TRUDY*, age 36, had been having frequent vaginal discharges. Despite numerous visits to her family doctor, they kept coming back. So she decides to see a gynaecologist that her friend recommended. After her visit, she goes home and cries; cervical cancer was her diagnosis. But how? She's only had two sexual partners, she's in a committed relationship and uses a condom most times. Sadly, none of those things matter, and the only Pap smear she's done was when she was 21. Trudy has no kids.
We often forget that cervical cancer is caused by a sexually transmitted virus, HPV. As with any STD, there are often NO SIGNS, and you only need to have unprotected sex ONCE to get it. The majority of cancers today are hard to detect in the early stages when cure is more likely. Cervical cancer is different — not only can we detect it before it becomes cancerous with Pap smears, but we can also potentially prevent it by immunising against the very virus that causes the cancer in the first place! Amazing, right?
Yet still it's still the second most common cancer affecting women in Jamaica. Women like Trudy are not uncommon in our government clinics. The programmes implemented by our government for cervical cancer screening, while useful, still have many drawbacks. Many women are like Trudy and don't get regular Pap smears. We have what we call “opportunistic screening”, which essentially means most Pap smears are done when women come in because they are having a problem like discharges or bleeding. So how do we combat this? Despite education programmes, many women don't voluntarily get them done.
That's where vaccines come in. Administer the vaccine to all girls at risk, and voila, reduction in cancer rates, right? It's not all a bed of roses, though. Firstly, the vaccine officially covers just two of the 14 strains of cervical cancer-causing HPV. These are the most common strains, however, and there is evidence that the vaccine does cover other strains as a “side benefit”.
Secondly, there are real side effects. But then, that's the situation with every vaccine. Measles, the flu, hepatitis, chicken pox — all of them have side effects. Common reactions include rash, pain and swelling at the injection site, nausea, vomiting, and fainting in young girls. Serious side effects were rare and no more likely than vaccines against hepatitis.
What of those claims about the vaccine being developed to cause infertility in poor, minority women? Well, these claims haven't been supported by science. In fact, during the testing of the vaccine, more than half of the test subjects were white. So if they were really trying to target minority women, why were they testing it out on mainly white women? What's even worse, the people making the claims are the same ones who claim that cervical cancer can be cured with a vinegar douche, so their credibility is questionable.
So are there bad things that can happen with the vaccine? Yes, there are. No vaccine or drug is perfect. Serious complications have been reported, but they are RARE and no more common than with any other vaccine. So if you're OK with getting your flu shot, measles shot or the hepatitis shot, then you shouldn't have an issue with the HPV vaccine.
It can't be used alone in the fight against cervical cancer; you still need to get regular Pap smears done. However, you will reduce your risk of getting the precancerous disease (which is what leads to cancer).
Don't be like Trudy. Get your regular Pap smears done (at least every three years), and if you're OK with vaccines, the HPV vaccine is as safe as the rest of them.
Dr Ryan Halsall is a gynaecologist at Island Laparoscopy. To schedule a consultation send e-mails to firstname.lastname@example.org or call 876-455-4527. Facebook page is http://www.Facebook.com/ilapjamaica .