Arizona Advanced Medicine Clinic

Cervical Cancer

The incidence of cervical cancer in the United States has dropped by over 70% since we began screening women of child-bearing age by means of the Pap smear. This is one preventive program (or at least an early diagnosis program) which actually works to decrease the incidence of a particularly nasty form of cancer in women - that of the entrance to the womb, the breeding ground for our future generations.

It turns out that there is actually a pretty well defined cause of cervical cancer - over 90% of them are related to infection by a sexually transmitted virus, the Human Papilloma Virus, otherwise known as HPV. This particular virus is also associated with vaginal, anal and oral cancers.

There are over 150 members of the HPV family[i]- called serotypes - which can be distinguished one from another by the specific proteins in their coat, and by the effect that they have on the human body.[ii]

Two types are associated with cervical cancer primarily - types 16 and 18, responsible for 70% of cancers.

Two other types are associated primarily with genital warts - types 6 and 11.

Concurrent infection with Chlamydia trachomatis, another sexually transmitted organism, apparently predisposes to persistent infection with HPV and subsequent development (in a low percentage) of cervical cancer.[iii]

HPV infection is also associated with the development of anal cancer in women - mostly in those who have had anal intercourse.

The natural history of HPV infection is that about 80% of infections clear spontaneously within 3 years.[iv]HPV type 16 cleared more slowly than other serotypes. Persistent cervical infection was also associated with persistent anal infection.

Cervical cancer screening has specific clinical guidelines: All the evidence and guidelines agree that HPV testing has no role in adolescents and should be performed in women 21 to 30 years of age only if a Pap test reveals atypical squamous cells of undetermined significance, an approach referred to as reflex testing."[v]In patients who have been treated for a very abnormal but not cancerous Pap smear (called high grade dysplasia), the risk of cervical cancer is increased for at least 20 years, but the risk of dying from cervical cancer is low, since most of them are diagnosed at an early stage, because of the screening program.

Given that the mortality is so low, and the results of treatment of the cancer are so good, what's all the fuss about the HPV vaccine? Why vaccinate against something which has a very low mortality rate? This issue is very well discussed in a 2011 article in the Annals of Medicine.[vi]

The list of serious adverse effects to the HPV vaccine, reported from around the world, includes the following: deaths, convulsions, paraesthesia, paralysis, Guillain-Barré syndrome (GBS), transverse myelitis, facial palsy, chronic fatigue syndrome, anaphylaxis, autoimmune disorders, deep vein thrombosis, pulmonary embolisms, and cervical cancers - the very disease which the vaccine is supposed to protect against.

The supposed benefits conferred have never been demonstrated. It takes about 20 years for persistent HPV infection to cause cancer. To date, the longest study has run for 8 years - less than half as long as it would need to run to even begin to demonstrate effectiveness.

Neither vaccine can actually clear HPV infection if it is already established.

The current age-standardized death rate from cervical cancer is two and a half times lower than the current incidence of adverse reactions to the vaccine. In the United Kingdom, the rate of adverse drug reactions to the Gardasil® vaccine is at least 24 times higher than the rate of adverse drug reactions to any other vaccine on the market.

The current HPV screening tests only screen for two out of 15 potentially oncogenic (tumor-causing) viruses. When women stopped having regular Pap smears in Finland, the incidence of cervical cancer increased 4-fold.

And yet, the US Government and the manufacturers of the most popular of the two vaccines, Gardsil® (Merck, Sharpe & Dome, Inc) and Cervarix® (Glaxo) have been clamoring to make the vaccine mandatory for girls as young as 9 years of age.

Given the risk of significant neurologic adverse reactions to a vaccine designed to prevent infection with a virus that affect the cervix of the uterus, not the nervous system, one begins to wonder whether promotion of the vaccine has more to do with financial impact on the manufacturer than on health impact on the vaccine recipients.

I already have cervical cancer, what do I do now?

It's too late for the vaccine - even if it had been proven to be effective, which it has not.

You have already had a cone biopsy, or hysterectomy, and there is no sign of metastatic disease.

OR you had your surgical procedures, and the disease has already metastasized - spread to distant areas.

Now what?

Cervical cancer may spread to the lungs, the liver, the bladder, the vagina or the rectum. In this case, both chemotherapy and radiation are used as standard treatments.

What about nutritional therapy? Conventional wisdom simply recommends eating enough to keep your weight up, and says nothing about the influence of diet on the "milieu" or tissue environment in which the cancer grew.

At the Arizona Center for Advanced Medicine we use multiple modalities of treatment for cancer:

There are many choices in addition to the standard surgery, radiation and chemotherapy. They are well worth exploring.

Call us at 480-240-2600 and we will be happy to explore your options with you.

[i]Downloaded from http://www.cancer.gov/cancertopics/factsheet/Risk/HPV 12/31/201312/31/2013.

[ii]Downloaded from http://www.cancer.gov/cancertopics/factsheet/Prevention/HPV-vaccine12/31/2013.

[iii]Silva J, Cerqueira F, Medeiros R. Chlamydia trachomatis infection: implications for HPV status and cervical cancer.Arch Gynecol Obstet. 2013 Dec 18.

[iv]Moscicki AB, Ma Y, Farhat S, Jay J, Hanson E, Benningfield S, Jonte J, Godwin-Medina C, Wilson R, Shiboski S. Natural history of anal human papillomavirus infection in heterosexual women and risks associated with persistence.Clin Infect Dis. 2013 Dec 23.

[v]Sarah Feldman, M.D., M.P.H. Making Sense of the New Cervical-Cancer Screening Guidelines. N Engl J Med. 2011 Dec 8;365(23):2145-7. doi: 10.1056/NEJMp1112532.

[vi]Tomljenovic L, Shaw CA. Human papillomavirus (HPV) vaccine policy and evidence-based medicine: are they at odds?Ann Med. 2013 Mar;45(2):182-93. doi: 10.3109/07853890.2011.645353

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