Doctor offers information on HPV
Eloisa Jahdi, MD, speaks during the Alliance Community Hospital Lecture Luncheon Sept. 9. Her topic was Decreasing the Risk of HPV-Related Cancers. (Review photos/Gayle Blair)
Attendees of the most recent Community Lecture Luncheon held Sept. 9 at Alliance Community Hospital heard a program on "Decreasing the Risk of HPV-Related Cancers" by hospital pathologist Eloisa Jahdi, M.D.
HPV, or human papilloma virus, is a the most common sexually transmitted virus, according to Jahdi. She said there are more than 100 types of HPV -- 30 of which are high risk because they can lead to the development of cancer.
Jahdi said the most risky types of HPV are 16 and 18, which put people at risk for cancer of the genitals, anus, mouth and throat.
"About 75 percent of the HPV types are called low risk because they do not cause cancer but they cause warts, which are very unsightly and can be difficult to treat sometimes because they can recur; they can multiply so much that it is very difficult to treat them," she explained.
Jahdi said HPV is passed through vaginal, oral and anal sex and through skin to skin contact.
"Men and women can get it and can pass it on without even knowing that they have it, and years can pass since one has had sex," she said.
She added that although it is rare, HPV can also be passed from mother to newborn during the delivery process.
Jahdi said HPV infection is considered an epidemic, occurring worldwide. She said more than 50 percent of people who have had sex will have HPV at some time in their life, but most cases go away on their own. However chronic infection can lead to health problems.
According to the National Institute of Health, virtually all cases of cervical cancer are caused by HPV (70 percent of which are due to types 16 and 18). HPV is also the cause of 90 percent of anal cancers, 80 percent of mouth and throat squamous cell cancers, 65 percent of vaginal cancers, 50 percent of vulvar cancers and 35 percent of penile cancers.
Jahdi said those at high risk for getting HPV are:
■ Those who had sex at early age (16 or younger).
■ Those with multiple sex partners.
■ Those with a sex partner with multiple sex partners.
■ Those with a male partner who is uncircumcised.
The doctor said there are some things people can do to lower the chances of getting HPV, such as abstinence, limiting their number of sex partners, maintaining a monogamous relationship, choosing a partner with no or few sex partners, using condoms (which reduces but doesn't eliminate exposure) and getting HPV vaccinations.
While there are screening tests for cervical cancer (Pap smear) and an HPV test, she said there are no screenings for anal and penile cancers and no approved screening test for oropharyngeal (mouth/throat) cancer.
HPV vaccines, which produce an immune response and protect cells from the virus, have been available for a decade. She explained each of the three types of vaccines:
■ Cervarix -- targets high risk types 16 and 18.
■ Gardisil -- targets 16 and 18 as well as types 6 and 11 (which cause 90 percent of genital warts).
■ Gardisil 9 -- targets 16 and 18, 6 and 11, and five additional high risk types (31, 33, 45, 52, 58).
"It (Gardisil 9) covers more, but since the other HPV types are rare, Cervarix and Gardisil are good enough," Jahdi said, adding that the vaccine is pricey, costing $130 to $160 per dose with three doses required.
She went over recommendations for the HPV vaccine which is routinely given at age 11 or 12, although children ages 9 and 10 may be given the vaccine. For those who haven't received the vaccine at those recommended ages, it is still recommended at some point between ages 13 and 26.
While there are typically only mild side effects, Jahdi said recently there have been controversies about the HPV vaccine causing chronic symptoms. Two of the issues in question are complex regional pain syndrome (CRPS) and postural orthostatic tachycardia syndrome (POTTS).
CRPS is a chronic pain condition affecting the limbs. "There have been reports that some of these younger women who have received the vaccination experience this without any other causes that they can determine," Jahdi said. "This can be very chronic and last for months."
She said POTTS is a condition in which the heart rate increases abnormally -- up to 40 beats per minute above normal -- when you get up from a sitting or lying position. It is accompanied by dizziness, fainting, headache, chest pain and weakness. "There are ongoing studies to see if a link really exists," she added.
Jahdi said when young people go to the doctor, they should be told about HPV and the vaccine but they often go uninformed, which has affected the number of vaccinations given. "In the United States, we are really behind. Vaccines have been available since 2006 and our rate of vaccination is only 40 percent in girls and 20 percent in boys," she said.
Jahdi suggested patients speak with their doctor about their HPV risks and recommendations for the vaccination.