The HPV Vaccine Is A Cancer Vaccine, Not A Sex Vaccine - Forbes

Posted: 07 Jun 2019 09:01 PM PDT

Marcia Cross, actress best known for her work on the hit television show Desperate Housewives, recently revealed that she is being treated for anal cancer, which is seen in less than 1% of cancer cases each year. The actress wanted to share her story, not only to raise awareness of this rare cancer, which may go undetected well after the cancer develops, but also to bring the importance of the human papillomavirus (HPV) vaccine to the public. Just as her husband, Tom Mahoney's, throat cancer, diagnosed in 2009, was caused by HPV, so is her anal cancer.

Cancers related to HPV infections are becoming more widely recognized, and, thanks to destigmatizing cancers of the genital tract and lower gastrointestinal tract, these cancers are being detected earlier and earlier. The actress's cancer was discovered when she had no symptoms, but was having a routine gynecologic check-up. Typically, one thinks of gynecologic exams to include something called a pap smear, where a sampling of cells are taken from the cervix, looking for pre-cancerous or cancerous cells, infections (including HPV), or visible or palpable masses of the cervix, uterus, ovaries, vagina, and vulva. In addition, a rectal examination can be performed (by a gynecologist or primary care physician) to evaluate for masses, but even more informative, these rectal examinations can be performed to test for occult blood (occult in this case meaning no obvious signs of bleeding) in the gastrointestinal tract.

This simple screening test, known as FOBT, or fecal occult blood test, where a sampling of the fluid from the gloved finger from a rectal exam is placed onto a cassette, and a "positive" indicates blood somewhere in the lower intestines. It has been one of the most widely used early screening tests for colon cancers, which often go undetected for months or even years before symptoms develop. A positive FOBT may indicate something relatively minor, such as internal hemorrhoids, benign polyps, or anal fissures, to more severe problems such as colorectal or anal cancers. A positive FOBT may be the only abnormality, with no symptoms or history of bleeding, but it should lead to further evaluation, including colonoscopy.

While colorectal cancer is the second-leading cause of cancer deaths in the United States, anal cancer is much less common. But unlike colorectal cancers, it is more likely that anal cancers will be due to HPV infections. In a prior Forbes article, the importance of the HPV vaccine reducing cancers not only of the cervix, but also of the throat, was described. In addition, HPV in the female genital tract can be transmitted from a pregnant mother to the fetus. An entity called RRP, or recurrent respiratory papillomatosis, is an HPV-based disease of infants and children, with warts in the airways leading to airway blockage, breathing problems, and a lifetime of surgeries to remove the warts on a regular basis.

There continues to be debate on the implications and importance of pre-teen girls and boys receiving the HPV vaccine, as many have erroneously thought that receiving the vaccine is an entree into early sexual activity. No study has demonstrated this. However, there is already strong evidence that providing the vaccine is lowering the incidence of cervical cancer. If the HPV vaccine is administered more routinely, it will ideally lead to reduction in other cancers, including throat cancers and anal cancers.

New HPV treatment aims to wipe out virus before it becomes life threatening - KPRC Click2Houston

Posted: 10 Jun 2019 08:00 PM PDT

A new treatment is showing promise for people infected with HPV, the human papillomavirus. Until now, nothing was available to clear the infection from the body. Now, researchers say they're seeing success in phase two trials of a new vaccine that helps the body rid itself of the virus.

Cancer was the last thing on Sandy Lalonde's mind in her early 30s. However, months of irregular periods convinced her to see her doctor for testing.

"She said, 'We have bad news. Your high-risk HPV test came back positive and we're pretty sure you have cervical cancer,'" Lalonde said.

The cancer was stage 2-A and had spread. Lalonde needed eight rounds of chemo and 25 rounds of external radiation to treat it. Dr. Diane Harper is studying a new therapy that she hopes will wipe out cervical cancer by eliminating the HPV virus that can cause it.

"Unlike chlamydia or gonorrhea, where you can take an antibiotic and get cured, we don't have anything that will get rid of HPV," Harper said.

Researchers enrolled 200 women with precancerous cervical lesions and gave them three injections one week apart. The therapy was a protein that triggered an immune response.

"It activates the immune system to go in and find the cells that are infected with HPV, or the cells that have started to change because of HPV, and attack them," Harper said.

At the end of six months, between 25% and 33% of the participants were cleared of lesions and HPV.

"The ability to clear the body of HPV is amazing, because just because they don't have cancer from it doesn't mean they don't have a whole host of other complications," Harper said.

Harper noted it's important to know that the vaccine researchers are testing is different from Gardasil, the vaccine given to preteens to prevent HPV.

The vaccine that is being tested clears tissue that already have HPV.

Additional trials are needed before this new vaccine could be considered by the Food and Drug Administration for approval.

Background

HPV is the most common sexually transmitted infection. It is usually harmless and goes away by itself, but some types can lead to cancer or genital warts.

There's no cure for HPV, but there's a lot you can do to keep HPV from having a negative impact on your health. There are vaccines that can help protect you from ever getting certain types of HPV. Genital warts can be removed by your nurse or doctor. High-risk HPV can usually be easily treated before it turns into cancer, which is why regular Pap/HPV tests are so important.

While condoms and dental dams don't offer complete protection, they can help lower your chances of getting HPV.

Cancers

High-risk HPV is more likely to cause cancer. For most people, the immune system is able to get rid of this type of infection. But some people develop a lasting infection. Over many years, the infection transforms normal cells into precancerous lesions or cancer. HPV infection causes nearly all cervical cancers. Of the cervical cancers related to HPV, about 70% are caused by 2 types: HPV-16 or HPV-18. Smoking may increase the risk of cervical cancer for women who have HPV. Although almost all cervical cancers are caused by HPV, it is important to remember that most genital HPV infections will not cause cancer. Next is oral cancer. HPV can cause cancer of the mouth and tongue. It can also cause cancer of the oropharynx. This is the middle part of the throat, from the tonsils to the tip of the voice box. These HPV-related cancers are increasing in men and women. Changes in sexual behavior, including an increase in oral sex, may be contributing to the increase. Also, HPV is associated with less common cancers, including anal cancer, vulvar and vaginal cancers in women, and penile cancer in men.

New research

Dr. Diane Harper, MPH, MS, senior associate director, MICHR, and professor of family medicine and obstetrics and gynecology at the University of Michigan, talked about next steps for the new therapy: "The next steps for this is to figure out do we want to tweak the molecule to see if we can get a higher coverage rate? Or do we combine this with something else to be able to get a better cure, or potentially, such as in head and neck cancer, can we combine this with a chemotherapeutic agent in people who already have cancer to help their cure rates become even better."

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