Cancer Breakthrough - How does it work?

The creator of the cervical cancer vaccine speaks out about what it will mean for future generations.

Until recently, early detection by having a regular Pap smear has been the best protection against cervical cancer, the second most common female cancer worldwide.

However thanks to Professor Ian Frazer, 2006 Australian of the Year and inventor of the new vaccine Gardasil, future generations will be protected from the deadly disease. We spoke to Professor Frazer about the vaccine.

How does the new vaccine program work?

The new vaccine will help protect girls and young women against the potentially deadly cervical cancer.
'Almost all cervical cancer is caused by the sexually transmitted human papilloma virus (HPV). The vaccines help protect against HPV,' Professor Frazer says.

Will it make Pap smears extinct?

'No. Women who are already sexually active will still
need a two-yearly Pap smear because they may already have been exposed to HPV. Even women who are eligible for the vaccine will still need Pap smears.'
Two strains of HPV cause 70 per cent of all cervical cancer cases.
'While the vaccine protects against these, it's not a safeguard against the remaining 30 per cent of cancerous HPV strains,' the professor says.

Does it protect against genital warts too?

'Yes. While the most dangerous strains of HPV are generally symptomless, the vaccine also protects against the symptomatic strains of HPV that cause most genital warts,' Professor Frazer says.
When should the vaccine be given?
Schools are starting the vaccination process this month. The vaccine will be given as a series of three injections
over seven months for girls aged 12 to 13 years.
'It will be given automatically during the first year of school in all high schools,' Professor Frazer says. 'For girls who miss out on this, there'll be a school-based catch-up vaccination program for 13 to 18-year-olds continuing over the next few years.
'Women who have not had sexual contact who are aged 26 years and under can also ask their GP for the vaccine. While the vaccine is free up until this age, there may be a cost for the consultation. Parents will be given information and consent forms to sign in schools.'

What about males?
So far the vaccine is not free for males, however, they can buy it from their chemist with a prescription for about $460
for a series of three injections.
'The jabs may help prevent against genital warts and penile and anal cancers and are most effective if given before becoming sexually active,' Professor Frazer says.

Who shouldn't have it?
'Anyone who doesn't want it, people in the course of an acute illness such as a viral infection or women who are pregnant and people who have had a previous bad reaction to this particular vaccine,' he says.
Side effects tend to be minor and the same as most vaccines and can include a sore arm, fainting and mild fever. It's not recommended that Gardasil be given at the same time as other vaccines.

DIFFERENT TYPES OF CANCER

Cervical cancer is the most preventable and curable of all cancers, particularly when abnormalities are detected early. Other gynaecological cancers to watch for include:

Uterine cancer

Actress Fran Drescher was diagnosed with this common cancer of the female reproductive system. Risk factors are obesity, high blood pressure and diabetes. Fran's diagnosis was difficult because she didn't have these.
'For two years I tried to get a diagnosis. I had staining between periods and cramping after sex, which is actually pretty classic for uterine cancer. But every doctor thought I was peri-menopausal, because nothing showed up on my ultrasounds.'

Ovarian cancer

Sometimes called the silent killer because its symptoms are vague, this cancer claimed the life of actress Marcheline Bertrand, Angelina Jolie's mother.
If you notice the following and they're persistent, ask your doctor about ovarian cancer
- swollen abdomen, pain, pressure or discomfort in the abdomen, bloating, changes in bowel or urinary habits, unusual vaginal bleeding, weight gain or loss, nausea, indigestion, pain with intercourse and back pain.
Tests such as an ultrasound and a CA125 blood test can provide a better picture.

DID YOU KNOW?

Cervical cancer deaths have been cut by 60 per cent since 1985, thanks to the free Pap smear program. Most women who've had gynaecological cancer do not get a recurrence. 'Now more women survive gynaecological cancer than die from it', according to the respected The Gynaecological Cancer Guide: Sex, Sanity & Survival (Michelle Anderson Publishing, visit www.michelleanderson publishing.com, $24.95).

WHAT IS HPV?

The human papilloma virus (HPV) is similar to the virus that causes warts on other parts of the body, and is very common
- four out of five people have it at some stage of their lives.
There are more than 100 types of HPV, some that affect genitals, commonly resulting in genital warts. HPV infections generally clear up naturally within eight to 14 months.

It's considered rare if an infection doesn't clear, however if an infection stays in the cells of the cervix, this abnormality can progress to cancer.

Genital HPV is spread through genital skin contact. Condoms are a barrier, but are limited protection as they don't cover all genital skin. HPV is not spread in blood or other body fluids. For more information, visit www.health.gov.au or
www.cancerscreening.gov.au.

TESTING TIMES

A Pap smear is still an important way to combat cervical cancer. Here's how to make sure your test is as effective as possible:

* Don't have intercourse the night before the test.

* Delay the test until any infections have cleared.

* Don't have a test during your period - wait a day or two.

* If you want to be extra cautious, ask about a ThinPrep test. Some doctors say this creates a clearer result. You may have to pay a fee for this.

'The bottom line is just to have a Pap smear every two years,' Professor Frazer says. 'If every woman had one, it could prevent the most common form of cervical cancer in up to 90 per cent of cases.'

CLINICAL NOTES

In recent times, the terminology used on your Pap smear report has changed. Here's what the terms stand for:

On the report
LSIL, formerly CIN1
What it means Low-grade abnormality. ‘Acute papilloma infection, which goes away by itself in 98 per cent of people,' Professor Frazer says.
'Have an annual smear, and if it doesn't go away after two years, see a gynaecologist. Be careful, because you may be infectious to other people.'

On the report
HSIL, formerly CIN2 and CIN3
What it means High-grade abnormality. 'It's not cancer, but may progress to cancer if left untreated.'
This can be completely removed in 90 to 95 per cent of women with one treatment. This is not infectious, but it must be treated.

On the report
Cervical cancer
What it means There are two main types of cervical cancer, squamous cell carcinoma, the most common type, starts in the skin-like cells that cover the outer surface of the cervix, and adenocarcinoma, that starts in the glandular cells, in the cervical canal.
'Usually the treatment is 100 per cent effective
if picked up early,' Professor Frazer says.

By Jane Worthington

Back to New Idea