Monday, August 29, 2011

Is Cancer Contagious? The ACS Says No, but is This the Truth?

In an article by the American Cancer Society titled “Is Cancer Contagious”, the comment is emphatically made that it is not. It goes on to say,

“If cancer were contagious, we would have cancer epidemics just as we have flu epidemics -- cancer would spread like measles, polio, or the common cold. We would expect a high rate of cancer among the families and friends of cancer patients and among health professionals to reflect their exposure to the disease. This is not the case.”

In the case of the human papillomavirus I would have to disagree. HPV is known to cause numerous cancers including cervical, vaginal, vulvar, anal and oral, as well as penile. Its main method of transmission is through intimate skin-to-skin contact. It does not require intercourse however this only increased the chances of contracting the virus especially for women through small tears or abrasions in the vagina during intercourse.

Family members don’t have intimate relations with each other and they don’t typically have them with their friends either. And it’s obvious that they aren’t having intimate relations with their physicians. So the theory as related in this article borders on nothing but the absurd.

While HPV does not transmit cancer in the literal sense of the word, it does introduce the precursors known, under the right conditions, to cause cancer. We know that HPV is a sexually transmitted disease and can also be transmitted through oral sex and some have indicated that kissing is not beyond the realm of possibilities as well as through foamites (inanimate objects, fingers, sex toys etc).
The article goes on to state:

“There is no evidence that close contact or things like sex, kissing, touching …… can spread cancer from one person to another.” On the contrary, more and more research is confirming that transmission of HPV is far more complex and involves multiple modes of transmission and one is certainly more likely to develop one of these cancers if they have been exposed to HPV than not.

Today, 99.9% of cervical cancers are the result of HPV and over 90% of anal cancers. Oral cancers continue to rise, particularly in younger men, at a staggering rate which has already exceeded the number of cervical cancers on an annual basis.
As with other HPV related cancers, it is not a difficulty in diagnosing these cancers that are the problem, but a lack of education on the part of physicians and the lack of public awareness and early screening opportunities.

Cancer in the broader sense of the conversation, or shall I say the potential for cancer, has shown to be very much contagious as it relates to HPV. The Hepatitis viruses have long been known to result in liver and pancreatic cancers. Perhaps we may ultimately find that all cancers are the result of various viruses, but until then, perhaps the ACS should take a bit more pragmatic view on its current position.

" Is Cancer Contagious? ." American Cancer Society :: Information and Resources for Cancer: Breast, Colon, Prostate, Lung and Other Forms. N.p., n.d. Web. 28 Aug. 2011.

"Hepatitis B Foundation: Hepatitis B and Primary Liver Cancer." Hepatitis B Foundation. N.p., n.d. Web. 28 Aug. 2011.

The Oral Cancer Foundation. Web.28 Aug. 2011.

Sunday, August 21, 2011

International Conference Update

The schedule for this year's International Papillomavirus Conference in Berlin Germany has been finalized. My presentation, HPV - The Patient Experience is the first in the experience of the conference given by a patient and I commend the organizers of this conference in recognizing the need to include the voice of those most affected by HPV - the patients.

It is my hope that this will set a new standard by which future conferences will continue to include the voice of the patient. There is much that can be learned from the patient's input however for too long the medical community has not appreciated that they could learn anything useful from them aside from the results provided regarding physical research. But HPV is not solely a physical condition but a psychological one as well.

In finalizing my presentation I realize just how much of the psychological aspects of an HPV diagnosis is relevant to the development of guidelines currently only focused on scientific physical evidence. While this is certainly a significant factor, the psychological aspect simply cannot be ignored if the patient is going to be treated as a whole.

We are not just physical nor just psychological beings but a delicate combination of both. It is important for me to dispel the myth that providing the patient with information will only result in hysteria and upset. In my experience it is exactly the opposite. It is that lack of education of the patient which results in psychological distress. The feelings of not only the unknown but the loss of control over their bodies as well The loss of control is especially true in the case of persistent disease in which the patient cannot in many instances effectuate a change in the progression of precancerous lesions. Younger individuals, once feeling invincible with the world ahead of them are now fearful and concerned about the potential for loss of future fertility and possibly death - something which, because of their age they typically would never have had to face if not for HPV.

It is also important that women not continue to have to bear the burden of HPV diagnosis themselves and a test for men must be developed. In addition the development of a therapeutic vaccine for those already infected with the virus is paramount. The percentage of individuals who actually complete the three doses of the current vaccine in the US is only 30% and without a widespread public education campaign far more individuals will become infected than those protected.

This will certainly prove to be a precedent setting conference.

Thursday, August 4, 2011

Comparisons Between AIDS and HPV

Both HIV/AIDS and HPV are viruses. Just as with HPV (Human Papillomavirus) which has been in existence for centuries, HIV/AIDS (Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome) has also existed as an unidentified condition decades before it’s identity as a retrovirus was discovered in the early 1980s. This is the same time frame during which HPV was identified as being responsible for cervical cancer. Actually the retroviruses responsible for AIDS were discovered in the very same year, 1984, as was the connection between HPV and cervical cancer.

According to information from those who researched AIDS in the earliest years, the time of onset of symptoms could be ten years or more. Similarly, while the incubation period for HPV is usually three months, symptoms are usually absent and actual progression to an invasive cancer takes a similar amount of time, approximately ten years.

Dr. Robert Yarchoan of the National Institute of Health, made the following comment regarding the early days of AIDS diagnoses, “I remember doing a rough mental calculation of the number of gays in the country and the percentage who were likely to be HIV-infected, and estimating that there were half a million to a million people infected with this lethal virus who did not know it.” With HPV estimated to affect over twenty million Americans and more than six million more acquiring the virus each year, still few people are even aware of what HPV stands for.

By the mid-eighties however, far more extensive research was being conducted with respect to pharmaceuticals and vaccines and more so after the United States Congress allocated additional funding in 1986. Within ten years of the identification of the AIDS virus there existed medications which could control the disease, yet it took another two decades for the first vaccine to become available for HPV in 2006. Even this vaccine is limited and does not cover all cancer-causing strains of HPV.

While the Pap smear and subsequent HPV test has resulted in a dramatic reduction in the number of cervical cancers this is the result of early identification, the treatment for which is typically some form of invasive tissue removing procedure, but certainly not a medication which would be far less traumatic and result in fewer consequnces (physical and psychological) for women, including potential infertility.

So why is AIDS so familiar to the majority while HPV remains relatively unknown? It would appear that the governments direct involvement as well as its massive funding for AIDS research may be the answer. The media also played more of a role in educating the public than they do today with HPV. Yet, high risk HPV has now been identified as being necessary for the progression to a minimum of five different cancers; cervical, vaginal, vulvar, anal and oral, with other conditions resulting from low risk strains.

While HPV may not be fatal within a short period of time as AIDS was, it is ultimately still responsible for millions of deaths throughout the world each year. The question remains, just how many cancers will need to be attributed to HPV before the government decides to involve itself both in education and funding? Despite all the similarities, the difference in how each has played out since discovery appear quite disturbing.