Gardasil Vaccine Protects Older Women.

Gardasil, the new Human Papilloma Virus vaccine approved for use in women aged 9 -26 years, in recent studies has been found to effective in women older than 27 years. It is effective up to age 45 years. I have had many of my older patients inquiring about the use of the Gardasil vaccine in older women. This is good news for those older women who are not already infected by the Human Papilloma Virus.

Oral Sex Is Not Free. It Can Cause Throat Cancer.

A study which is appearing in this week's New England Journal of Medicine showed that both men and women who claimed they had six or more oral sex partners during their lifetime had about 9x increased risk of having cancer of the base of the tongue or the tonsils. The Human Papilloma Virus (HPV) was the culprit. In the study, the participants who had HPV infection were 32 times more likely to develop this type of oral cancer than those without the HPV infection.

The Gardasil vaccine contains 4 types of HPV viruses, namely 16 and 18 that cause about 70% of all cervical cancers and 6 and 11 that cause genital warts. In this study, of the 100 cancer patients enrolled, 72 had HPV 16. Two major risks that promote throat cancer are smoking (3 times greater) or drinking (2.5 times greater). These cancers are more common in men than in women. Does it mean that to prevent oral cancer in men who practise oral sex, these men should be offered the Gardasil vaccine? Only more studies can tell.

Between 12,000 and 15,000 new cases of oral and pharynx cancer are diagnosed each hear. 3000 people die form it. Dr. Robert Haddad, clinical director of the Head and Neck Oncology Program at the Dana-Farber Cancer Institute has seen younger men in their 30's and 40's getting this cancer. The bottom line is that since men don't know which women will have cancer causing viruses in their vagina, they should avoid oral sex as the price has become too much to ignore.

Reference:

New England Journal of Medicine (NEJM)

Cervical Cancer Vaccine May Prevent Precancerous Changes on the Cervix

An article published in the May 10th New England Journal of Medicine showed that young women not infected with Human Papilloma Virus HPV 16 and 18 who were vaccinated with the Gardasil vaccine had a lower occurrence of the high grade precancerous diseases on the cervix than those who were vaccinated with placebo.

The study was done on 12,167 women aged 15-26 years who had not been previously infected with the HPV. Thus the vaccine, if given to young women who have not already been exposed to the Human Papilloma Virus, is effective in preventing cervical dysplasia in women that will be apparent within years rather than decades.

"Human papillomavirus types 16 (HPV-16) and 18 (HPV-18) cause approximately 70% of cervical cancers worldwide,"

Laura A. Koutsky, PhD, from the University of Washington in Seattle, and colleagues from the FUTURE II study group.

Reference:N Engl J Med. 2007;356:1915-1917.