Airdate: October 11, 2012
Dr. Oz – 30 And Older: The New Face Of HPV
- What is HPV and who is at risk?
- Symptoms and diagnosis of HPV and cervical cancer
- Oral cancer and HPV
- Who is getting HPV?
- HPV vaccine debate
Dr. Oz stated that 80% of the female population will be infected with the HPV virus by the time they reach age 80 and they don't even know it. He talks to cervical cancer survivors, discusses the risks, symptoms, and prevention measures for the HPV virus.
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Dr. Oz – 30 And Older: The New Face Of HPV
Twenty million women are currently infected with Human papillomavirus (HPV) and six million new diagnosis are made each year. Sadly, HPV goes unnoticed in most cases until it's too late. Knowing the risks, signs, and symptoms for HPV. The virus can lay dormant in the body for 10 and even 20 years before signs and symptoms develop.
By then cancer cells may have already spread through the cervix putting a woman's life at risk. HPV is spreading through the American population at an alarming rate.
A woman in the audience shared that she was diagnosed with cervical cancer that was caused by HPV. She is now infertile.
Trisha is a cervical cancer survivor and said people need to be educated. There are stigmas and stereotypes that are keeping women misinformed leading to many going unchecked for possible risks of HPV.
Judy is also a cervical cancer survivor. She is a nurse and visited her OB/GYN annually. Judy did everything right, knew about it, and she still developed cervical cancer.
One of Sandy's sisters died from cervical cancer brought by HPV. Before her sister's diagnosis, Sandy was diagnosed with HPV at age 31. She contacted all four of her sisters and encouraged them to get checked by their doctor for HPV as well. One of her sisters didn't get checked. Seven years later she experienced pain and heavy menstrual bleeding then was rushed to the hospital for vaginal hemorrhaging. Three months later she was dead. If HPV and the cervical cancer was caught early it could have been prevented.
There is a common belief that HPV is a young woman's disease. HPV is typically associated with sexually transmitted diseases making many older women think they are not risks. Women need to know their body's so they can know when there is a change and have it checked by a doctor.
Dr. Oz: What is HPV?
Women can be at risk for HPV and cervical cancer and not even know the signs. HPV is a virus that lives on the 1/1000 of an inch of skin, explained Dr. Diane Harper, MD, MPH, HPV expert with the University of Missouri-Kansas School of Medicine. HPV can live anywhere in the body without any outward signs.
Dr. Oz said HPV is not just a sexually transmitted disease. Older women in a monogamous relationship for years are at risk for contracting HPV. HPV is communicated by skin to skin contact and can be dormant for several years, as many as 20, greatly widening the scope of at-risk populations.
Dr. Jennifer Ashton, MD, board certified OB/GYN and author of Your Body Beautiful, said men also need to be aware of the HPV virus. Men can contract HPV. Men also need to be aware that if their wife or girlfriend is diagnosed with HPV it does not mean that they have cheated. A woman may have been exposed years before the current relationship so women should not feel shamed or socially stigmatized to stay quiet about an HPV diagnosis.
Any type of sex or heavy petting can cause a transmission of the HPV virus. The HPV cells can then invade the cells of the cervix, grow out of control and can become cervical cancer.
Dr. Oz showed a photo of a cervix and asked the audience if they could tell if it was normal or if it was infected with the HPV virus? The audience didn't know and Dr. Oz explained that even doctors can't tell. Another picture of a cervix with and cancerous lesion was shown. Once cancer has taken over the organ, the damage is readily visible and it may be too late for the patient.
Getting a clear pap smear doesn't mean a person is in the clear. A clear pap smear is not provide conclusive evidence that a person if free of the HPV virus.
Dr. Oz: Oral Cancer and HPV
Cervical cancer is not the only type of cancer linked the the HPV virus. Oral cancer can develop through oral sex and the passing of the HPV virus. HPV is the leading cause of oral cancer which was once thought to be caused only by smoking and drinking.
Dr. Ashton explained that dentists and oral surgeons are increasingly finding suspicious lesions and went sent for biopsy come back as cancer caused by the HPV virus.
To prevent the spread of HPV during oral sex, Dr. Ashton said to use condoms and dental dams. However, she admitted that in12 years of practice as a gynecologist she never seen a woman use a dental dam. To make your own dental dam, explained Dr. Ashton, a woman can place a piece of plastic wrap over her vagina while oral sex is preformed on her.
If you've engaged in oral sex or engaged in other risky behaviors, Dr. Harper explained to have a conversation with your doctor and to be checked for both HPV as well as for oral health.
In addition to oral cancer, HPV has been linked to cervical cancer as mentioned above, vulvar cancer, penial cancer. Seven out of 10 cases of vagina cancers have been attributed to HPV and eight out of 10 anal cancers are attributed to HPV.
Dr. Ashton said that engaging in anal sex is not a criteria for contracting anal cancer. It's skin-to-skin contact that spreads HPV and sexual penetration is not required.
Dr. Oz How Do People Get HPV?
Women are asking their doctors, how did I get this? Many women who are diagnosed with HPV related cancers are wondering how they could have possibly contracted HPV when it's discussed as a sexually transmitted disease.
Dr. Ashoton explained that there is no way to know when someone came in contact with the virus and, as we learned earlier, the virus can be latent for years. While there are advances in knowledge of the HPV virus and connections to cancer, doctors still don't know the how and why of contracting the virus.
Dr. Harper said if someone gets a diagnosis of HPV don't panic. A diagnosis of being a carrier of the HPV virus may or may lead to a development of cancer. Ninety percent of HPV infections will go away without incidence and only 5% will develop into cancer. Staying in the medical system by getting regular pap smears and annual gynecology exams will allow doctors to monitor the virus and to catch a development of precancerous cells.
Dr. Ashton said with an HPV diagnosis it's important stay healthy as with all other immune issues. Smokers should stop now, she said. Quitting cigarettes is the simplest and most important thing to do to keep HPV from developing into a cancer.
Dr. Oz added that taking B Vitamins, in particular Niacin, and lycopene supplements to support the body in shedding the HPV virus.
A 54 year old woman in the audience shared that she is not married and wanted to know does using a condom provide enough protection from getting the HPV virus? Dr. Harper explained that a condom protects some areas of the body from skin-to-skin spread of HPV but she said to remember that the penis sits on the scrotum. If the scrotum then comes in contact with the woman's skin there are increased risks of spreading HPV.
That's a big reason why both men and women are developing anal and other cancers from HPV. During intimacy, skin-to-skin contact happens in more ways than most people are willing to believe or admit to and HPV can spread without sexual intercourse.
[And in really bad taste,] Dr. Oz said now that he knows the scrotum carries HPV explains how he gets it on his fingernails. [What? He did not just say that, did he? Yes, yes he did.]
For a person with genital warts caused by HPV will they develop cervical, or other, cancer(s)? Dr. Harper explained that there are many different forms of HPV. Your dog and your cat also carry the HPV virus but HPV is species specific and there are several types of HPV within each species. The dog form of HPV cannot be communicated to a cat or to a human, and visa-versa.
Dr. Ashton added that one type of HPV can cause external genital warts and that form poses a lower risk for developing into cancer. It's the other forms of the HPV virus that can develop into cancer.
Can men and boys be tested for HPV? Dr. Harper said there is no good method for testing men. HPV cannot be detect, as of yet, in men and therefore men can't be tested.
Dr. Oz Another Test For HPV
Routine pap smear tests may not be enough to detect HPV. Michelle, Dr. Oz fan, shared that she had years of normal pap smears. While preparing to start a family at age 33, her doctor ran a routine HPV test that can back positive. She had been married only one year and had to start questioning what will her future hold.
Why are women getting normal pap smears yet not finding HPV? Dr. Ashton explained that sometimes the pap instruments don't reach high enough into the cervix and sometimes the area swiped doesn't contain the virus cells and therefore it's possible that a pap smear can come back negative for HPV when they in fact were infected.
Dr. Ashton said a COBAS HPV test can check for a variety of different high risk HPV viruses with only one specimen ask. She encourages women to talk to their doctor to determine if this test is right.
Once an HPV diagnosis is given, it can take 3-5 years before cancer cells can develop, said Dr. Harper. Women don't need annual pap smear tests, that is over testing, they only need to be checked every three years. If patients get both a pap smear test and an HPV test then they can wait five years before testing again but they still need to go the gynecologist annual for a physical exam.
What's the difference between what a pap smear checks and what an HPV test checks? A pap smear takes a visual look at cells and a pathologist determines if the cells look normal or abnormal. An HPV test is a DNA that looks at the molecular structure of the cell and compare it to the structure of virus cells. Both tests look at the same cells, explained Dr. Harper, but they look the cells in a different way.
To summarize what Drs. Harper and Ashton are advising, Dr. Oz said it boils down to women over the age 30 until age 65 should ask their gynecologist about having the HPV test at same time as a pap smear. If both the pap and HPV tests are negative for HPV then delay the next pap smear for 5 years but continue to have an annual OB/GYN exam.
Dr. Oz HPV Vaccine Debate
Thousands of questions and comments were sent in to Dr. Oz regarding HPV and cervical cancer. The most common was questions about the HPV vaccine.
Kirk's daughter died of cervical cancer at age 23. From diagnosis to death was only one year. Kirk said parents and women should educate themselves about the HPV vaccine and seriously consider getting it saying you're playing Russian roulette if you don't.
Dr. Harper said that both HPV vaccines, Gardasil and Cevarix, can prevent the virus that leads to cervical cancer. Disclaimer: Dr. Oz stated that Dr. Harper has worked for and been paid by both companies that produce Gardasil and Cervarix.
Dr. Harper said that getting the HPV vaccine can give women a good pap test result. It is not know, however how long the HPV vaccine will last and it doesn't cover every type of HPV that can cause cervical cancer therefore getting the HPV vaccine doesn't not provide complete protection from the HPV virus.
At what age should women get the HPV vaccine? Some people talk about getting the vaccine as early as age nine, or age 11. Dr. Harper said age nine is too early. Research has not provided clear information for how long the vaccine will last.
Dr. Oz said getting HPV vaccine is a personal decision and depends on when a women becomes sexually active. Dr. Harper said age 15 is a good place to start and women can get the vaccine up to age 26. If it the vaccine covers for about 10 years then women will be covered from some forms of the HPV virus during peak sexual activity years.
Dr. Ashton said older women are getting the vaccine which constitutes off-label use. She explained that there is only limited data for use of the HPV vaccine in older women and some data says there can be some protection but it's still unknown how much protection and for how long.
Dr. Oz: Side-effects of HPV Vaccine
It's been reported that 75% of teens and women who have received the HPV vaccine experience pain, redness, and swelling on the injection site. Dr. Harper said people who are afraid of needles should sit down for 15 minutes after receiving an injection. There are other rare side-effects that have occurred less than 10,000 times. These rare side-effects were not discussed.
The FDA has approved the use of the HPV vaccine in men and in the future the FDA may recommend the vaccine to protect against oral cancer.
Dr. Harper shared that she has two sons. One of her sons is gay and he asked for the HPV vaccine because he understood that his sexual behavior puts him at greater risks for the HPV virus. She stated the HPV vaccine has only been tested in men for three years after injection and data shows that after two years the protective antibodies fall and may men may not longer be protected.
Dr. Oz: Reduce Risks of HPV
Dr. Oz recommended B Vitamins, especially folic acid, which could help the body sluff the virus off the skin. Quitting smoking is another way to reduce the risks associated with HPV.
Dr. Oz wants people to get the word out about HPV and to talk openly about the risks and to start a conversation to answer the questions women have about HPV and cancer risks.
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