There is a new tool to protect girls as young as nine years old from in infection likely to affect them as they grow up. On June 8, 2006, the Food and Drug Administration (www.FDA.gov) licensed Merck’s new vaccine (www.Merck.com), Gardasil for the prevention of the most common sexually transmitted disease and a form of cancer in females. The human papilloma virus infects men and women alike. According to the Center for Disease Control (www.CDC.gov), over half of American’s will contract HPV
infection in their lifetime. While there are over 70 types of HPV, Gardasil offers protection against the strains most likely to cause cervical cancer and genital warts.
The HPV vaccines are effective against the two strains of HPV that are responsible for 90% of genital warts. Genital warts are the most common sexually transmitted disease. Children born to a mother with a genital wart outbreak may contract the disease in infancy.
According to the American Cancer Society (www.Cancer.org), almost 10,000 women will find that they have cervical cancer in 2006; in 2006, nearly 4000 women may succumb to the disease. Cervical cancer is not as prevalent as breast cancer, which affects about 20 times the number of women and kills 10 times more women. (Breast cancer affects men as well.)
The advent of a vaccine designed to prevent a cancer is exciting. The hepatitis B vaccine, which has made the once common ailment rare, protects users from a form of liver cancer. While cancer protection is a welcome side effect of the hepatitis B vaccine, a stated purpose of the HPV vaccine is to protect women from cervical cancer.
The human papilloma virus is a factor in oral health. Over 30,000 Americans find that they have oral cancer every year. Oral cancer only has about a 50% 5-year survival rate. While tobacco and alcohol use remain the primary cause of oral cancer, there is a growing body of evidence linking HPV with invasive oral cancers. There is a possibility that just as the hepatitis B vaccine decreases the incidence of liver cancer, the HPV vaccine will decrease the incidence of oral cancer. The prevention of oral cancer would dramatically increase the usefulness of HPV vaccines.
Even when the HPV vaccines become available, oral cancer screening by a dentist and pap smears will remain effective tools against oral and cervical cancer. The vaccines offer no protection against most strains of the human papilloma virus. In addition, HPV only causes about 70% of cervical cancers. The link between HPV and oral cancer is convincing, but remains uncertain.
Prevent oral cancer by limiting alcohol consumption and by not smoking. Early detection of oral cancer is important. Dentists examine all surfaces of the mouth, tongue and lips for ulcers, growths and red or white patches. If the dentist finds anything unusual, simple and painless techniques exist to remove part of or the entire lesion for microscopic examination. Treatments for oral cancers include surgical removal of the affected area, radiation treatment, and chemotherapy.
The venerable Pap smear remains the state of the art in early cervical cancer detection. The physician gently removes cells from the cervix and vagina. Another physician, a pathologist, examines the cells under a microscope. If there are abnormal cells in the sample, further testing may include a visual exam with a special microscope and a biopsy. A biopsy is the removal of a piece of tissue for microscopic examination.
Merck stands to gain billions of dollars in sales to the over 60 million women (and girls) who are eligible for vaccination in the next few years. That profitability will double if the Food and Drug Administration decides to recommend vaccinating males against HPV as well. Men are carriers of the infection.
Merck is under threat by thousands of lawsuits from people who had strokes and heart attacks after taking the arthritis medication Vioxx. New lawsuits may be on the horizon from users of Merck’s Fosamax. Fosamax is one of the most popular treatments for osteoporosis, a disease that weakens bones, and Paget’s disease of bone, a less common condition. Fosamax is a member of the bisphosphonate family of drugs. Recent research shows a relationship between bisphosphonates and osteonecrosis of the jaw, a painful condition that causes loss of bone and teeth. In time, Merck will learn of their liability is for both of these medications. Merck may need to use profits from Gardasil to bankroll that future liability.
Your physician will help you decide if Gardasil is useful for you or your child. After vaccination, remember to continue regular cancer screening and prevention.