactly is HPV?

 

HPV is a group of more than 150 related viruses, named for the warts (papillomas) some HPV types can cause. Some other HPV types can lead to cancer. According to the CDC website:

 

“In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.

 

HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer). Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.”

 

According to, El Universal, a popular Mexican newsite, a research team at Mexico’s National Polytechnic Institute led by Eva Ramon Gallegos, was able to eliminate HPV in dozens of patients using a non-invasive photodynamic therapy. Which makes us all ask, what is photodynamic therapy? Well, according to cancer.gov:

 

“Photodynamic therapy (PDT) is a treatment that uses a drug, called a photosensitizer or photosensitizing agent, and a particular type of light. When photosensitizers are exposed to a specific wavelength of light, they produce a form of oxygen that kills nearby cells.”

 

Sounds like science fiction to me but whatever works! Anyway, according to Ramon’s study, the team was able to eliminate HPV in 100 percent of patients that had no premalignant lesions and in 64.3 percent of subjects with lesions.

 

Now, I know that viral headlines all across the internet screamed the HPV has been cured but, um - not so fast. There are over 100 different kinds of HPV. Some cause health problems, some do not. Some, but not many, cause cancer. One of the reasons cancer is so hard to cure is because each type of cancer will require a completely different cure. Something that cures cervical cancer, for example, will probably not cure breast cancer. And something that cures type 6,11,16 and 18 (most of the problematic HPV types) types of HPV might not work on other types of HPV.

 

As pointed out by Liz Highleyman, the editor in chief at www.cancerhealth.com in her A Cure for HPV, not so fast…, there are too many forms of HPV to claim they have all been cured. Highleyman notes the Mexican  research only focused on two types of HPV. So, while the research is good news, it’s not exactly a full cure. From her article:   

 

It’s not clear how photodynamic treatment might eliminate HPV infection, which would seem to require some type of antiviral therapy. But there’s clearly something going on.  

Despite the unanswered questions raised by the recent reports, the findings from the Mexican study are good news for people with HPV-associated dysplasia. Photodynamic therapy is well tolerated and noninvasive. Using PDT instead of surgery to remove precancerous tissue could help preserve function in people with anal lesions and the ability to carry a pregnancy in women with cervical lesions.

 

The news also presents an opportunity to promote HPV vaccination. The new Gardasil 9 vaccine protects against several of the most common cancer-causing HPV types (16, 18, 31, 33, 45, 52 and 58) and two wart-causing types (6 and 11). It is recommended for girls and boys around age 11 or 12, before they become sexually active. However, the FDA recently approved the vaccine for women and men up to age 45, meaning people who were not vaccinated as teens or young adults may still be able to benefit.”

 

Okay. So perhaps “cures HPV” is too strong a statement. But things seem to be heading in the right direction!

Published in Health
Friday, 14 September 2018 16:42

Are pap smears going away?

For some yes, as new cancer screening guidelines suggest swapping the embarrassing procedure with HPV only tests. These HPV only tests can even be done in the privacy of one’s home.

The US Preventive Services Task Force (USPSTF) suggest women between the ages of 30-65 may be screened for cervical cancer by testing for the HPV virus, high risk strains, every 5 years without undergoing a concurrent Pap smear. This is opposed to the “co-testing” recommended up until now. Women can, however, if desired, choose to have Pap smears every 3 years. These guidelines do not pertain to those who have cervical cancer or symptoms that could suggest a malignant process such as pain, bleeding and weight loss.

However one concern many physicians have is the lack of other testing being done during a “Pap Smear” visit.  Pelvic exams evaluating for gynecological pathology, breast exams, counseling and preventative health recommendations are often done during a woman’s physical and extending the testing intervals to twice a decade could put one at risk of another illness being missed.

Moreover, would an at home HPV test be sufficient enough to screen for cancer?  Smoking may also predispose one for cervical cancer so testing for the HPV virus alone may not be enough.

What is the cervix and what is cervical cancer?

 

The uterus looks similar to a light bulb.  The larger top portion being where the fetus develops, and the bottom, narrower area, the cervix.  The cervix thins and dilates during childbirth, as you’ve heard in the movies “she’s only 7 cm!” and then after childbirth becomes narrow again.  It affects nearly 12,000 and kills 4,000 women each year.  It can affect women of any age but is more common between 20 and 50.

 

375x321_cervix

HTTP://WWW.WEBMD.COM/WOMEN

 

What causes cervical cancer?

 

The most common cause is HPV (Human Papillomavirus), especially HPV-16 and HPV-18.  This is acquired through unprotected sex, so condom use is encouraged. Thus it's one of the most preventable causes of cancer.  Additionally, there are 3 vaccines for HPV currently approved by the FDA, Gardasil, Gardasil 9, and Cervarix.

What are the symptoms of cervical cancer?

 

Early cervical cancer may not be symptomatic but as it develops it may cause an odor, pain with urination, pelvic pain and bleeding. This bleeding may occur after sex, a pelvic exam, or intermittent bleeding not associated with a menstrual cycle.

Is cervical cancer treatable?

 

Yes.  Early detection is key and can be done by a Pap Smear, explained below.  Multiple treatments are available including surgery, chemotherapy,  radiation therapy, and targeted therapy such as Bevacizumab (Avastin®) which prevents new blood vessel growth that can feed a tumor.

Who should get screened for Cervical Cancer?

 

The USPSTF (United States Preventive Services Task Force) recommended the following:

Women aged 21 to 65 years

The USPSTF recommends for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting).

 

See the Clinical Considerations section for the relative benefits and harms of alternative screening strategies for women 21 years or older.

A

Women older than 65 years

The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer.

 

See the Clinical Considerations section for discussion of adequate prior screening and risk factors that support screening after age 65 years.

D

Women younger than 21 years

The USPSTF recommends against screening for cervical cancer in women younger than 21 years.

D

Women who have had a hysterectomy

The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion (ie, cervical intraepithelial neoplasia [CIN] grade 2 or 3) or cervical cancer.

The first 3 recommendations apply to individuals who have a cervix, regardless of their sexual history or HPV vaccination status. These recommendations do not apply to individuals who have been diagnosed with a high-grade precancerous cervical lesion or cervical cancer. These recommendations also do not apply to individuals with in utero exposure to diethylstilbestrol or those who have a compromised immune system (eg, women living with HIV).

 

What is a Pap Smear?

 

It is the cytology (cell analysis) of the cervix. Years ago, a cytobrush would collect the cells and the medical provider would “smear” it onto a slide, place fixative, and then send it to the laboratory for the pathologist to analyze it. Now ThinPrep® Pap tests are used more commonly as the cells from the brush are placed into a container with fixative, and this vial is sent to the pathologist to spin down and analyze.

 

cervical-smear-test-equipment-97358274-575db1493df78c98dc633c53

TEK IMAGE/SPL / GETTY IMAGES

 

In order to obtain the cells from the cervix, the medical provider needs to use a speculum to open the vaginal canal and allow access to the uterus.  A woman may be in the lithotomy position…lying on one’s back on the exam table with her feet in stirrups and knees bent. During the speculum exam, the medical provider may take cultures to test for common vaginal infections such as yeast, bacteria vaginosis, or sexually transmitted illnesses such as gonorrhea and chlamydia.  After the speculum exam, the provider may perform a pelvic exam with her gloved hand to examine the uterus and ovaries, evaluating for tenderness, shape, size and masses.

How is an HPV test done?

 

An HPV test can be done with the cells obtained during the Pap Smear.  At home tests require the patient to swab their vagina (female) or urethra (male) or rectum and then mail the swab to the lab.  The laboratory evaluates the cells to see if the HPV virus that causes cervical cancer is present.

In summary the thousands of deaths that occur each year to cervical cancer can be prevented with simple testing, such as the Pap Smear.  Discuss with your medical provider when cervical cancer screening is best for you.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Published in Health