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This new research which has been confirmed with subsequent studies indicates that recurrence was 6 times as likely for those having been treated for CIN to develop invasive cervical cancer. The highest rate of recurrence was with those treated with CRYOSURGERY!
http://www.caring4cancer.com/go/cancer/news?NewsItemId=43738
Cancer Surgery Hemorrhoids Anal cancer Cryosurgery Cervical cancer HPV Lung cancer Gardasil
That is very interesting. I wonder why that is? What is done during cryotherapy? I assume it has something to do with freezing? So, are they just not getting it cold enough deeper down in the cells so that death of the targeted cells occurs? I know when I was like 14, my mom had warts frozen from her vaginal canal or something with her cervix. All I remember is that she told me that she had warts frozen off and it wasn't her vulver area or her bum. So was that cryotherapy?
I know nothing about any of the procedures that are done and I would sure love some info and pros vs cons of them.
Anyway, as always, you have some great info to offer us ladies, thank you. I will keep this in mind, if God forbid, I should ever need to refer to it.
Thanks!
It's also important to know statistically the number of women who go on to have invasive cervical cancer - those numbers are low. Again, I have a love/hate relationship w/stats because I think people are more important than numbers. At the same time, statistics can help put things into perpspective so that a bigger picture can be seen.
Faith, With respect to the number of women who go on to develop cervical cancer and the statistics being "low" I would like to say that everything is relative. Three to ten % of those exposed to the HPV virus will go on to develop significant dysplasias and/or or cancer. If we were talking about 600 or 6000 people then indeed that number would be "low", but we are talking about 6 MILLION people a year which translates into 180,000 to 600,000 people! On the high end, that is just under three times the number of people who are diagnosed with lung cancer each year.
This information, too often perpetuated by doctors and clinicians fails to emcompass the real numbers. I'm sure most of them are just passing along what they heard about a small percentage of the whole, but when that whole equates to millions, it's time to look a bit closer.
I wish they would look at numbers of people who are suffering.. who have to have major surgeries.. who are no longer able to conceive due to scar tissue build up or hysterectomies.. or who continue to suffer with dysplasia over and over and over. Those numbers would be more useful to me.
I get so angry sometimes. I have AIS and it's like well that is precancer, so that doesn't count. Apparently I'm not in the small percentage of people who have cervical cancer.. so it is like what I'm going through is insignificant.
Sapphkat, This is why I have broken down the numbers into the REAL people who are suffering from dysplasias and cancers resulting from HPV. 180K to 600K are REAL people, the 3 to 10% which the medical profession considers "low". Again it's all relative and when we're talking about over six milion acquiring HPV each year that 3 to 10% accounts for a significant number of individuals such as yourself and frankly me, dealing with invasive anal cancer.
The medical organizations must be brought to a higher account with respect to HPV and in particular colorectal surgeons who do not perform anal Paps with HPV testing. Women with CIN have a much higher incidence of developing AIN and anal cancer than others yet it is almost imposible to obtain these tests. Why? Because the American Academy of Colorectal Surgeons has YET to issue recommendations to its members with a standardized protocol to handle patients with HPV. When 90 to 99% of anal cancers are HPV related and with anal cancer on the rise, there is no longer any excuse to avoid these most necessary of actions on their part.
HI Dragonfly,
I think the significance of the study is to point out that women have an increased risk of recurrence, not an automatic progression, if previously diagnosed & treated for CIN, esp w/cryo, (up to 25 yrs), therefore, the point being made - women, especially aged 40+, need to be diligent with exams long term even if previously and successfully treated for CIN due to a higher risk for recurrence which is not to say that every woman will develop cancer.
Again, part of the problem is that no one can say who will go on to develop cancer. There's also the concern that women are being overtreated for dysplasias - rendering them infertile, damaging their reproductive organs, etc, - too aggressive treatment.
I wholeheartedly agree with you that there needs to be some sort of standardized approach to HPV related diseases including what's considered a thorough examination once a woman is determined HPV+ w/high risk strain, and you make an excellent point about colorectal drs... why not include an anal Pap @ time of every colonoscopy, male & female, since colorectal drs are in that area anyway? I believe part of the colonoscopy is visual inspection of the rectum, but that is not the same thing as a diagnostic anal Pap. I suspect people would be more compliant having this type of Pap done knowing it would be done while under sedation for a colonoscopy. The length of time between colonscopies can be as much as 10 yrs, but if doing anal Paps @ same time became a standard practice, at least baseline data would be obtained, and in both sexes. I also agree with you & Sapphkat that laissez faire attitudes toward HPV related diseases will not help to improve anything.
Faith, Many people confuse colonoscopies with anal dysplasia/cancer issues. A colonoscopy is pretty much useless as it is designed to view the rectum (which is not the same as the anus) and the colon. It is not designed to view the very small area of the anal canal. A high resolution anoscopy is utilized for this specifically for the anal canal and surrounding transition zone area.
Work is currently being done on genetic predisposition involving progression of disease but this I"m sure will be years away. Many years ago, a study found that a certain group of Jewish women did not have issues with HPV and it was found to be because of an alteration in p53, a protein we all have which is considered an anti-tumor protein. Normally HPV attacks this protein which is what allows the virus to avoid the bodies immune response. This alteration in the gene of these women indeed affected their issues with HPV in a positive way.
Until then a true national awareness campaign regarding HPV (NOT just as it related to cervical cancer) needs to be undertaken and doctors all need to get on the same page.
Hi Dragonfly,
I've had both colonoscopies and anuscopy and PPH so I'm familiar with the differences & I also think drs are quick to write off rectal bleeding as hemorrhoid issues (which are common). And, as benign as hemorrhoids are, people can still require transfusions from too much blood loss. It certainly is a part of the body that is difficult for some to talk about let alone have examined, thus my thinking for incorporating an anal Pap/exam/HPV screening into the recommended colonoscopy screening - why not have it all done at once and while under sedation? This would be an easy place to start to make a change.
I get what you're saying about a national HPV awareness campaign and HPV related diseases. Look @ how the stigma prevails for cervical though - and I'm not shy about sharing my disgust about the fact that womens' studies in medicine come second to men & that women's female parts are considered much more expendable than men's. For example, a testosterone patch for women is available in Europe, not in the US. Why??? Over half a million women are hysterectomized each year and they cannot get a testosterone patch - one of the hormones greatly affected from this type of surgery. They can get a prescription from their dr for testosterone from compounding pharmacies if they know enough to ask or have a dr w/thorough understanding of the changes this type of surgery causes, but no patch is available, thank you FDA.
Absolutely agree with you that more research needs to be done and I have said all along that when HPV is viewed as a male/female problem, when the numbers start showing the effect on the male population, HPV will be taken much more seriously in the medical community. I also don't feel like sitting around waiting for that day to happen so I intend to do my part and I appreciate all of the light you & others shed on HPV related issues and your willingness to share personal experiences and get the word out.
There's a great analysis article at the following link (of the paper that dragonfly posted). The majority of "recurrences" occur within two years post treatment and are thought most likely to be residual dysplasia or disease that was missed by the procedure. I think that's an important point, because even though the risk of problems remains elevated for many years (which makes sense, given the HPV exposure), the biggest risk seems to be in those first few years of followup, and I think the availability now of HPV testing (which is a good indicator of residual disease) is going to be helpful in followup to let us know whether treatment was successful or not. For those of us who were "treated", a big issue is ongoing worry. You don't want to feel like you're a ticking time bomb with a recurrence potentially happening at any minute. I think HPV testing is a good "leading indicator" also of a problem that might develop in the future, so for me, has really put my mind at ease to know that tool is available -- at least to give additional information on the likelihood of vaginal or cervical problems occuring. Now I wish that would be readily available for testing in other areas too. Faith and dragonfly, I completely agree with you both how HPV is not taken seriously enough by the doctors, and that needs to change!! It does affect hundreds of thousands of women, just in the U.S., causing procedures that may alter a woman's reproductive and sexual functioning. And, dragonfly, I agree that awareness needs to extend to other parts of the body affected by HPV.
vhttp://jnci.oxfordjournals.org/cgi/content/full/djp097
BTW, the figures I quoted above 180K to 600K individuals as those being in the 3 to 10% of folks to who develop problems, that was in the US alone.
And, the FDA needs to get their act together and approve Gardasil for boys/men. It's been on the "fast track" supposedly since February.
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