Win32 Virus Removal

Hello readers!

I'm willing to bet that very few of you know that January is Cervical Cancer Awareness Month! I know I didn't. This changed when I was kindly invited to interview two local experts in the diagnosis and treatment of this disorder, as well as a patient that actually has it. What follows is the first in a series of articles focusing on cervical cancer from both a medical and patient perspective.

Cervical Cancer and HPV

The human papilloma virus (HPV) has recently been shown to be the most important risk factor for cervical cancer (a risk factor is something that increases one's risk of getting a particular disorder). There are other risk factors such as smoking, immunosuppression (reduced immune function), multiple full-term pregnancies, oral contraceptive use, and others; however, these are beyond the scope of the present article, whose purpose is to focus on the single most important risk factor, the HPV virus.

The HPV virus is virtually ubiquitous in the population; if you have ever had unprotected sex, then the chances are great that you have had (or currently do have) the virus. The good news is that most peoples' immune systems manage to clear the virus from their bodies naturally. However, in some individuals this does not occur, and the virus persists. In some of those instances, cervical cancer may develop.

There a number of types of HPV virus in nature; some of these cause a condition called genital warts (in which wart-like growths occur on the genitals) while others cause cervical cancer. Genital warts can occur in both men and women.

Fortunately, both the incidence (rate of occurrence) and mortality rates for cervical cancer in the U.S. have been falling. In 2005, the incidence and mortality rates of cervical cancer (as reported by the National Cancer Institute) were roughly 6-14 per 100,000 women and 2-5 per 100,000 women, respectively. Both rates were somewhat higher for Hispanic and African-American women as compared with Caucasians.

Cervical cancer remains a significant health threat; if undetected, it spreads into surrounding tissues (such as the uterus or vagina, pelvic wall, or bladder) or distant parts of the body causing debility and eventually, death.

As with any cancer, it is best to detect it early; by the time overt symptoms occur (such as excessive bleeding during menstruation, pelvic pain, or pain during urination) it may be too late to achieve a cure. This is why periodic PAP smears are so important; there is now a test available that can detect the presence of the HPV virus in cervical cells obtained in a routine PAP smear sample.

How The HPV Virus Causes Cervical Cancer

Via unprotected sex, the HPV virus comes into contact with and infects normal cells in the cervix. Over time, the virus influences the cells to become abnormal, or dysplastic. There are several stages of this dysplasia, ranging from mild all the way to cancerous. Your physician can send samples of cervical cells for examination under a microscope, where this determination can be made.

When the dysplasia is mild, observation may be the only treatment warranted. When more advanced, removal of the abnormal cells by laser treatment or surgery may be necessary. In any case, the take-home message here is that observation is the key, and this is only possible if periodic PAP smears are done! So ladies, please don't skip out on them!

The HPV Vaccine

Given the above, it's easy to see why the medical community is so excited by the recent availability of a vaccine for the HPV virus; since this virus is the #1 cause of cervical cancer, its administration can significantly reduce its occurrence. In effect, cervical cancer may now be considered to be a largely preventable disease. The amount of human suffering and death that can now be prevented from happening is staggering to this author.

The HPV vaccine is relatively simple to administer and is not associated with any known adverse medical consequences. After the initial dose, it is re-administered two and then six months later (it is given in the arm, like most other vaccines). It is available for girls/women between the ages of 9 and 26 (the reasoning here is that after age 26 the cervical cells may be less likely to be protected by the HPV vaccine; this upper-age cutoff may change however, as more clinical data are accumulated over time).

Optimally, the HPV vaccine should be given before a woman becomes sexually active, since the best way to prevent cervical cancer is to prevent infection by the HPV virus in the first place. However, having had unprotected sex (remember, virtually everyone that has EVER had unprotected sex is almost certain to have had the virus at some point) is not a reason to forego the vaccine; the vaccine will interfere with viral activity even if the virus is still present (really cool!).

The HPV vaccine has also recently been approved for boys as well (the reasoning here is to reduce the available "pool" of virus in the population as well as to prevent genital warts, which are quite painful).

Be sure to stay tuned here for upcoming articles focusing on the treatment of cervical cancer, and the personal experience of a patient.

Many thanks to Dr. Mary Weiss, M.D., Medical Director at the Swedish Physicians Central Seattle Clinic and Chief of Staff-Elect at Swedish Medical Center for kindly donating her time and knowledge for an interview, as well as to Jennifer Bragg & Sarah Haeger for making this series possible.