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Old 07-06-2011, 10:26 AM
 
Location: North Carolina
531 posts, read 1,766,815 times
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HPV is a moving target: through mutation, new strains are coming into being all the time. Thus, you'll need a booster at some point. It's kind of like the flu: last year's shot doesn't protect you this year.

Cervical cancer is the most curable of all the female cancers AND we have a very good screening test for it. Even if you have been Gardisil-ed, you still are supposed to get your Pap smear.

So why get Gardisil-ed? I'm not some wacko anti-vaxer--I think most childhood vaccines have proven their worth and safety. But this one....I think someone wanted Merck to make a lot of money.

 
Old 07-06-2011, 05:18 PM
 
Location: Georgia, USA
21,557 posts, read 26,166,023 times
Reputation: 26585
Quote:
Originally Posted by goat1of2 View Post
HPV is a moving target: through mutation, new strains are coming into being all the time. Thus, you'll need a booster at some point. It's kind of like the flu: last year's shot doesn't protect you this year.

Cervical cancer is the most curable of all the female cancers AND we have a very good screening test for it. Even if you have been Gardisil-ed, you still are supposed to get your Pap smear.

So why get Gardisil-ed? I'm not some wacko anti-vaxer--I think most childhood vaccines have proven their worth and safety. But this one....I think someone wanted Merck to make a lot of money.
Again, the Pap smear is not used to diagnose cancer. It is used to diagnose PRE-cancerous conditions. This is expensive, painful biopsies may be required, and there may be fertility problems if extensive biopsies are needed.

Gardasil has been designed to cover the 4 HPV strains that are associated with the majority of cancers and wart infections. It is not yet known if boosters will be needed.

The cost-benefit analyses have been done. It saves money in the long run to get the vaccine and reduce the number of biopsies needed.

And not all women who develop cervical cancer are cured. HPV is also associated with other female genital cancers, male and female anal cancers, and some head and neck cancers.
 
Old 07-06-2011, 06:48 PM
 
Location: In a house
13,258 posts, read 34,677,768 times
Reputation: 20198
suzy speaks truth. Here's what happened with my severe cervical dysplasia caused directly by active HPV:

1. pap smear comes back abnormal, whatever level is really bad, it's been a couple decades so I don't remember and I've been normal ever since.
2. subsequent vaginal tissue sample taken, appointment made for laser cone biopsy
3. tissue sample shows fast growth of white cells, which indicates a pre-cancerous condition that is guaranteed to become cancerous if I don't get rid of it NOW.
3. cone biopsy removes 1/3 of my cervix, making it a *huge* risk if I ever decide I want to get pregnant. I'm at the peak of my childbearing years at this point, I was either 29 or 30. Biopsy also removes several mucous glands along the walls of my vagina.
4. That night, my cervical area and vagina are so swollen they block off my urethra, making urination almost impossible - even though I have a full bladder and REALLY need to go. For the next 6 hours, I'm up, hobbling with assistance from spouse, to the bathroom to emit a tiny trickle of urine, since I *cannot* push against the muscles in there to force any more out, and can only let out what chooses to come out on its own. Which is a few drops each time. While I'm doped up on percosets, in agony, swollen, weak-kneed, and nearly incoherent.
5. 2 days later - visit the ob/gyn (who was also the surgeon, thankfully) for a post-op checkup. All's well, swelling almost gone, can pee again, and I'm given the go-ahead to use my muscles to push urine out if necessary.
6. 3 days later - first bowel movement since before surgery. Excruciating.
7. 1 month later - D&C
8 . 3 months later - D&C
9. 3 months after that, and every 3 months for the next 2 years: D&C
10. 2nd yearly pap comes back normal - I can stop getting the D&Cs but have to have a pap every 6 months instead of once yearly for the next 2 years.

The insurance picked up most of this. But any woman who doesn't have an HMO or co-pay, who has to instead deal with minimum out of pockets and deductibles, is looking at several thousand dollars, over a 4-year period.

And that's NOT including radiation or chemo, which I was fortunate not to need.

OR...

I could've been vaccinated, maybe even twice, and risked passing out a couple of times during the few days following the vaccine. I definitely would be a candidate for passing out since I have low blood sugar. But I would've stayed home and been prepared for it.

Unfortunately the vaccine didn't exist, then. And I had never even heard of HPV until they gave me the diagnosis, along with the appointment to have a third of my cervix removed.
 
Old 07-06-2011, 07:07 PM
 
8,325 posts, read 17,688,151 times
Reputation: 10907
Quote:
Originally Posted by AnonChick View Post
It's a tough decision to make, I think. You have to weigh the risks to your own children and decide which is the least harmful risk:

Side effects for Gardasil (or Ceravix - Gardasil isn't the only vaccine).

Or knowing that at least 2 out of your 5 daughters will contract HPV at some point in their lives, and that HPV is the *primary* (not the only) cause of cervical cancer.

So - you want to risk your daughters going through cervical cancer? Or you want to risk the side effects of the vaccine.

You're risking their lives, either way you do it. There is no simple solution yet. Hopefully some day there will.

Thanks for you reply, but they still not getting it.

Oh..and they didn't get the chicken pox vax, or the hepatitis fax, or the flu shot....
 
Old 07-07-2011, 05:11 AM
 
Location: North Carolina
531 posts, read 1,766,815 times
Reputation: 302
Quote:
Originally Posted by AnonChick View Post
suzy speaks truth. Here's what happened with my severe cervical dysplasia caused directly by active HPV:.....

.
I am so sorry you had such a nightmare experience BUT there's a very good chance that Gardisil would not have prevented it since your cancerous condition may have been one of the 30% against which it does not protect. OR the vaccine's effectiveness may not last until you are 29 (the age you say you were diagnosed). Many cervical cancers are in far older women, who will be 30-plus years removed from their Gardisil vaccine they had back in their mid-teens.

The vast majority of abnormal pap smears find "squamous cells"--a fancy name for your common wart. In fact, the more common name for HPV is "genital warts"! The wart is frozen off your cervix. A nearly painless procedure, some cramping. No biopsy needed. Sure there is some expense, but if the side effects of this vaccine keep becoming more apparent and if it requires boosters every few years, I don't think the risk and cost outweighs the reward. Especially when cervical dysplasia is not a big deal when detected early. And most people's bodies clear the HPV infection with no warts whatsoever. (Heck, straight men almost NEVER have problems...they are just carriers...isn't that always the way?)

By all means let's keep working on vaccines. In developing countries where Pap smears are unavailable, a vaccine for cervical, even a flawed one, is a lifesaver overall. In developed nations, however, the risk/reward ratio just isn't doing it for me yet. Only about 4500 deaths from cervical per year in the US! And many of those preventable with regular smears.

Remember, Merck is doing the CYA thing by telling women they must still get their regular Pap smear. What does that tell you? What is that saving?

I gotta ask...were you getting your regular Pap smears? Because cervical is usually one of the slow-growing cancers. In rare cases (yours, maybe) it can be fast-growing. If so, I am sorry, but that would make your experience rare and not useful as an argument for routine vaccination of millions of women in a country with affordable and available Pap smears.
 
Old 07-07-2011, 06:05 AM
 
8,325 posts, read 17,688,151 times
Reputation: 10907
Both HPV and genital warts are STDs. The more sexual partners you have, the higher your risk of getting either one..not to mention all the other nasty STDs out there.
 
Old 07-07-2011, 06:12 AM
 
Location: North Carolina
531 posts, read 1,766,815 times
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Quote:
Originally Posted by Kim in FL View Post
Both HPV and genital warts are STDs. The more sexual partners you have, the higher your risk of getting either one..not to mention all the other nasty STDs out there.
Which brings up my other criticism...why are we only talking about vaccinating girls? Yet another indicator that this vaccination "strategy" is not ready for primetime.

I want a vaccination against HPVs--just not this one. More work is needed. That's all I'm saying.
 
Old 07-07-2011, 06:22 AM
 
8,325 posts, read 17,688,151 times
Reputation: 10907
Quote:
Originally Posted by goat1of2 View Post
Which brings up my other criticism...why are we only talking about vaccinating girls? Yet another indicator that this vaccination "strategy" is not ready for primetime.

I want a vaccination against HPVs--just not this one. More work is needed. That's all I'm saying.

Probably because the age of teenage moms is getting younger and younger.

At my hospital the youngest mom I've seen in the last three yrs was 11. Yup. 11. I about fell over. We average 3-5 teen moms under the age of 16 every month.

Society thinks abstinance is a religious thing and therefore you can't teach it in school.......the current sex ed they are teaching in school isn't working either...nor is the free birth control they are giving out.

So what is the answer?
 
Old 07-07-2011, 01:23 PM
 
Location: Georgia, USA
21,557 posts, read 26,166,023 times
Reputation: 26585
Quote:
Originally Posted by goat1of2 View Post
I am so sorry you had such a nightmare experience BUT there's a very good chance that Gardisil would not have prevented it since your cancerous condition may have been one of the 30% against which it does not protect. OR the vaccine's effectiveness may not last until you are 29 (the age you say you were diagnosed). Many cervical cancers are in far older women, who will be 30-plus years removed from their Gardisil vaccine they had back in their mid-teens.
Again, it is not yet known whether boosters will be needed. Gardasil is too new for there to be enough experience to tell. But by 30 years from now we will know. If boosters are needed, we will have an idea of how frequently. Gardasil also apparently provide some protection against 10 other types, including 31, which is very similar to 16: Those 10 are associated with about 20% of cervical cancers.

HPV Vaccine Protects Against 10 "Other" Strains

The efficacy for these types is not as good as for the types actually in the vaccine, so I would not be surprised to find more types added to the vaccine as time goes by.

Quote:
The vast majority of abnormal pap smears find "squamous cells"--a fancy name for your common wart.
No, "squamous cells" is not a synonym for wart. Squamous cells are the patient's own cells which cover the cervix and are scraped off during the Pap smear. All Pap smears, normal and abnormal, contain squamous cells, or the specimen will be ruled inadequate for evaluation by the cytologist.

You may be thinking of the Pap smear report that says, "Atypical squamous cells of undetermined significance" or "ASCUS" for short. This report may either trigger another Pap smear after treating for any cervical or vaginal infections or a test for HPV.

Quote:
In fact, the more common name for HPV is "genital warts"! The wart is frozen off your cervix. A nearly painless procedure, some cramping. No biopsy needed. Sure there is some expense, but if the side effects of this vaccine keep becoming more apparent and if it requires boosters every few years, I don't think the risk and cost outweighs the reward. Especially when cervical dysplasia is not a big deal when detected early. And most people's bodies clear the HPV infection with no warts whatsoever. (Heck, straight men almost NEVER have problems...they are just carriers...isn't that always the way?)
Most gynecologists will not treat the cervix for any HPV associated condition without a biopsy first.

What side effects are you referring to? Keep in mind that despite the desire of those on the internet to blame any illness which occurs after the vaccine on the vaccine, there is no scientific support for that. If boosters become necessary, current evidence suggests it will be at longer than 8.5 year intervals. Would you not be vaccinated against tetanus because boosters are recommended every 10 years? And if boosters do appear to be needed, the patient is now an adult and can decide for herself whether her sexual behavior puts her at a level of risk for which a booster might be a good idea.

Not all HPV infections produce actual warts. Cervical infection may trigger dysplasia without causing anything that looks like a wart.

Quote:
By all means let's keep working on vaccines. In developing countries where Pap smears are unavailable, a vaccine for cervical, even a flawed one, is a lifesaver overall. In developed nations, however, the risk/reward ratio just isn't doing it for me yet. Only about 4500 deaths from cervical per year in the US! And many of those preventable with regular smears.
What "flaws" do you see in the vaccine?

It is wrong to focus only on the deaths from cervical cancer. Those women who survive generally lose their uterus at a minimum and may also need radiotherapy. You need to also consider vaginal and vulvar cancer, anal cancer, and head and neck cancer. Treatment for head and neck cancer can be particularly disfiguring and debilitating. And types 16 and 18 appear to be the ones involved in head and neck cancers:

Human Papillomavirus Types in Head and Neck Squamous Cell Carcinomas Worldwide: A Systematic Review

HPV Vaccine Stops Throat Cancer? - Cancer Information (Cancers, Symptoms, Treatment) on MedicineNet.com


Quote:
Remember, Merck is doing the CYA thing by telling women they must still get their regular Pap smear. What does that tell you? What is that saving?
The saving is in the decreased number of colposcopies, biopsies, hysterectomies, and followup monitoring needed.

For an article that shows how the cost benefit analysis is done:

Human Papilllomavirus Vaccination | CDC EID

Quote:
I gotta ask...were you getting your regular Pap smears? Because cervical is usually one of the slow-growing cancers. In rare cases (yours, maybe) it can be fast-growing. If so, I am sorry, but that would make your experience rare and not useful as an argument for routine vaccination of millions of women in a country with affordable and available Pap smears.
The goal of the vaccine is prevention. Pap smears diagnose after the HPV infection has already occurred. Since there is no way to know which women with high risk HPV infections will go on to develop high grade dysplasia and possibly cancer, many women will get treated who may not have needed it. It is very stressful to be told to come back every 3 months for another smear. And, as your question implies, not all women get regular smears. By taking the vaccine, a woman will have her risk of ever needing evaluation for an abnormal smear greatly reduced.

Finally, males need to be vaccinated, too. It will reduce the risk to unvaccinated partners as well as reduce the risk of penile cancer (admittedly a lower risk than female genital cancers) and head and neck cancers.

If enough people are vaccinated, eventually herd immunity comes into play. The risk of anyone having contact with someone with the HPV types in the vaccine goes way down.
 
Old 07-07-2011, 03:28 PM
 
Location: In a house
13,258 posts, read 34,677,768 times
Reputation: 20198
Yeah that other post really got me confused - I never had genital OR herpetic warts. And, my displasia wasn't fast-occurring - the pap that showed the displasia was before I was married...

and you can have HPV for quite awhile before ever showing any symptoms at all. And if the symptom you show is displasia, it's because it had built up to it over time. It doesn't just show up one day, where it hadn' been there the day before. You only get paps yearly - so it had 11 months and change to build up.

And squamous cells are skin cells. That's why there are two kinds of skin cancer: basal cell carcinoma and squamous cell carcinoma. The cancer is either in the basal cells, which are usually normal, or in your squamous cells, which are usually normal.

Eh. Suzy explains it better. Honestly though, I still think it's a personal decision, and there's a risk to life no matter which way you go on it. For me, the risk of feeling faint and possibly sick for a couple of days, would have been significantly less traumatic, than the whole series of events one has to experience when one is diagnosed with HPV-caused severe displasia (precancerous cervical condition).
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