Monday, February 9, 2009

Alternatives to the Gardasil Vaccine—Look, No Side Effects

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No, I don’t have a snake oil cure for either HPV or cervical cancer.

But while I struggle with the decision about whether or not to vaccinate my daughters with Gardasil, I’m also trying to figure out an alternative strategy. After all, I don’t much like what I’m hearing about Gardasil, but I also have two people in my life who’ve fallen foul of HPV and have each endured two operations.

Gardasil, like it or loathe it, has focused our attention on the high incidence of HPV, and that’s not a bad thing. If you have some ideas about ways to decrease the risk of pre-cancerous or cancerous lesions forming, please chime in down in the comments section. All of us, not just young girls, need to be aware of ways to protect ourselves.

Just get the check-up, already.

Cervical cancer rates plummeted in the US after women began getting regular check-ups, including Pap smears.

The American Cancer Society currently recommends getting regular screenings by three years after becoming sexually active, or by the age of 21, whichever comes first. (Go to caonline.amcancersoc.org/cgi/content/full/52/6/342 for the full guidelines.) Young women should get smears every one to two years, depending on the test used; women over 30 may be able to switch to every three years.

But although it catches 70- 80 percent of lesions, the Pap smear isn’t infallible. Ask whether you should get an HPV test. And ask in particular about the HPV-DNA test. According to the Journal of the National Cancer Institute, doctors can find about 30 percent more cervical cancer cases when women get a HPV-DNA test before their annual Pap test and then, if they test positive, get another test a year later.

Bottom line: cervical cancer is almost always slow-growing. If you’re one of the unlucky ten percent whose HPV infection turns ugly, you have an extremely good chance of fixing it before cervical cancer develops—as long as you get regular screenings.

Focus on strengthening the host rather than killing the invader.

In other words, pay attention to your general health and immune system. At least 90 percent of all HPV infections clear up by themselves, so be one of the people that simply shrug off infection.

· Eat your carrots. Grandma was right, dammit; an apple (plus some leafy greens, citrus, grapes, tomatoes, broccoli, whatever adds up to 5-10 servings of fruit and veggies) every day really does keep the doctor away—not to mention HPV. A University of Arizona study reported in the journal Cancer Epidemiology, Biomarkers & Prevention found that women who ate a lot of veggies were more than 50 percent less likely to have persistent HPV infections. Fruits and juices appeared to be less protective than vegetables, but are obviously still valuable for good health. Mix it up.

· No smoking. If you smoke, stop it. At once. Smoking increases your risk of developing pre-cancerous lesions by up to a whopping 27 times—yes, times, not percent—perhaps because both smoking and HPV affect the molecules (called cytokines) that control tumor growth. Think I’m just nagging? Check out the study authored by Anthony Gunnell from the Karolinska Institutet in Stockholm, Sweden.

· Some supplements MAY help. Astragalus, particularly in the Chinese formula called Jade Screen, can help boost your immune system, as can the bioflavonoid quercetin. Lycopene may also help—the U of A study discovered that women whose blood showed the highest levels of cis-lycopene, found in tomatoes and tomato products, pink grapefruit and watermelon, saw the greatest decrease in risk. Turmeric is good for a lot of things and it’s a great reason to eat curry.

Don’t Sleep Around.

Stop squealing. I grew up in the 60s and 70s, for goodness sake; I’m no prude. But biology is inescapable—ask any of the many women who focused on their careers and put off childbearing until their late 30s and early 40s. Just as fertility really, truly does decline as you get older, so sleeping around really, truly does spread disease. As they say, you have ‘sex’ with every single person each of your partners ever slept with, and women who have sex with two or more partners, particularly at a young age when HPV infection incidence peaks, have a higher risk of developing cervical cancer. A condom helps but it’s very far from foolproof because the virus is spread by skin to skin contact, not, ahem, via bodily fluids. It’s also possible to contract HPV via oral sex. Sorry.

Snip, snip.

Uncircumcised males are more likely to carry HPV. A study published last year in The Journal of Infectious Diseases showed that uncircumcised men are about twice as likely to carry HPV infections, which upped the risk of cervical cancer slightly for their partners. Should you add a caution to your e-Harmony profile, or grill a prospective partner about his foreskin status? I dunno. I’m just telling you the facts.

See, I told you I didn’t have a snake oil cure to help you avoid Gardasil and all its potential side effects. I’ll even say that for some people, especially high-risk people, Gardasil may well be a good idea. This is just what I know so far and what I talk to my daughters about. I’ll update this post as information becomes available.

But talk to your doctor. In general, bloggers raise questions that you may want to get answered and are often the first to stick pins in sacred cows. Sometimes they’re responsible and smart and decent researchers, and sometimes they aren’t. But either way, they’re no substitute for expert advice and medical care. If you don’t trust your doctor, find one you DO trust. Research. Think. Question. But don’t just assume disease only happens to someone else.

So what’s YOUR strategy to avoid or shake off HPV?

4 comments:

tlc-tugger said...

How dare you imply that foreskin amputation has no side effects?

The foreskin includes over half a male's sensual pleasure-receptive nerve endings. In the adult it comprises about 15 square inches of exquisite sexual interface. It protects the glans from drying and abrasion and provides an awesome frictionless rolling/gliding mode of stimulation during manipulation or intercourse.

Do you know if wearing the skin rolled back off the glans (so the mucosa can dry and callous as with circumcision) provides the same supposed resistance to HPV? You don't? How dare you propose a disfigurement before you have found out.

A 2003 study hosted at the Israel Medical Association web site debunks the foreskin/HPV link anyway. And have you by chance heard of condoms? No, you'd rather mutilate a male's genitals than take a vaccine or even think.

Foreskin feels REALLY good. HIS body HIS decision.

Anonymous said...

Hey tlc-tugger. Is that your real name?

STDgirl said...

A friend on "HIVlover.com" said the number of this site increase about 2 time in 2008.

Kristin Johns said...

Dear tlc-tugger,

Goodness. 15 square inches? I'll have to take your word for it as I don't often take a graphing calculator to bed.

You're right, of course; and I've no doubt that anti-circumcision people could come up with many reasons why circumcision is not side-effect free. I'm sure that fainting mothers alone account for many injuries.

But if decrease in pleasure is the only side-effect of circumcision, then you must remember that men often complain that the alternative you propose, condoms, also decrease pleasure. And for the more easily bored among us, so does another precaution--not sleeping around.

I doubt that many lusty 16-year olds would be up for your proposal of, er, hanging it out to dry, but hey, if someone reading this wants to try it, go for it. Just try not to get arrested.

Oh, and there have been several studies since the Israeli study you mention--two in the issue I mentioned alone.