To Banish a Cancer

Scientific American ^ | February 2006 | Editors of Scientific American

[doc30]

Medicine usually progresses in incremental steps. One antidepressant or cholesterol-lowering drug follows another with only marginally improved therapeutic benefit. Vaccines are different. Disease prevention through immunization, whether for polio or mumps, has the potential to transform medical practice, sometimes eliminating illness altogether. Smallpox is now (we hope) confined to heavily protected freezers in Russia and at the Centers for Disease Control and Prevention in Atlanta. Vaccine developers appear to be on the verge of another remarkable achievement. Two vaccines that are nearing approval by the Food and Drug Administration in the U.S.--one from Merck, the other from Glaxo­SmithKline--have demonstrated in clinical trials that they can prevent infection from the two types of the human papillomavirus (HPV) that account for up to 70 percent of cervical cancers. That could make a big dent in a disease that is the second most common malignancy affecting women worldwide and that kills more than half of its victims. In the U.S., in excess of 10,000 women contract invasive cervical cancer annually and nearly 4,000 die of the disease.

The public health community needs to ready itself now for a task as imposing as developing the vaccine. It must convince millions of parents to get their children vaccinated against a sexually transmitted disease. Many youths contract HPV within a few years of their first experience, often in their early teens. That means that the best time to administer the vaccine is probably between the ages of 10 and 12, when children are less likely to have had sex and when they are scheduled to get boosters for chicken pox, measles and the like. The Merck vaccine also protects against two other types of HPV that cause almost all genital warts, an incentive to get boys immunized, too.

A public health campaign to vaccinate 11-year-olds against STDs will assuredly be a delicate undertaking. A survey that appeared in late November 2005 in the Journal of Adolescent Health noted that half of the 513 physicians polled thought that parents would resist immunizing a child against an STD. Physicians also fretted about parents' perceptions of vaccine safety, with 71 percent saying that those concerns could prove a barrier to vaccination. Worries about antivaccine barnstorming by religious conservatives may be overblown, however. Although some conservatives think that the vaccine will undercut their "abstinence is best" mantra, others have understood that immunization does not exclude a personal decision to refrain from having sex.

Political agendas should be set aside on this one for the sake of public health. The CDC's Advisory Committee on Immunization Practices, which compiles the national list of recommended vaccines, should give Merck's Gardasil and Glaxo's Cervarix its full endorsement. The approval would spur other activity, such as procuring reimbursement from insurers, that would move the vaccine on its way to becoming a routine part of care. And public health officials and drug companies must meet the challenge of mounting a clear and forceful information campaign. The most important message to get across is that this vaccine is a lifesaver and that every child heading into adolescence should get the jab.

[doc30]

This article will surely stir the pot of controversy. A new vaccine is in the works that will prevent HPV, a sexually transmitted virus that causes the second most common form of fatal cancer in women. The issue is that the virus is most commonly acquired shortly after a girl becomes sexually active. Men and boys can carry it and never know. In order to prevent infection, vaccination has to be given before sexual activity occurs. SO should children be immunized (first controversial topic) for sexually transmitted diseases (second controversial topic) that is known to cause cancer later in life? Personally, I would get my kids immunized and I'd be honest about it being for a cancer causing virus, but I would never, ever tell them it was an STD virus. An immunization now is a simple and effective way to prevent a very nasty cancer later in life.

[farlander]

Why in the world would anyone not vaccinate their children against this ? Why is this controversial at all ? What's the controversy ? That we can now protect kids against a nasty disease ?

[doc30]

There are those that would feel vaccination against an STD would lead to promescuity, and others that fear vaccines aren't safe. I am with you that this is vaccine is a good thing.

[rellimpank]

--but I would never, ever tell them it was an STD virus.--

--I suspect they'd find out the truth--

[lilylangtree]

Immunization against cancer--great idea!

[Voltage]

Immunization against cancer--great idea!

Sounds like a great opportunity for trial laywers. Certainly something can be found wrong...could be worth millions!!

[doc30]

Eventually, but it depends on when they get the 'birds and bees' talk. Vaccinate before then, and no, it won't be told then. After, when they are getting the idea of what sex is about, then that is a different story. Their mom will tell them.

[HonestConservative]

Excellent post,doc.


These developments are major milestones in virus related research which will open doors to multiple advances in other virus related diseases.

If it was a vaccine for HIV, wonder what the pc crowd would have to say?

[muawiyah]

No doubt the writer meant this as a pun: "drug companies must meet the challenge of mounting "

[MortMan]

There's a third question. How was the vaccine developed?

[sandbar]

I would get all three of my daughters vaccinated. My best friend has this and lost her uterus after only having one child due to cervical cancer. She isn't a slut, she slept with one guy before her husband and her husband slept with two before her. It just takes one... That whole you've slept with who they slept with and on and on as the saying goes.

[sandbar]

A 10 year old isn't going to go, hey, I got vaccinated against HPV, woo hoo, I can have sex without worry!

[Rubber_Duckie_27]

Hey, most parents now immunize their kids against an STD (Hep B) on the day of birth! I've been tested and am HBsAg-negative, so we'll wait a few weeks or months after birth to start the vaccination series. I know the Hep B vaccine helps greatly when the mother is HBsAg-positive, but I'm not, and see no point in assaulting a newborn's immune system within 12 hours of birth. Just my opinion, of course. ;-)

I'd probably have my kids vaccinated for HPV in the pre-teen years. At the age they'd get it, it's not like the kids really know what the shots are FOR anyways. It's all a jumble of letters - MMR, Hep B, Tdap, IPV.


I think with a careful discussion about the birds and the bees, and familial expectations that teens will not be sexually active, this vaccine could be quite protective. Of course the ideal would be for one's kids to wait until they're serious,monogamous, and out of their teens to have sex, preferably until marriage. However, the reality is that less than 20% of people today go to the altar as virgins - including kids raised in good moral families. HPV in men is particularly asymptomatic and if a daughter's husband had a few "wild" college years before settling down, he could pass the infection along unknowingly. I'd rather my kids be protected from the teen years on.