Many years ago experts discovered a relationship between infection with HPV (human papillomavirus) and cervical cancer. Since then, these experts have learned much more about how HPV can lead to cervical cancer.
Women and their healthcare providers have increasingly won the battle against cervical cancer in recent decades. Cervical cancer is the most common health problem linked to HPV in women. Nearly all cervical cancers are caused by HPV.
Listen in as Howard M. Saul, DO explains that with early detection and HPV Vaccines, we have made great strides in the fight against Cervical cancer.
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HPV and Cervical Cancer: Get the Important Facts
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Learn more about Howard M. Saul, DO
Howard M. Saul, DO
Howard M. Saul, DO is a Gynecologic Oncologist.Learn more about Howard M. Saul, DO
Transcription:
Melanie Cole (Host): We're learning so much more about the causes and the links to cervical cancer and STIs. My guest today is Dr Howard Saul. He's a board certified Gynecologic Oncologist with Lourdes Health System. Welcome to the show, Dr. Saul. First of all, let's just talk about the annual test that women get, the Pap smear. When do you want us to start getting those, and what is the link to cervical cancer?
Dr. Howard Saul (Guest): As you know, the Pap smear has been the main reason for a woman to come in annually to see a doctor. The Pap smear has not only been revolutionary in the terms of decreasing the incidence and death of cervical cancer but it's also been an entry point for a woman to come in and address all her other health issues.
Melanie Cole: So, that is our annual. And you’re supposed to start, people come in somewhere in their 20s and start their annuals. Now, there has been some talk about the Pap smear lately.
Dr. Saul: Yes, there has been. So, specifically from a cancer prevention standpoint we've learned a lot about the Pap smear. The Pap smear is something, believe it or not, was named for Dr. Papanicolaou, who was not even a cancer researcher. He was a reproductive endocrinologist really looking at the menstrual cycle and, lo and behold, he ended up discovering these abnormal cells in the cervix which led us to a tremendous discovery that cervical cancer starts in a pre-cancer form. It's many years in this pre-cancer form that it exists before it becomes invasive cancer, invasive cervical cancer. And throughout a period of time, we have multiple opportunities to intervene in the precancerous stage to prevent it from becoming into cancer. So, the Pap smear has been our entry into trying to discover pre-cancer of the cervix. What we've discovered is that, in many women, these pre-cancerous changes do not progress to serious disease. It's trying to sort out the ones that may progress from the ones that may not progress, that's been our biggest focus over these last many years. We used to recommend that a woman has a Pap smear every single year. However, we've learned that for most women we can now spread out those Pap smears between every three years and every five years, depending upon that women's history. However, many of us still recommend a woman to come in for an annual Pap smear and the reason for that is pretty simple. If I tell you that you don't need to see me for between three to five years, more than likely, I'm never going to see you again unless you have a problem. When you come in for an annual, then I can not only address the cervical issue but then I could check your blood pressure, check your cholesterol and all these other health factors that are very important. So, the Pap smear is not only a ticket to cervical health, it's a general wellness ticket, and that's what a lot of people are looking at. So, when we are thinking about spacing out Pap smears for many-many years, we have to think of that person who we're taking care of at that time. Is this a person that's still going to come in every single year or once she hears three to five years, that's the message that “I don't need to see you anymore unless I have a problem.”
MelanieCole: Dr. Saul, then let's talk about that link to HPV. We're learning more and more about that and now there's a vaccine that we're giving to our eleven-, twelve- and thirteen-year-old children, both boys and girls, that they're calling the cervical cancer vaccine. If you're somebody past the age of 26 already, you can't get the vaccine. Speak about that link. Are we being tested for HPV? Does that, then, diminish our need for those annual Pap smears? Put all that together for us.
Dr. Saul: Let's understand a little bit about the history of cervical cancer. Back in 1930, cervical cancer was the number one cause of female cancer death in the United States. After the introduction of the Pap smear in the late 40s and early 50s, cervical cancer deaths started to decrease dramatically such that now in the year 2016, we're going to see roughly 13,000 new cases of cervical cancer in the United States today and 4,000 deaths. Although that seems like a pretty small number, those numbers are still pretty significant. We learned a number of years ago about bacteria and how bacteria is involved in our entire body. We can't even live without having healthy bacteria in our body. Then, we started to explore the body and found out our bodies are inhabited with viruses. We're actually a walking zoo and some of these viruses are known as “human Papilloma” viruses. There are many different subtypes of human Papillomaviruses. Only a small fraction of them are key in the development of pre-cancer and cancer of the cervix. These viruses, for the most part, are innocent, meaning that most people that carry these viruses, and which there are many people that do carry these viruses, will not have a problem at all for the rest of their lives due to having the virus. Some people will. Those people have what's known as “high risk subtypes” of that virus. A number of years ago we've been barked on an unbelievable thing, from going from cervical cancer screening to now cervical cancer prevention. We've been able to prevent a number of cancers by using vaccine. Not every cancer is virus related and not every cancer could be impacted by a vaccine, but we knew from the hepatitis vaccine that we've been able to prevent liver cancer. The same thing goes with human Papillomavirus vaccine. The sooner we get a person to take the HPV vaccine, the sooner they're protected. There are a number of different vaccines that are out today that can protect both men and women from not only pre-cancer and cancer of the cervix, but also pre-cancer of other organs that we have as well, like anal cancer, vulvar cancer, and, believe it or not, even throat cancer. So, these vaccines are very vital and very, very important. Believe it or not, the initial series of vaccines only take six months, three shots, and we feel that those vaccines lasts for many-many years after they are first given. It's best to give the vaccine to a person that's never been exposed to human Papilloma virus. That's why we like to vaccinate people as young as 11, 12 years old. However, even if a person was to be exposed to human Papillomavirus, and they're below the age of 26, the vaccine still can be quite protective because the vaccine can protect a number of different strains of human Papilloma virus, not only to prevent the illnesses of pre-cancer and cancer of the cervix, but also human Papillomavirus -related genital warts, which is a huge health problem. The HPV vaccine is not only safe, it's tremendously effective. We have a long history of trials using human Papillomavirus to show, in fact, it is efficacious and safe.
MelanieCole: Dr. Saul, if you are past the age where you couldn't get that then, do you just get tested for HPV, and if you do not show any signs of that, then you can look toward those alternate Pap smear schedules?
Dr. Saul: Yes, we feel that a person who is HPV negative, especially high risk HPV negative, those people are at very, very low risk to develop cervical cancer. So, that's the type of target we're looking to maybe extended distances between Pap smears. However, we also learn that HPV, in and of itself, is not enough to cause cervical cancer. More often than not, we need other co-factors and, believe it or not, the chief co-factor that we've learned about is cigarette smoking. Cigarette smoking together with human Papillomavirus is a terrible combination because cigarette smoking destroys and distorts the immune system of that cervix. I try to encourage people not only to take vaccine. I encourage people not to smoke as well.
Melanie Cole: Are there any symptoms of cervical cancer? We only have a minute or two left, but are there some symptoms you'd like people to be aware of? Red flags you'd like them to call their doctor about?
Dr. Saul: A chief red flag is abnormal vaginal discharge, bleeding after having sexual relations, bleeding in between periods, any pelvic pain that's unexplained. Any of those things could be a sign of a gynecologic issue that needs to be addressed by a doctor. Of course, even after a person has had a menopause, bleeding after menopause may also be a symptom and a sign of either a cervical problem or even a uterine problem.
Melanie Cole: So, wrap it up for us. Give your best advice for women listening about cervical cancer, what you tell them every single day and why they should come to Lourdes Health System for their care?
Dr. Saul: At Lourdes, we've been really pioneering not only effective treatment for cervical cancer--cervical cancer treatment has evolved from not only screening to prevention and breakthrough treatments for even advanced cancer when it's diagnosed. We have tremendous methods of treatment of women that actually have advanced cervical cancer that are quite effective, but prevention is our number one strategy. The more we can encourage our young women and men to get the HPV vaccine, the less cervical cancer we will see in the future, as well as other HPV related cancers.
Melanie Cole: Thank you so much for being with us, Dr. Saul. It is great information. It’s so important for women to hear. You're listening to Lourdes Health Talk, and for more information you can go to lourdesnet.org. That's lourdesnet.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): We're learning so much more about the causes and the links to cervical cancer and STIs. My guest today is Dr Howard Saul. He's a board certified Gynecologic Oncologist with Lourdes Health System. Welcome to the show, Dr. Saul. First of all, let's just talk about the annual test that women get, the Pap smear. When do you want us to start getting those, and what is the link to cervical cancer?
Dr. Howard Saul (Guest): As you know, the Pap smear has been the main reason for a woman to come in annually to see a doctor. The Pap smear has not only been revolutionary in the terms of decreasing the incidence and death of cervical cancer but it's also been an entry point for a woman to come in and address all her other health issues.
Melanie Cole: So, that is our annual. And you’re supposed to start, people come in somewhere in their 20s and start their annuals. Now, there has been some talk about the Pap smear lately.
Dr. Saul: Yes, there has been. So, specifically from a cancer prevention standpoint we've learned a lot about the Pap smear. The Pap smear is something, believe it or not, was named for Dr. Papanicolaou, who was not even a cancer researcher. He was a reproductive endocrinologist really looking at the menstrual cycle and, lo and behold, he ended up discovering these abnormal cells in the cervix which led us to a tremendous discovery that cervical cancer starts in a pre-cancer form. It's many years in this pre-cancer form that it exists before it becomes invasive cancer, invasive cervical cancer. And throughout a period of time, we have multiple opportunities to intervene in the precancerous stage to prevent it from becoming into cancer. So, the Pap smear has been our entry into trying to discover pre-cancer of the cervix. What we've discovered is that, in many women, these pre-cancerous changes do not progress to serious disease. It's trying to sort out the ones that may progress from the ones that may not progress, that's been our biggest focus over these last many years. We used to recommend that a woman has a Pap smear every single year. However, we've learned that for most women we can now spread out those Pap smears between every three years and every five years, depending upon that women's history. However, many of us still recommend a woman to come in for an annual Pap smear and the reason for that is pretty simple. If I tell you that you don't need to see me for between three to five years, more than likely, I'm never going to see you again unless you have a problem. When you come in for an annual, then I can not only address the cervical issue but then I could check your blood pressure, check your cholesterol and all these other health factors that are very important. So, the Pap smear is not only a ticket to cervical health, it's a general wellness ticket, and that's what a lot of people are looking at. So, when we are thinking about spacing out Pap smears for many-many years, we have to think of that person who we're taking care of at that time. Is this a person that's still going to come in every single year or once she hears three to five years, that's the message that “I don't need to see you anymore unless I have a problem.”
MelanieCole: Dr. Saul, then let's talk about that link to HPV. We're learning more and more about that and now there's a vaccine that we're giving to our eleven-, twelve- and thirteen-year-old children, both boys and girls, that they're calling the cervical cancer vaccine. If you're somebody past the age of 26 already, you can't get the vaccine. Speak about that link. Are we being tested for HPV? Does that, then, diminish our need for those annual Pap smears? Put all that together for us.
Dr. Saul: Let's understand a little bit about the history of cervical cancer. Back in 1930, cervical cancer was the number one cause of female cancer death in the United States. After the introduction of the Pap smear in the late 40s and early 50s, cervical cancer deaths started to decrease dramatically such that now in the year 2016, we're going to see roughly 13,000 new cases of cervical cancer in the United States today and 4,000 deaths. Although that seems like a pretty small number, those numbers are still pretty significant. We learned a number of years ago about bacteria and how bacteria is involved in our entire body. We can't even live without having healthy bacteria in our body. Then, we started to explore the body and found out our bodies are inhabited with viruses. We're actually a walking zoo and some of these viruses are known as “human Papilloma” viruses. There are many different subtypes of human Papillomaviruses. Only a small fraction of them are key in the development of pre-cancer and cancer of the cervix. These viruses, for the most part, are innocent, meaning that most people that carry these viruses, and which there are many people that do carry these viruses, will not have a problem at all for the rest of their lives due to having the virus. Some people will. Those people have what's known as “high risk subtypes” of that virus. A number of years ago we've been barked on an unbelievable thing, from going from cervical cancer screening to now cervical cancer prevention. We've been able to prevent a number of cancers by using vaccine. Not every cancer is virus related and not every cancer could be impacted by a vaccine, but we knew from the hepatitis vaccine that we've been able to prevent liver cancer. The same thing goes with human Papillomavirus vaccine. The sooner we get a person to take the HPV vaccine, the sooner they're protected. There are a number of different vaccines that are out today that can protect both men and women from not only pre-cancer and cancer of the cervix, but also pre-cancer of other organs that we have as well, like anal cancer, vulvar cancer, and, believe it or not, even throat cancer. So, these vaccines are very vital and very, very important. Believe it or not, the initial series of vaccines only take six months, three shots, and we feel that those vaccines lasts for many-many years after they are first given. It's best to give the vaccine to a person that's never been exposed to human Papilloma virus. That's why we like to vaccinate people as young as 11, 12 years old. However, even if a person was to be exposed to human Papillomavirus, and they're below the age of 26, the vaccine still can be quite protective because the vaccine can protect a number of different strains of human Papilloma virus, not only to prevent the illnesses of pre-cancer and cancer of the cervix, but also human Papillomavirus -related genital warts, which is a huge health problem. The HPV vaccine is not only safe, it's tremendously effective. We have a long history of trials using human Papillomavirus to show, in fact, it is efficacious and safe.
MelanieCole: Dr. Saul, if you are past the age where you couldn't get that then, do you just get tested for HPV, and if you do not show any signs of that, then you can look toward those alternate Pap smear schedules?
Dr. Saul: Yes, we feel that a person who is HPV negative, especially high risk HPV negative, those people are at very, very low risk to develop cervical cancer. So, that's the type of target we're looking to maybe extended distances between Pap smears. However, we also learn that HPV, in and of itself, is not enough to cause cervical cancer. More often than not, we need other co-factors and, believe it or not, the chief co-factor that we've learned about is cigarette smoking. Cigarette smoking together with human Papillomavirus is a terrible combination because cigarette smoking destroys and distorts the immune system of that cervix. I try to encourage people not only to take vaccine. I encourage people not to smoke as well.
Melanie Cole: Are there any symptoms of cervical cancer? We only have a minute or two left, but are there some symptoms you'd like people to be aware of? Red flags you'd like them to call their doctor about?
Dr. Saul: A chief red flag is abnormal vaginal discharge, bleeding after having sexual relations, bleeding in between periods, any pelvic pain that's unexplained. Any of those things could be a sign of a gynecologic issue that needs to be addressed by a doctor. Of course, even after a person has had a menopause, bleeding after menopause may also be a symptom and a sign of either a cervical problem or even a uterine problem.
Melanie Cole: So, wrap it up for us. Give your best advice for women listening about cervical cancer, what you tell them every single day and why they should come to Lourdes Health System for their care?
Dr. Saul: At Lourdes, we've been really pioneering not only effective treatment for cervical cancer--cervical cancer treatment has evolved from not only screening to prevention and breakthrough treatments for even advanced cancer when it's diagnosed. We have tremendous methods of treatment of women that actually have advanced cervical cancer that are quite effective, but prevention is our number one strategy. The more we can encourage our young women and men to get the HPV vaccine, the less cervical cancer we will see in the future, as well as other HPV related cancers.
Melanie Cole: Thank you so much for being with us, Dr. Saul. It is great information. It’s so important for women to hear. You're listening to Lourdes Health Talk, and for more information you can go to lourdesnet.org. That's lourdesnet.org. This is Melanie Cole. Thanks so much for listening.
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