Protect Yourself Against Cervical Cancer

"Dear KnowYourV, how can I protect myself and reduce my chances of getting cervical cancer?"

With the rise of HPV infections & lesions showing up in places like the tongue, throat and anal and labial areas, everyone is becoming concerned. HPV (Human Papilloma Virus), is in the condyloma (genital wart) family. But unlike other genital warts, HPV warts are flat and cannot be detected without placing a special solution on the area. The solution reacts in such a way that the HPV lesions turn a whitish color, and this helps in diagnosis and treatment.

Since HPV is transmitted sexually, the best way to protect yourself from infection is to ensure safe sexual practices. Condoms are the best way to prevent most STD's, but it is thought that the HPV virus is so small that it can escape through a condom’s tiny pores. The addition of spermicidal foams and jellies can help.

The biggest breakthrough in the past few years has been the introduction of a vaccine initially approved for females age 8 to 27. Now the vaccines approval has been extended to males of the same age. This will hopefully be the #1 way to prevent transmission.

Women are typically at higher risk for acquiring these types of STDs as we are the semen recepors. Men, on the other hand, are depositors. Because we are the receptors of the semen, if the semen is infected, we serve as little incubators.

That is why it is so nice to use the WaterWorks cleansing system. WaterWorks can be used immediately after sex to rinse out semen quicklyreducing the time HPV can sit in vagina. Not only does WaterWorks function to reduce vaginal odors, it can also be used for daily feminine cleansing.

If you have not spoken to your healthcare provider about getting the HPV vaccine, it is a good idea to at least get information to read about it.

Read more...

Answers to Your HPV Questions

How many of you have gone to your ObGyn for your annual exam feeling good that you did the right thing, by being responsible and getting your annual checkup and Pap smear? Then, you find out that your pap came back positive for HPV?

Now you may start searching the Internet for all available information on HPV and what it means. Since its a sexually transmitted virus, and my last pap was negative, does this mean my partner cheated on me? Does it mean I'm going to get cervical cancer? There different types, so does it matter which kind I have? I've never had warts - does this mean I'm going to get warts since its a warty virus? Will it affect my chance to get pregnant? Can I give it to my baby during birth? If my partner has it and I get treated can he give it back to me? Can men be treated too so I don't have to worry about him giving it back to me? Could I have had this and given it to my partner? Do we need to use condoms so we don't pass it back and forth? Is it living in my blood stream and infecting my whole body? I read that it can cause oral and throat cancers from oral sex and anal cancer from anal sex or just the semen or penis touching the anal area - is this true?

I know there are so many questions. I get it, it is confusing and so is the information out there.

First, the reason women are urged to get Pap smears every year is to screen for cervical cancer. Almost all cervical cancers are caused by human papilloma virus (HPV). HPV is a common virus that can be passed from one person to another during sex. This means that you can become infected with it the very first time you have sex if your partner has had sex with someone before you. Likewise, if your current partner was a virgin when you met and you were not, you can pass it to him. That's why we say, "When we have sex with someone, it's like we are having sex with everyone they have had sex with." We are exposed to any and all viruses and STDs that they have been exposed to. Not a happy thought.

This can be distressing to women because, today, there is no way to treat men or even screen them like we do with Paps for women. And, if you are married and trying to get pregnant, condoms are not an option.

The good thing is, if you are good about getting your pap exams and following up if you get HPV or an abnormal result, then you can be treated. So, this can ease your worry about getting cancer.

HPV and the treatment will not interfere with your ability to get pregnant, but active, untreated forms can be transferred to your baby at birth.
Just remember, sex is sex. So, you can get HPV or any other type of STD with anal sex (anal cancer, anal warts, herpes, gonorrhea, chlamydia, etc.), oral sex (oral HPV, warts on your vocal chords or gums and tongue) and even by rubbing genitals together without penetration.

HPV is the most common sexually transmitted infection in the United States. There are over 100 types of HPV and they all belong to the condyloma or wart family. Many of them can cause genital warts. There are the 40 types can cause cervical or other genital cancers. The other 60 or so HPV types can cause infections and warts elsewhere on the body, even on the hands and face. They can infect the genital areas like the vulva (area outside the vagina), labia, and anus, and the linings of the vagina, cervix, and rectum. These types can also infect the lining of the mouth and throat. Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer. They are invisible unless the cervix is washed by a strong vinegar solution called acetic acid while other types can cause visible warts on the labia, anus, throat, vocal chords or skin.

HPV is so common that most people get it at some time in their lives. HPV usually causes no symptoms so you can't tell that you have it. For most women, HPV will go away on its own because our immune system can eventually kick it, especially in monogamous relationships. High risk behavior, such as having sex with many different partners on a regular basis, smoking, or having HIV or AIDS, or any disease like diabetes or autoimmune syndromes can also increase your chances of HPV because they weaken the immune system.

HPV types are often referred to as "low-risk" (wart-causing) or "high-risk" (cancer-causing), based on whether they put a person at risk for cancer. The International Agency for Research on Cancer found that 13 HPV types can cause cancer of the cervix; one of these types can cause cancers of the vulva, vagina, penis, anus, and certain head and neck cancers (specifically, the oropharynx, which includes the back of the throat, base of the tongue and tonsils). The types of HPV that can cause genital warts are not the same as the types that can cause cancer.

When the body's immune system can't get rid of a high-risk HPV infection, it can linger over time and turn normal cells into abnormal cells and then cancer. About 10% of women with high-risk HPV on their cervix will develop long-lasting HPV infections that put them at risk for cervical cancer.

When high-risk HPV lingers and infects the cells of the cervix, vulva, vagina, penis anus, or the oropharynx, it can cause cell changes called dysplasia, which is not a precancerous change. If ignored and untreated, they may eventually develop into cancer.

Using condoms can help prevent getting it. Using WaterWorks for famine hygiene immediately after sex can help clear the vagina of semen that could be infected with it. It is always easier to get any STD when having sex during our period so this is an especially important time to use WaterWorks. WaterWorks is not the same as douching because it uses only plain water with no chemicals and can be used every day if you want. It is FDA cleared for clearing vaginal odors and feminine hygiene.

Read more...

HPV - Human Papillomavirus: What You Need to Know

I know many of you are worried when you are sent to me from your primary care doctor (or return after a pap I have done showing abnormal results) with dysplasia or Human papillomavirus - HPV. HPV is the name for a group of more than 100 types of viruses; more than 40 types of HPV can be passed through sexual contact.

We may feel like we are the only ones who have such a thing when we get it, but HPV is so easy to get and so common that over 70% of sexually active people will have HPV at some point in their lives. In fact, HPV is the most common STD in America, with well over 25 million cases and rising. Some people will never know they even have it because they never break out with warts or never have an abnormal pap test. HPV usually has no symptoms, but can have periods of flaring up and then hibernating. Most of the time there are no signs of infection or "flare ups" (such as abnormal discharge or itching) to alert us of a problem.

The pap test is designed to detect abnormalities of cervical cells and also HPV infections. The pap test will focus on High Risk abnormalities, as these types are known to cause cervical cancer. Low Risk types can cause genital warts - which are obvious when they are present and which can be removed. The HPV that causes cancer cannot be seen visibly when your doctor looks at your cervix or anal area. HPV is a flat warty virus that is invisible to the naked eye. The vaccine focuses on preventing only the top High Risk types of HPV.

If you have an abnormal pap test it is important to follow-up for further testing by your doctor to determine the reason for it. Sometimes yeast or bacterial infections, cervical irritation or hormone changes can be the cause. An abnormal pap does not always mean HPV infection or cervical cancer. A colposcopy is often done to help your doctor see the abnormal tissue on the cervix. It is a lot like getting a pap smear except a special magnifying scope can be used with a strong iodine solution or acetic acid solution that causes the HPV to show up white. This helps your doctor know where to do a biopsy to send a sample to pathology for further evaluation. Some colposcopies are being done with colpo biopsy brushes which are much faster and less painful.

If you do have HPV, there are different ways it can be treated right in your doctor's office. Using Cryosurgery, abnormal tissue is frozen off. The Loop Electrosurgical Excision procedure (LEEP) uses a hot wire loop to remove tissue. Laser treatment uses a beam of light to destroy abnormal tissue.

Cone biopsy, where a cone-shaped sample of abnormal tissue is removed from the cervix and looked at under the microscope, is done in the operating room and reserved for instances when biopsies show early signs of cancer. This biopsy also can serve as a treatment if all the abnormal tissue is removed.

If you have had the HPV vaccine, it does not mean you do not need to worry about HPV or about getting a pap test. HPV can lay dormant for years, and even undetected HPV can show up after the vaccine because the vaccine does not cure HPV. It simply prevents us from getting infected or reinfected.

Being in an exclusive relationship is the best way to prevent HPV infection or reinfection. Note, condoms don’t always protect you from HPV. But, they may reduce your risk of getting genital warts and other STDs.

Just remember, the best thing is to follow up with your doctor and get your annual pap smears, so you know you are healthy. Encourage your partner to visit the doctor as well.

Read more...

What You Need to Know About Human Papillomavirus (HPV)

Human papillomavirus (HPV) seems to be one of those infections women get that has a lot of rumors and misinformation associated with it. Some patients come in saying, "I have HPV and my doctor told me I have pre-cancer." Others come in worried because you have an abnormal pap smear and HPV infection and have been told that you have cervical cancer. HPV can, indeed, cause cervical, anal and oral cancer. It is also the cause of genital warts, but just having an abnormal pap smear and an HPV infection does not mean you have cancer or that you will ever get cancer.

HPV is the most common sexually transmitted infection in the United States. An estimated 20 million people are currently infected, and an estimated 6.2 million new HPV infections occur annually. HPV infection is common among adolescents and young adults. Prevalence among adolescent girls is as high as 64%. Up to 75% of new infections occur among persons 15–24 years of age. It is estimated that more than 80% of sexually active women will have been infected by age 50.

About 11,070 new cases of cervical cancer will be diagnosed in the United States a year, and, of those, approximately 3,870 women will die as a result of cervical cancer. HPV is believed to be responsible for nearly all of these cases of cervical cancer. HPV types 16 and 18 are associated with 70% of these cancers.

HPV is classified as either high- or low-risk types. The low-risk types do not carry a risk of cancer, but can cause genital warts, and, for some women, an increase in discharge, negative culture results and no treatment. Low- and high-risk HPV infections can just come and go, and even spontaneously resolve. High-risk types, if persistent, are the ones tested for on pap smears and will cause cancer if they do not resolve. The high risk types are: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 69, 73 and 82.

In addition to cervical cancer, HPV is believed to be responsible for 90% of anal cancers, 40% of vulvar, vaginal, or penile cancers, and 12% of oral and pharyngeal cancers. Population-based estimates, primarily from clinics treating persons with sexually transmitted infections, indicate that about 1% of the sexually active adolescent and adult population in the United States have clinically apparent genital warts. More than 90% of cases of anogenital warts are associated with the low-risk HPV types 6 and 11.

HPV is transmitted by direct contact, usually sexual, with an infected person. Transmission occurs most frequently with sexual intercourse but can occur following nonpenetrative sexual activity. Studies of newly acquired HPV infection demonstrate that infection occurs soon after onset of sexual activity. HPV transmission can be reduced, but not eliminated, through the use of condoms and recent studies demonstrated a significant reduction in HPV infection among young women after initiation of sexual activity when their partners used condoms consistently and correctly. Abstaining from sexual activity is the surest way to prevent genital HPV infection. For those who choose to be sexually active, a monogamous relationship with an uninfected partner is the only sure way to ever prevent HPV infection.

The reason I bring this up is because there is so much conversation that HPV is only caused by risky behavior, when the truth is, if you are virgin and marry or have your first sexual experience with someone who has HPV you can get it that fast just like getting any other sexually transmitted disease.

We've heard it said that Risk factors for HPV infection are related to sexual behavior, including the number of sex partners, lifetime history of sex partners, and the partners’ sexual history. Most studies
suggest that young age (less than 25 years) is a risk factor for infection.
Most cases and deaths from cervical cancer can be prevented through regular Pap tests at your gynecologist.

Read more...

Is Cervical Cancer Preventable?

Cervical cancer can be preventable with regular Pap tests and pelvic exams. Unlike many cancers, cervical cancer can be detected very early, and Pap tests can detect if you are at risk for getting cervical cancer way before it is there.

The reason I'm bringing this up is because I was recently in surgery with my favorite Gynecological Oncologist (a cancer specialist for women) and we were very busy removing tumors from one patient after another - large tumors in the pelvis from the ovaries and the uterus. We were at the end of our day with one patient left who had been diagnosed with cervical cancer by a recent Pap test in her doctor’s office.

Cervical cancer is the type of cancer that grows from the origin of the cancer out until it invades the vagina, bladder, colon and moves up into the uterus. It can invade blood vessels and lymph nodes along the way, and that can help it to travel to other parts of the body.

It is important that we physically examine every patient prior to starting surgery and make sure all their vital signs are normal, like blood pressure, heart rate, and temperature. We do physical exams after someone is asleep (Exam Under Anesthesia - EUA) to determine if someone is a candidate for surgery or if they need to go directly for chemotherapy and radiation instead. Unfortunately, when we examined her, the cervical cancer had grown into her vagina and had become very large. We had to make the decision at that point to wake her up and recommend chemo and radiation as that would give her the best possible chance for a cure. Seems strange, but true.

I know we all like the idea of "getting the cancer out" and then chemo and radiation if necessary, right? I know the nurses in the room were really shook-up about this: “Wow, Dr. Boyd is it because she didn't get her paps every year? How fast did it get to this stage?” I know it is shocking and something we all worry about.

So could you have cervical cancer and not even know it? The truth is, yes, because it causes no pain or symptoms and is caused by the HPV virus that needs to be detected when you go in for your yearly exams and Pap tests. It cannot be detected on a blood test.

A Pap test can save your life. It can find the earliest signs of cervical cancer. If caught early, the chance of curing cervical cancer is very high. Pap tests also can find infections and abnormal cervical cells that can turn into cancer later on. Getting regular Pap tests is the best thing you can do to prevent cervical cancer. In fact, regular Pap tests have led to a major decline in the number of cervical cancer cases and deaths.

It is important for all women to have Pap tests, along with pelvic exam as part of their routine health care. If you are 21 years or older and have been sexually active, then you need a Pap test. Even women who have gone through menopause still need regular Pap tests. Even after a hysterectomy, paps and pelvic exams are very important as Vulvar, vaginal and anal cancer are caused by HPV, and with oral sex many women are getting oral and throat cancer from the virus.

Bottom line, put your health first. Find a doctor you trust and can talk to. You are worth it.

Read more...

Is There Treatment For HPV?

 " I've been told I have HPV and I wanted to know if there is any treatment for it?"

HPV is a virus that is acquired through sexual contact. There are over a hundred types of HPV. Some can cause visible condyloma (a growth resembling a wart) and other types infect cells internally. When the cells are infected internally, the virus can take over the cell & start causing tissue changes consistent with early signs of cancer. These early changes are called dysplasia, and are not cancer, but if left untreated can eventually become cancer.

Condyloma are seen on the labia majora and labia minora, mons pubis, vaginal opening and around the anus.  These can be treated with prescription solutions that can be applied at home. Many women choose to have them removed surgically using a CO2 laser. This is much quicker, less painful and works better when there are multiple condyloma in different areas.

When the HPV infection shows up on your pap smear, the virus cannot be seen as a visible lesion or a wart.  In this case, it has infected the cervical cells internally. When this happens, your OB/Gyn will call you to notify you of the abnormal pap test and the high risk HPV status.

At this point, further testing will be ordered. If your pap test is otherwise normal, but is positive for high risk HPV, it is ok to return to your doctor for paps every six months. If your pap test is positive for dysplasia (mild, moderate, or severe) then it is usually best to have a colposcopy done with a biopsy.

If this test returns from the pathologist showing no underlying cancer cells, then the next step would be to remove the infected tissue. This can be done in two ways: 1) If the biopsy and pap show only mild dysplasia, the tissue can be frozen off (cryotherapy), and a follow up pap done is in three months to make sure it has cleared and healed; 2) The other option is to perform a LEEP procedure, which is done by numbing the cervix with lidocaine and shaving off the abnormal tissue with small instruments that have wire loops on the ends . The tissue can then be sent to pathology for evaluation. If no cancer is seen, the patient can return in 3 months for a repeat pap and continued close survellence.

When these procedures are done, HPV can be completely removed, however there is always a chance of reinfection from the male partner. Many women worry because they have a misconception that HPV is in the blood and can circulate throughout their bodies, but in reality HPV can only infect the areas it comes in contact with.

Read more...

What does HPV and Dysplasia mean, for me?

Dear KnowYourV,
I just got the results of my pap smear back and it showed 'high risk HPV with mild to moderate dysplasia'. I'm worried because someone told me HPV is an STD and that dysplasia is pre-cancerous."

Well, Vanessa let's back up a little bit. First of all, the reason you come in once a year for your pap is to screen for cervical cancer. And since so many more women do get tested yearly now, we rarely see advanced cases of cervical cancer like they saw years ago.

These days, if a woman has an abnormal pap, we do repeat paps or biopsies immediately to evaluate the cervical tissue. If necessary, any abnormal tissue with HPV can be removed so healthy tissue can grow in its place. This way, dysplasia or high risk HPV never have a chance to progress to a cancerous condition.

HPV (Human Papilloma Virus) is transferred through sexual contact and belongs to the wart family. It can show up as visible genital warts or flat 'invisible' kind that can cause cervical cancer. Men harbor it in their semen and women carry it in their cervical tissue and cervical/vaginal fluids.

There are two types of HPV: 'low risk’ and ‘high risk'. High risk is the one reported on pap smears and is responsible for cervical Cancer. It can also cause penile cancer, anal cancer, vulvar cancer and oral cancer. Therefore, it can be transferred though anal sex and oral sex as well.

It's possible to get HPV from your first sexual partner and not know you have it. There are no symptoms and it can lay dormant for years. Just like the herpes virus, it may erupt during times of stress or during pregnancy. When HPV begins to flare up, it causes cellular changes in the tissues. When your pap specimen is taken, the cells are looked at under a microscope and the clinician can see the HPV infection and any affects it is having upon your cervix.

Dysplasia is not cancer; it is not even pre-cancer. It is only a descriptive name given to tissue at a certain point in time so that it can be compared with another point in time to note changes. With dysplasia, the terms ‘mild’, ‘moderate’ and ‘severe’ are used, and then it may go to cancer. Most of these changes take several years to happen, and most women choose some form of treatment long before cancer would become an issue.

What about the men? That's what women worry about when they find out they have HPV - shouldn't the men be tested too? Unfortunately, it doesn't do much good, because HPV is in their semen, and there is no way to treat them. They are not at risk for cancer the same as we are.

Fortunately, the new HPV vaccine, which can be given starting at age 8 to boys and girls, should start making a huge impact in the future.

The most important thing is keep getting your pap smears on a regular basis. Over 75% of the U.S. population has HPV, and it is as high as 85% worldwide. So, you are definitely not alone in this. It is a battle we've been working hard to win, and the vaccine is one step along with regular pap tests.

As I've told you, one of the best things you can do daily to help yourself feel fresh and clean is use the new WaterWorks feminine cleansing system. This is so wonderful because it can be used when you shower, and does not require special formulas or chemicals - just plain tap water. And, it can be used more than once a day. Most women will use it right after sex to rinse out semen, which helps them feel clean and fresh right away. Plus this can also immediately rinse away any semen infected with HPV or other STDs. This is important, since a woman's body acts like a little incubator for bacteria or viruses. That is why so many women love using their WaterWorks - it gives them confidence and they feel they are working towards better health with better hygiene. Plus WaterWorks is FDA cleared for vaginal cleansing to remove unwanted odor with or without discharge.

Read more...

What should I know about HPV, human papilloma virus, and what are its signs and symptoms?

Dear KnowYourV,  

What should I know about HPV, human papilloma virus, and what are its signs and symptoms?" 

This has become one of the most commonly asked questions recently, since HPV is a sexually transmitted virus and the #1 cause of cervical cancer worldwide.

As women come in for their annual exams and pap smears, questions arise about HPV testing and detection. Infections by genital HPV are very common. In fact, over 70% of people who are sexually active will contract the virus at some point in their lives. Yet many will not know it because they will not have any symptoms.

Whether or not symptoms occur has to do with the type of HPV, and there are more than 100 types of this virus. Some types of HPV are associated with genital warts, either visible or flat and not visible. Other types of HPV are associated with cervical and other cancers, with no warts nor other noticeable symptoms. Still more common forms of HPV produce warts on other parts of your body like your hands and feet. Many people who get genital HPV will clear it spontaneously over time, however, the longer it stays in your body (and depending on which type of HPV you have), the higher the risk for cervical, anal or oral cancer.

Since HPV infections are contracted through sexual contact, many women have concerns about their current partner and how to find out when they contracted the virus. Women in monogamous relationships who have tested positive for HPV worry about re-infection from their partner, if their partner is positive, or protecting a negative partner.

For most women, it is an abnormal pap smear that first alerts them to a positive HPV test. Like most viruses, HPV has an incubation period, and it is possible to be infected with the virus even years earlier, only to have it lay dormant. During times of stress to the body, either emotional or physical, the HPV can re activate, just like we experience with cold sores or acne outbreaks.

As I've explained previously, the prevalence of HPV and its dormant period can make it impossible to know who the infection originated from – a current partner or a previous one. We can contract it during our first sexual experience and it may not be detected until years later on a pap smear.

Concerns about HPV are increasing, as they are now finding oral and throat cancer on the rise due to viral infections from oral sex . There has also been recent publicity about celebrities that have battled throat and anal cancer.

HPV has become the most important reason for women to come in for their annual exams and pap smears. Also, good dentists will screen for any suspicious or HPV-type oral lesions during your routine exams. Thankfully, most gynecologists now report that cervical cancer has been on the decline in America due to early detection of High Risk HPV.

Women tend to be at an increased risk as their bodies tend to function as incubators for such viruses when semen is deposited. So, it is best to get up after sex and rinse out that semen with the amazing WaterWorks System. It may look and act like a douche but works nothing like it. It is completely reuseable, and uses only natural tap water, no chemicals. The stainless steel nozzle coupled with the downward gentle sprinkling action of the water makes it unique. The stainless steel reacts with the water and vaginal wall to remove unwanted odor, and the gentle sprinkling action of the water cleans and rinses out any remaining semen. This has helped so many women feel cleaner, fresher and odor-free without the use of medication or douching, which can be harmful to the natural environment of the vagina.

So keep up the good work, stay healthy, eat right and get out there and move your muscles around. You will start to feel much better.

Read more...