The Elusive Human Papillomavirus

She Said

When I finally met my birth family for the first time in 1995, my grandmother said, almost in passing, "Make sure you keep up to date on your Pap tests your mother had cervical cancer." Reluctantly, I acquiesced to my first exam in over six years.

The test revealed a stage-3 cervical cancer that was subsequently treated with surgery. I often wonder what would have happened if I hadn't sought out my birth family, if my grandmother hadn't mentioned the test, if I hadn't listened.

He Said

According to Statistics Canada, cervical cancer is the 11th most common cancer diagnosis in Canadian women and the 13th most common cancer-related cause of death.

However, in developed countries, Pap tests have led to a 75-percent reduction in the disease. Cervical cancer almost always comes from a viral infection called human papillomavirus (HPV). While both men and women with HPV often exhibit no symptoms, some strains of the virus cause genital warts, which may appear as raised, flat, or cauliflower-shaped lesions. For the most part, the warts themselves are harmless.

See the chapter on "Sexual Health and Sexually Transmitted Infections" at the Public Health Agency of Canada's website phac-aspc.gc.ca/std-mts/index.html and the Canadian Cancer Agency's information on cervical cancer at cancer.ca/ccs/internet/standard/0,2939,3172_10175_275922_langId-en,00.html.

She Said

Dr. Dirk Van Niekerk is an investigator and instructor at UBC's Pathology and Laboratory Medicine Department. He studies HPV, focusing on virogenic cancers (those caused by a virus). Dr. Van Niekerk says, "There are over 100 types of HPV, 40 of which can infect the genital tract. Only about 15 of these types are able to cause cervical cancer; these are considered high risk. HPV infections are extremely common and in most cases go away on their own."

When I had my cancer, I'd been monogamous and married for years, and completely asymptomatic. Dr.Van Niekerk explains, "Most HPV infections are without any symptoms and with no effective therapy."

He Said

Pharmaceutical companies have developed vaccines against specific strains of HPV. Dr. Van Niekerk says, "We don't know how long vaccine protection would last, but studies indicate protection for at least four years." In July of 2006, Health Canada approved the use of Gardasil for females between nine and 26 years of age to immunize against HPV.

The Pap test is the main diagnostic tool; however, many clinicians feel that it makes sense to add a test for HPV infection to the Pap test as part of cervical cancer screening. Dr. Van Niekerk hopes to see clinical trials investigating HPV-specific testing as soon as 2007.

She Said

I wanted to know if there were natural treatments for HPV. I found almost no research on the efficacy of natural remedies on HPV. However, various essentials oils have been used to treat warts. Both thuja, sometimes called cedarleaf (Thuja occidentalis) and tea tree (Melaleuca alternifolia) essential oils, in conjunction with vitamin E oil, have been noted among traditional treatments.

As with all viruses, a healthy diet and the use of immunity-enhancing herbs, such as astragalus (Astragalus membranaceus) and echinacea (Echinacea spp.) should be considered. An international consortium of investigators conducted a study on HPV between 1993 and 1995 that included 1,392 women. This research indicated that diet is a major factor in persistence of the virus, noting that "the key fruit associated with decreased [HPV] infection was papaya." An article on this research, titled "Dietary Intake and Risk of Persistent Human Papillomavirus Infection," is accessible online at medscape.com/viewarticle/467360_3. (Registration is required, but access is free.)

He Said

Dr. Van Niekerk notes that the National Advisory Committee on Immunization (NACI) of Canada will meet soon to discuss their recommendations on HPV vaccinations. For more information, see sexualityandu.ca/hpvinfo/home.aspx. For print resources, two excellent books that include information on virogenic cancers are Curing Cancer: Solving One of the Greatest Mysteries of Our Time by Michael Waldholz (Simon & Schuster, 1997), and One Renegade Cell: How Cancer Begins by Robert A. Weinberg (Basic Books, 1998).

She Said

Last week my doctor's office called to inform me that I'm due for my yearly checkup. I'm wondering if it can wait until after Christmas. Probably not.

I picked up some papaya yesterday, and will make the appointment…this afternoon.