Vaccines to Prevent Cancer

To HPV or not to HPV, that is the question!

We have vaccines to prevent many types of infectious diseases, all of which have contributed significantly to the increased length of life of both men and women, up from 35 years in 1900 to 80 years in 2000. While vaccines have played a major role in not only our length of life, but in our quality of life, scientists have always dreamed of the magic bullet, a vaccine to prevent cancer.

Cancer of the cervix in women is a life-threatening growth in the tissue between the upper vagina and the lower uterus in women. This cancer is caused by a virus called Human Papilloma Virus (HPV). Over 70 percent of cervical cancer is caused by HPV types 16 and 18.

So all the medical community was excited to read of the "breakthrough" development of a vaccine against these two common strains of HPV, type 16 and type 18, as well as types 6 and 11. This vaccine was tested and found to be 100 percent successful in preventing HPV infection, and 100 percent successful in preventing the earliest changes of cancer of the cervix caused by HPV 16 or 18.

The vaccine is given in three doses 2 months apart. This produces good levels of antibodies in women that reduces the likelihood they will ever get HPV infection.

Who should get HPV vaccination? Current guidelines from the Centers for Disease Control and National Cancer Institute have indicated that girls and women between the ages of 9 and 26 should receive the HPV vaccine, preferably before they begin to be sexually active.

What about boys and men? HPV vaccination can also prevent them from developing HPV infection, and they are of course the source of HPV infection of women which results in cervical cancer. However, guidelines have not yet been established for vaccinating boys and men. Clinical trials are under way.

What other cancers can HPV vaccination prevent? In addition to the vaccine preventing 70% of cervical cancer, many cancers of the vulva and vagina can be prevented in women, and cancer of the penis in men. Importantly, many cancers of the throat, tongue, and voice box which are unrelated to smoking or alcohol exposure, are actually caused by HPV, usually HPV 16 or HPV 18. So the HPV vaccine will also prevent many of the oral and throat cancers that are so devastatingly serious in adults, both men and women. Surprisingly, the vaccine also prevents the unsightly and uncomfortable genital warts, which are usually caused by HPV types 6 or 11.

So why isn't every woman receiving HPV vaccinations at the appropriate age? There has been a raging social dialogue in which many parents do not wish their daughters to receive HPV vaccine because they fear it may lead to sexual promiscuity. As a physician, I am certainly sympathetic with those fears. But I am more concerned in my family and in my patients about preventing these serious and life-threatening cancers that cause horrible side effects. To cure these cancers, treatment requires surgery, radiation therapy, and even chemotherapy. In a patient that develops any of these HPV related cancers, quality of life is forever changed. What better gift we can give our children than the reduction of cancer in their later lives?

So what is the take home message? Talk to your physician about vaccinating yourself (if you are at a younger age) and your children to try to prevent HPV. Never getting a cancer is a lot better than having to fight it once it has occurred! The day of the breakthrough HPV vaccine is here and this medicine is available to everyone.