Cancer Survivors, Doctors Say Politics Clouds HPV Vaccine Debate
By Jamie Stengle
The Associated Press
Monday 05 March 2007
Dallas - After being diagnosed with cervical cancer at age 35, Cheryl Swope Lieck underwent chemotherapy, radiation and eventually had a hysterectomy.
To her, supporting Gov. Rick Perry's mandate to get young girls vaccinated against the virus that causes most cases of cervical cancer makes sense.
"When people politicize things that ought not be politicized, it always astounds me," said Lieck, who is now 40, cancer free and planning to get her two daughters, ages 8 and 11, vaccinated.
Perry made national headlines last month by ordering that Texas schoolgirls going into sixth grade in 2008 be vaccinated against the human papilloma virus, or HPV, which causes most cases of cervical cancer and genital warts. Texas would be the first state in the U.S. to require the vaccine, but a number of other states are considering similar measures.
The result has been a political firestorm. Much of the opposition has come from Perry's fellow conservatives, who say vaccine requirement encourages pre-marital teenage sex and tramples parental rights.
Others agree that the vaccine is beneficial, but don't think it should be mandated by the state. Some think the vaccine - approved by the Food and Drug Administration in June - is still too new.
But politics aside, doctors say that the availability of a vaccine that can prevent cancer is something that at least merits a serious conversation between parents, their children and their doctor.
As a medical oncologist, Dr. Maurie Markman sees women with cervical cancer that has spread. He said his advice to friends and colleagues who ask about the vaccine for their daughters is simple: "Get them vaccinated. There is no other advice I can give. This is a profoundly effective cancer prevention strategy."
"My recommendation is very straightforward. It has nothing to do with politics," said Markman, vice president for clinical research at The University of Texas M. D. Anderson Cancer Center. "I see what cervix cancer can do. I see the pain, the suffering ... the negative aspects of this disease. The importance of preventing it I can't possibly overstate."
About 25 million women in the U.S. - or about one in four who are ages 14 to 59 - are infected with at least one type of HPV, according to the Centers for Disease Control and Prevention.
About 3 million of those women are infected with one of the HPV strains that Gardasil - the new vaccine by Merck & Co. - protects against. Those strains account for 70 percent of cervical cancers and nearly all cases of genital warts.
About half of all men and women get an HPV infection at some point in their lives. While most overcome the infection on their own, the infection can lead to cervical cancer in women. It rarely causes cancer in men.
The American Cancer Society estimates that this year, about 11,150 U.S. women will be diagnosed with invasive cervical cancer. About 3,700 women will die.
A CDC advisory committee recommends the vaccine for girls ages 11 and 12. It's permissible for girls from age 9 to 26.
"A doctor who is treating a patient should offer this vaccine to their patients as a standard of practice," said CDC spokesman Curtis Allen.
Dr. Janet Realini, a public health expert in San Antonio, said that people are confusing whether they are for or against the mandate with whether they are for or against the vaccine.
"I think it's clear that we should be for the vaccine," she said. "The part where there's disagreement is: 'Is it time to mandate it?'"
The political debate means that "everyone's emotions are so high that the negativity has spilled over to the vaccine," she said.
Doctors scoff at the notion that getting the vaccine will encourage sexual activity, pointing out that there are many other sexually transmitted diseases to worry about, in addition to pregnancy.
"It's not really about sex. It's about vaccinating someone against a disease," said Realini, medical director of the family planning program for the San Antonio Metropolitan Health District.
"This doesn't mean people will run out to have sex," said Realini, also medical director for Project Worth, a public education program that focuses on areas of the city with high rates of teen pregnancy.
"If you think your daughter is going to make the right decisions, great, help her make the right decisions, but don't deny her the vaccine," Realini said.
Doctors point out that even if a woman does not have sex until marriage, her husband could carry the virus and pass it to her. Also, no one can predict divorce or widowhood.
About half of women who get cervical cancer haven't had a recent pap test, said Allen. Such tests can often - but not always - detect early any abnormal cells that could lead to cervical cancer.
For that reason, low-income women who are uninsured or can't afford annual checkups are especially at risk for the disease.
Lieck, a county attorney in Chambers County in southeast Texas, said she hadn't even heard of HPV when she was diagnosed with cervical cancer. Lieck, who said she's always had insurance and never missed a yearly Pap test, said that before she was diagnosed with cervical cancer, all her pap tests came back normal.
"All of this didn't have to happen," said Lieck, who has been married for 15 years.
She said that protecting girls from the pain she went through should be above any political agenda.
"Absolutely we should teach abstinence, but we should also do everything we can to protect them," Lieck said. |
