Genital Warts — How to Cope With Psychological and Emotional Pain?
Aside from being physically disruptive, genital warts may cause the sufferer psychological and emotional pain. It is common for an individual with genital warts or HPV infection to be frustrated, embarrassed, and anxious about having genital warts and the risks associated with it. This is normal, but it would help if you take into the account the fact that genital warts can be controlled and managed. There may not be a cure for the virus itself, but with perseverance and patience, the symptoms will go away. It would also help if you try to overcome your emotions first and concentrate on gathering information about the said disease in order to know how to deal with it. Doing so will definitely help you come to terms with the situation, do something about it, and move on to have a happier and healthier life.
Again, it is normal to feel upset and anxious once you find out you have genital warts. You may even think that you are less attractive, experience a decrease in sex drive, and feel a certain amount of isolation from everyone else. You may even feel angry at your partner, thinking that he/she must have been the one whom you got the infection from even though in reality it is hard to pinpoint who passed on the virus to you. It may take some time to get over these negative emotions, but you should understand that it is still possible to have a normal life even if you have or have had genital warts.
There are many ways to cope emotionally with genital warts. You may talk to someone whom you know you can fully trust. Do not be ashamed to confide in someone about your situation. You are not alone. There are a lot of people out there who are going through the same ordeal. Moreover, as mentioned above, you may join a genital warts support group. You may find such support groups offline or online. With the former, there is a certain amount of human interaction. You will meet with actual people and have in-person conversations. With online support groups, you can voice out your concerns anonymously. Support groups can offer you a lot of useful information, such as resources regarding treatments.
You should also talk to your partner about your situation. But before this, you should do a lot of research about genital warts so that you would be prepared to answer all of his/her questions. Brace yourself for the possibility of rejection. Understand that your partner will feel hurt and confused, just like how you felt at first. Explain that even though there is no cure for the virus, there are a lot of treatment options available that would get rid of the warts. Also mention that in most cases, the virus goes away within two years. Also, tell your partner that not everyone who gets exposed to the virus will get genital warts; a strong immune system is responsible for protecting you. Finally, instead moping about the situation, identify ways on how you can deal with it together.
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Genital Rash Can Transmit HIV
IT HAS been observed that people who have rashes around their genital organs have the potential of contracting the Human Immunodeficiency Virus (HIV) during intimate affairs with HIV-infected partners.
Dr. Wisdom Amegbletor, Medical Director in-charge of the New Crystal Clinic made the observation during an interview with HEALTH MATTERS last Friday.
Genital rash, he explained, almost always resulted in discharges especially when constantly scratched by the sufferer.
When this happens, fluids that spring from the affected parts are transmitted to the other partner during sexual intercourse despite the use of a condom.
“I’ve had rather unfortunate cases in my Consulting Room where people who claimed to have used contraceptives during sexual contacts were diagnosed with HIV.
“Such people had expressed surprise at the turn of events but further checks on them revealed that they had had genital rashes during those moments of the sexual acts,” he pointed out.
According to him, any fluid discharged from any part of the body of an HIV-infected person contains the virus, hence the need for people to be extra careful during contacts with any form of fluids.
The Medical Director advised people who have rashes around their genital organs to seek immediate medical attention.
When contacted, Mr. Abraham Nana Pampam, a Tema-based traditional healer, also held similar views, saying rashes around the genital area should be gotten rid of as soon as sufferers realise such occurrence.
Common herbal medications and ointments, he indicated, could be used in the effective treatment of Genital Rash.
Studies have shown that Genital Warts are caused by a virus called the Human Papilloma Virus.
The warts can be removed but the sufferer would have the virus for the rest of his life; It is very common for the warts to reappear after they have been removed.
The disease is spread by coming into contact with the warts, but often it cannot be seen.
Genital warts can have varying appearances.
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Teen Sexual Behavior Does Not Predict HPV Risk
A teen’s sexual activity doesn’t predict her future risk for HPV, and shouldn’t determine whether she receives the HPV vaccine, according to University of Michigan researchers.
The U of M study conducted by C.S. Mott Children’s Hospital’s Child Health Evaluation and Research Unit found that the sexual activity of adolescents did not predict future contraction of HPV as adults. HPV, genital human papillomavirus, is the most common sexually transmitted infection, according to the Centers for Disease Control and Prevention.
The findings support the CDC’s recommendation for universal vaccination for all women ages 11 to 26, regardless of sexual experience, said Dr. Amanda Dempsey, the study’s lead researcher.
“We couldn’t find any discernible adolescent behavior, including sexual activity, that was associated with an increased risk of HPV infection as a sexually active young adult,” Dempsey said. “HPV is so prevalent that everyone who becomes sexually active is at risk.”
Dempsey says she and her colleagues undertook the study because of a continued “reluctance among parents to be okay with vaccinating their younger female adolescent children. In clinic, I hear some parents expressing that their adolescent child wouldn’t need the vaccine because she’s not at risk. We wanted to examine more closely a girl’s risk for HPV during adolescence based on her behaviors.”
They also wanted to address conflicting recommendations about who should get the vaccine, Dempsey said. While the CDC recommends it for all women age 11 to 26, the American Cancer Society recommends that women 18 and older talk with their doctors about whether they’re at risk for the virus based on their sexual history.
The problem with that approach, the study results indicate, is that “you really can’t pick out one or two behaviors that predict if you’ve been exposed to HPV,” Dempsey said. “HPV is just so common and so easily transmitted from person to person that it doesn’t take more than one partner to get exposed. It doesn’t matter what you did as an adolescent. Most people are going to become sexually active and at that point are going to be at risk.”
The prospective study — one that relies on information gathered at the time of a person’s life being studied rather than asking participants to remember information retrospectively — examined data on 3,181 adolescents who participated in a long-term study. Researchers were able to use data collected on participants from early adolescence on to link their HPV status with the behaviors the girls reported several years earlier.
The U of M researchers found no correlation between an adult woman’s HPV infection and her number of sexual partners, her history of having an older male sexual partners and/or a new sex partner with the past year, her illegal drug use, her history of sex while alcohol-impaired or her regular use of cigarettes or alcohol.
HPV infection generally occurs shortly after a woman becomes sexually active. Most women never know they have the virus because it usually goes away on its own and may not cause any symptoms.
The HPV vaccine guards against four types of HPV: two that cause 70 out of 100 cases of cervical cancer and two that cause 90 out of 100 cases of genital warts. There are more than 100 types of HPV, but only some types lead to cervical cancer or genital warts.
Because the vaccine protects against only four strains, even women who have tested positive for HPV should still get vaccinated, Dempsey said.
The study appears in the July issue of Pediatrics.
Merck’s Gardasil not cleared for older women
U.S. regulators have told Merck & Co they cannot yet approve Merck’s application to expand marketing of its cervical cancer vaccine Gardasil to an older group of women, the drugmaker said on Wednesday.
Merck had applied for the use of Gardasil in women ages 27 through 45. The U.S. Food and Drug Administration said in a letter regarding the application that it has completed its review and there are “issues” that preclude approval within the expected review time frame, Merck said.
“It’s hard to get a feel for if this is a dead issue or if this is delayed,” said Linda Bannister, an analyst for Edward Jones. “At the minimum, it’s going to be delayed.”
Merck said it also failed to win FDA approval to expand Gardasil to protect against more strains of the Human Papillomavirus that causes cervical cancer. The company for now is dropping plans to pursue that expansion, a spokeswoman said.
Shares of the New Jersey-based drug maker, which also reiterated its long-term revenue and earnings targets, fell 0.8 percent.
Gardasil, approved in June 2006 for preventing cervical cancer and genital warts in females ages 9-26, has been one of Merck’s most successful newer products and has helped the company recover after the 2004 withdrawal of its Vioxx arthritis treatment.
The Gardasil setbacks could raise concerns about the degree of growth that Merck can hope to achieve with the product, which is the world’s first vaccine to prevent cervical cancer.
A Merck spokeswoman said the agency has specific questions regarding Gardasil’s effectiveness in this older age group.
The company said it had already discussed the questions with the FDA and expects to respond to the agency in July.
“Once we go back to the FDA, we’ll have a better sense of what the review timing looks like,” spokeswoman Amy Rose said.
The agency’s response on the application for the older group does not affect Gardasil’s current approval for females ages 9 to 26, Merck said.
Global sales of Gardasil rose 7 percent in the first quarter to $390 million. Cowen and Co has predicted annual sales of the vaccine would reach $1.9 billion in 2008 and jump to $3 billion by 2012.
Edward Jones’ Bannister said she had expected Gardasil sales to reach $2.6 billion by 2012, with about one-third to come from that older age group.
Deutsche Bank analyst Barbara Ryan said failure to win approval for the older age group could reduce her $3.8 billion estimate for 2012 sales by about $300 million.
Ryan said the most important new opportunity for the vaccine will be for its use in males. The vaccine could help prevent males from contracting Human Papillomavirus and spreading it to females through sexual contact. Merck is on track to seek approval for use in males by the end of the year, Rose said.
Gardasil has benefited from lengthy delays in approval of GlaxoSmithKline’s rival Cervarix vaccine. The FDA in December issued a complete response letter for Cervarix, meaning it had completed its review of the product but had further questions about it.
Bannister said the Gardasil delay reflects broader challenges facing drug makers within the U.S. regulatory environment.
“It’s not specific to Merck,” Bannister said. “This is an industry-wide issue.”
Merck shares fell 29 cents to $36.74 in afternoon trading on the New York Stock Exchange. The shares have fallen some 37 percent this year, hurt by setbacks to its cholesterol franchise.
Cervical Cancer Vaccines May Start Soon
A cervical cancer vaccine programme is likely to be introduced in the Republic in the near future, on foot of today’s publication of a Health Information and Quality Authority (Hiqa) report.
The HIQA value-for-money report should pave the way for the early announcement of a formal immunisation programme aimed at 12-year-old girls. The report also recommends a once-off vaccination programme for 13 to 15 year-olds.
Cervical cancer is caused by certain types of the human papillomavirus (HPV), with evidence of infection found in 99 per cent of women with cervical cancer.
The Minister for Health, Mary Harney has said she would introduce a HPV/cervical cancer vaccine programme if advised to do so.
Although there are in excess of 200 HPV strains, just a small number are associated with the development of cancer of the cervix. HPV types 16 and 18 are found in almost 70 per cent of cervical cancers, while another five sub types are responsible of a further 20 per cent of cases. Some HPV types are non cancerous but are linked to the presence of warts in the genital area.
Cancer of the neck of the womb (cervix) is diagnosed in almost 200 women here every year; some 70 women die from the disease annually.
Cervical cancer usually develops quite slowly, passing through a number of pre invasive stages (carcinoma in situ - CIN) before progressing to full blown disease. If caught in the early stages, it has a five-year survival rate of 80 per cent or greater.
HPV is a sexually transmitted infection; it is estimated that almost 80 per cent of sexually active people have been infected with at least one virus type by the age of 50. It is usually symptomless and in 90 per cent of cases, the body clears itself of the virus within two years of infection. But it is when the virus persists that the risk of cervical cancer increases.
Gardasil and Cervarix are the approved vaccines against HPV. Both aim to prevent cervical cancer; in addition Gardasil is active against those HPV subtypes known to cause genital warts. Both products involve a three-vaccine course, given over a six-month period. And clinical trials involving a five-year follow-up, have shown that vaccination is 100 per cent effective in preventing HPV infection and non-invasive cancer .
HPV vaccines must be given before infection with the virus occurs. This means administering the course prior to the person becoming sexually active so that a comprehensive vaccination program would need to be administered to girls in the 11- to 13-year age bracket.
Vaccination Against Human Papillomavirus Decreases Related Tests and Treatment for Cervical Cancer
Researchers affiliated with the Quadrivalent HPV Vaccine Merck Study Group have reported that vaccination against human papillomavirus (HPV) is associated with a reduction in Pap tests, colposcopy, cervical biopsy, and definitive treatment among women who were uninfected at the time of vaccination. The details of this study were presented at the 39th annual meeting of the Society of Gynecologic Oncologists (SGO) in Tampa, Florida, from March 9 to 12, 2008.
Pap smears have decreased the incidence and death rate of cervical cancer among women in developed countries such as the United States. Cervical cancer is caused by specific high-risk strains of HPV, which can be detected by a special test called Hybrid Capture II (made by Digene).
Now that an HPV vaccine (Gardasil®, manufactured by Merck) has been approved by the U.S. FDA, further reductions in cervical cancer incidence and death may be anticipated. Gardasil is a quadrivalent vaccine because it confers protection against four subtypes of HPV (HPV 6 and HPV 11, which cause 90 percent of genital warts, and HPV 16 and HPV 18, which cause 70 percent of cervical cancers).
Despite the success of Pap smear programs and the ability to detect HPV, over 2 billion dollars in healthcare expenditure occurs annually as a result of abnormal Pap tests and their subsequent evaluation, which often requires cervical biopsies and other surgical procedures on the cervix. This is because, although Pap smears and HPV detection allow a pre-cancerous or dysplastic state of the cervix to be detected and treated before it can turn into cancer, neither of these two methods eliminate the original problem, which is infection with HPV.
The end-of-study data from three pivotal Phase II/III clinical trials of the quadrivalent HPV vaccine were reported at the SGO meeting. A total of 18,150 16 to 26-year-old women were enrolled in one of three randomized, placebo-controlled trials. Vaccine or placebo was given at Day 1, Month 2, and Month 6. Subjects underwent Pap testing on Day 1 and every six to 12 months for up to 48 months. Patients with specific abnormalities on the Pap smear were referred for colposcopy and, depending on the findings, definitive treatment was carried out.
After an average follow-up period of four years, the investigators noted a reduction in Pap tests, colposcopy, cervical biopsy, and definitive treatment among women who were uninfected with HPV at the time of vaccination. Interestingly, these reductions were seen irrespective of the specific type of HPV involved.
Comments: Vaccination with the quadrivalent vaccine appears to be able to decrease the number of Pap tests, colposcopies, cervical biopsies, and treatment women require. This occurs presumably because the vaccine protects against infection with HPV, which is the inciting event in the development of pre-cancerous cervical disease. Long-term studies are required to determine the duration of protection that is achieved by the three-dose vaccination series.
Gen-Probe HPV assay launched in Europe
Gen-Probe has launched its new Aptima HPV Assay in Europe. The diagnostic test, for detecting high-risk strains of the human papillomavirus (HPV), has been CE-marked and is now available for sale in 13 European countries.
The assay is an amplified nucleic acid test that detects 14 high-risk HPV types associated with cervical cancer. Specifically, it detects two messenger RNAs (mRNAs), E6 and E7, that are made in higher amounts when HPV infections progress toward cervical cancer. Gen-Probe believes that targeting these mRNAs may more accurately identify women at higher risk of having, or developing, cervical cancer than competing assays that target HPV DNA. Detecting HPV DNA identifies women who are infected, but HPV infections are common and many resolve without causing cervical cancer.
“Increased specificity – meaning fewer false positive results – is important so women are not subjected to the anxiety and expense of unnecessary medical procedures,” said Jack Cuzick, professor of epidemiology at the Cancer Research UK Centre for Epidemiology, Mathematics and Statistics in London, who is leading the 953-woman ‘Predictors’ study – a head-to-head comparison of various HPV assays.
The assay has been designed to run on Gen-Probe’s fully-automated Tigris instrument system and on the company’s semi-automated DTS instrument platform.
It is being manufactured in Cardiff by Molecular Light Technology, a subsidiary of Gen-Probe.
The assay is still in clinical studies in the US, and has not yet been approved for marketing in that country by the US Food and Drug Administration.
HPV is a group of viruses with more than 100 types, 14 of which are considered to be high-risk for the development of cervical cancer. Most women will be infected with HPV at some point in their lives, but most of these infections resolve without any clinical symptoms or consequences. A small number of HPV infections progress and result in disease, which can range from genital warts to cervical cancer.
1 in 4 teen girls have STD
A virus that causes cervical cancer is by far the most common sexually transmitted infection in teen girls ages 14 to 19, while the highest overall prevalence is among black girls — nearly half the blacks studied had at least one STD. That rate compared with 20% among both whites and Mexican-American teens, the study from the federal Centers for Disease Control and Prevention found.
About half of the girls acknowledged ever having sex; among them, the rate was 40%. While some teens define sex as only intercourse, other types of intimate behavior including oral sex can spread some infections.
For many, the numbers likely seem “overwhelming because you’re talking about nearly half of the sexually experienced teens at any one time having evidence of an STD,” said Dr. Margaret Blythe, an adolescent medicine specialist at Indiana University School of Medicine and head of the American Academy of Pediatrics’ committee on adolescence.
But the study highlights what many doctors who treat teens see every day, Blythe said.
Dr. John Douglas, director of the CDC’s division of STD prevention, said the results are the first to examine the combined national prevalence of common sexually transmitted diseases among adolescent girls. He said the data, from 2003-04, likely reflect current rates of infection.
“High STD rates among young women, particularly African-American young women, are clear signs that we must continue developing ways to reach those most at risk,” Douglas said.
The CDC’s Dr. Kevin Fenton said given that STDs can cause infertility and cervical cancer in women, “screening, vaccination and other prevention strategies for sexually active women are among our highest public health priorities.”
The study by CDC researcher Dr. Sara Forhan is an analysis of nationally representative data on 838 girls who participated in a 2003-04 government health survey. Teens were tested for four infections: human papillomavirus, or HPV, which can cause cervical cancer and affected 18% of girls studied; chlamydia, which affected 4%; trichomoniasis, 2.5%; and herpes simplex virus, 2%.
Blythe said the results are similar to previous studies examining rates of those diseases individually.
The results were prepared for release Tuesday at a CDC conference in Chicago on preventing sexually transmitted diseases.
HPV can cause genital warts but often has no symptoms. A vaccine targeting several HPV strains recently became available, but Douglas said it likely has not yet had much impact on HPV prevalence rates in teen girls.
Chlamydia and trichomoniasis can be treated with antibiotics. The CDC recommends annual chlamydia screening for all sexually active women under age 25. It also recommends the three-dose HPV vaccine for girls aged 11-12 years, and catch-up shots for females aged 13 to 26.
The American Academy of Pediatrics has similar recommendations.
Douglas said screening tests are underused in part because many teens don’t think they’re at risk, but also, some doctors mistakenly think, ‘”Sexually transmitted diseases don’t happen to the kinds of patients I see.”‘
Blythe said some doctors also are reluctant to discuss STDs with teen patients or offer screening because of confidentiality concerns, knowing parents would have to be told of the results.
The American Academy of Pediatrics supports confidential teen screening, she said.
HPV Vaccine & Fainting
by Amy Fleming
Allentown, PA - Recently the Centers for Disease Control & Prevention reported that in the last two years, more than 450 youngsters fainted after getting a vaccination.
That may explain why some teenagers are taking a new position on the HPV vaccine.
Gardasil protects against a virus that cervical cancer and genital warts.
Researchers aren’t sure why, but about 10% of girls in studies for the HPV vaccine got dizzy or passed out after the shot.
The Gardasil website lists fainting as a possible side effect.
To be safe rather than sorry, doctors are proposing an easy solution.
“The recommendation as a result of this, is pretty simple. Just that you give them a vaccine either sitting sown or lying down and you watch them for 15 to 20 minutes just to make sure that they don’t have any significant reaction,” said Dr. Larry Glazerman.
The vaccine is given in a series of three shots.
For more information on the vaccine go to www.gardasil.com.
More links found between cancer in men and HPV, but men aren’t approved for vaccination
by Brian Boyer
Men are neither vaccinated nor screened for human papillomavirus, but two university studies suggested last week that it may be the cause of cancer for many men, and that those cancers could have been prevented.
The virus, better known as HPV, is the primary cause of cervical cancer in women. Recent research, at the University of Michigan and University of Louisville, suggests that it is also the cause of a disease that disproportionately affects men, cancers of the head and neck.
“You should be testing everybody,” said Payal Desai, leader of a pilot study at the Louisville’s James Graham Brown Cancer Center. Both men and women carry HPV, the virus that will affect at least 50 percent of sexually active people, according to the Food and Drug Administration, though only a fraction of those will develop cancer.
More than 35,000 new cases of head and neck cancer are expected to be diagnosed in the United States in 2008, according to the American Cancer Society. Twice as many men as women will develop the disease, which the society estimates will kill 7,590 Americans this year.
Currently a screening test only exists for women. Similarly, a vaccine for HPV exists, but is only approved for use in women ages 9 to 26. Studies are under way to test the efficacy of the HPV vaccine in men, according to the FDA.
If the vaccine were successful in preventing HPV infections in men, the studies suggest it is possible that a significant number of cancer cases in men could be avoided.
In one study, tissue samples from 43 head and neck cancer patients were tested by the Louisville team. They found that almost one-third of the samples tested positive for HPV, specifically the strain of the virus known as HPV 16.
In the other study, at Michigan’s Comprehensive Cancer Center, had similar findings. More than one-third of the 66 head and neck cancer cases they examined tested positive for HPV 16. This study’s primary finding was encouraging: The HPV-associated tumors responded significantly better to treatment than those not associated with HPV.
In women, HPV types 16 and 18 are responsible for 70 percent of cervical cancer cases. The American Cancer Society estimates that 11,070 cases will be diagnosed, and that the disease will kill 3,870 women in the United States in 2008.
Infection by strains 16 and 18 can be prevented through vaccination, with almost 100 percent effectiveness. The drug Gardasil, first made available to young women in 2006, also vaccinates against types 6 and 11, which are responsible for 90 percent genital warts cases.
Desai presented the findings of their study May 15 at the American College of Physicians Internal Medicine Conference. The results have not yet been published. The University of Michigan study was published online May 12 in the Journal of Clinical Oncology. In February, another study, at the National Cancer Institute and Johns Hopkins Medical Insitutions, suggested a link in men between HPV and oral cancer.