What is cervical cancer?
Cervical cancer is malignant tumor of the cervix (mouth of the womb). It is the second most cancer in women and the third most common gynecologic cancer, the second being cancer of the ovary. The most common gynecologic malignancy is endometrial (inner wall of womb) cancer, which is the fourth most common cancer in women. The first being cancer of the breasts, followed by colorectal cancer and lung cancer. Cervical cancer develops in women at the mean age of 50 years old, although it can occur in women as young as 20. In the Philippines it is the number 2 most common form of cancer among women. In the United States it accounts for least 3000 mortality, and globally, about 300,000, annually.
How prevalent is cervical cancer?
In the Philippines, there are about 5,000 new cases of cervical cancer each year. However, more alarming than that is the fact that there are between 10,000 to 25,000 women walking around (not seen by physician) who have undiagnosed pre-invasive lesions in their cervix. If diagnosed early, these women could be saved. For every four survivors of breasts cancer, there are less than 3 women who survive cervical cancer, which shows how virulent cervical cancer is.
What causes cervical cancer?
Human Papilloma Virus (HPV, also known as genital herpes virus) accounts for most, if not all, cervical cancers. At least 50% of sexually active men and women are infected with genital HPV, especially those with multiple partners. There are about 20 million American men and women infected with HPV, many linked with abnormal pap tests, genital warts and cervical cancer. It is estimated that 10,370 new cases of cervical cancers will be discovered in 2005. Between half a million to a million Americans have genital warts, transmitted thru sexual contacts.
Is there cure for cervical cancer?
Better than the cure! A vaccine that prevents cervical cancer has just been discovered, and was found to be “effective 100%, in the short term, at blocking the cancer and lesions likely to turn to cancer” (like the pre-invasive lesions), according to drug manufacturer, Merck & Co.
What is this “new” wonder drug?
The vaccine, which is genetically engineered, is Gardasil, which blocks infection caused by two of the more than 100 types of human papilloma virus (HPV), strains 16 and 18. These two sexually transmitted viruses are responsible for about 70% of cervical cancers. HPV, in one form or the other, afflicts about 20 million Americans. The other strains of the virus cause painful genital warts, and sometimes, cervical cancers too. Part III clinical trials in 225,000 women worldwide are underway
How good is the study?
Excellent. The final stage investigation on Gardasil involved 10,559 sexually active women (ages 16 to 26 in the United States and in 12 other countries) who did NOT have HPV 16 or 18 infection. One half of the subjects were given 3 vaccine shots over 6 months, while the other half (control group) received the placebo (dummy) shots. Among those who got Gardasil were still virus-free after 6 months and none of them developed cervical cancer or precancerous lesions over the 2 year follow-up. Twenty one in the control group had precancerous lesions and cervical cancers.” To have 100 percent efficacy is something that you have very rarely,” Dr. Eliav Barr, Merck’s head of clinical development for Gardasil, told The Associated Press.
How early should the vaccine be given?
Students in grammar school, middle school and high school should be vaccinated before they become sexually active, because once they catch HPV infection, there is no cure; herpes is for life. This was the recommendation of Dr. Gloria Bachmann, director of The Women’s Health Institute at Robert Wood Johnson Medical School in Brunswick, NJ., who said this vaccine is a “phenomenal breakthrough.” Prophylaxis Gardasil vaccination comprehensively eliminates HPV 16 and 18 associated non-invasive and invasive cervical cancer. The vaccine also cuts down infection with HPV 6 and 11, the causes of 90% of genital warts.
Is Gardasil limited to cervical cancer prevention?
No. The US Food and Drug Administration approved Merck’s application for the distribution and sale of Gardasil on June 8, 2006 for ages 9 to 26 for the prevention of cervical cancer and other HPV related diseases. On September 15, 2008, the US FDA approved the expanded use of Gardasil for the prevention of certain vulvar and vaginal cancers. This vaccine is in head-to-head competition with a rival (Cervarix) from GlaxoSmithKline, a UK-based company. As the good old cliché goes “an ounce of prevention is better than a pound of cure.”
Is Gardasil also used for boys?
Yes, since boys are potential spreader of sexually transmitted diseases, the FDA recommendation includes giving the Gardasil 9 vaccine to boys and young men (ages 9-26) since October 16, 2009. On December 22, 2010, the FDA recommended its use to prevent genital warts and anal cancer.
There are some parents who objected to having their young sons be vaccinated with this vaccine, fearing its potential complication, in spite of clinical evidence showing the vaccine’s medically accepted standard level of safety. This unfortunate controversy has left many of these boys and young men exposed to the these venereal diseases and their potential role as carriers and spreaders of sexually-transmitted illnesses. It is indeed a big waste of billions of dollars and manpower, time, and resources spent in the laboratory experiments and researches that led to the discovery of this wonderful life-saving vaccine that has been clinically proven to be very effective (at least 99.9 percent) in preventing cervical, vulvar, anal, cancers. This is as foolish as the refusal of some people in Pakistan, Nigeria, and even some in the United States to allow their children to get polio vaccine, resulting in the expected outcome. Let us all be proactive and pre-emptive advocates and take advantage of the great state-of-the-art advances in medical science and technology for disease prevention, health, and longevity.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]
