'Web' of protection


The Human Papilloma Virus (HPV). - File picture

“With great power comes great responsibility” - the famous quote often associated with the aspiration of being the Spider-Man. In fact this phase is actually attributed to Uncle Ben, and not Peter Parker. Well, Uncle Ben really never phrased it in the dialogue of the Marvel Comic, this actually appear as a narrative caption in the comic’s last panel. 

You may have guessed, I am a huge fan of the Marvel crusader created by Stan Lee since the 1970s. I recalled my Chinese up bringing in Kota Baru, where the solitary appeal of a superhero was a Mythical Monkey God.

The only place I seem to be able to have glimpse of my teenage obsession crime fighter was at the Indian Barber shop behind Odeon Cinema, where I could get hold of the Marvel Comics. The normal struggle of an adolescent Peter Parker transformed into the “self-made” super strength idol with agility just seemed so real and so exotic.

This Labor Day was the opening day of the new Amazing Spider-Man.  I was not terribly excited about the new version of the “rejected, inadequate and lonely” Peter Parker that I once could relate to in my teenage years. I was also not really enthused by the emergence of Gwen Stacy, who incidentally was the first true love of Peter Parker. In fact, I am no longer captivated by the “superpower” of my superhero. 

Kofi Annan once said: “Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family.” I begin to realise the power of knowledge is surpassing any form of superpower in all the Marvel Avengers. This brings me to answering the letter from CK. 

“Dear Dr G,

I am a father of two beautiful teenagers. My son is 14 and my daughter is 12.

I am contemplating for my children to have the HPV vaccines, and would like you advice for my decision.

I understand the HPV vaccine is for the protection of Sexually Transmitted Infections, Why is it given for adolescent girls? Is it true this vaccine can protect against the development of cervical cancer?

I also believe the vaccine is approved for teenage boys, too. Why do they need protection against cervical cancer?

What are the risk and benefits of my children having this vaccine?

I am really worried and confused.

Please help.

Regards,

CK” 

Nearly two decades ago, a German scientist, Harold Hausen, had unearthed the correlation between infections of Human Papilloma Virus (HPV) with cervical cancer. The discovery had earned him the Nobel Prize in Medicine. Following the initial breakthrough, the association of HPV with cancers such as penile, vulvar, anal and oral cancers have also been demonstrated. Such discovery had completely transformed the knowledge of cancer initiation and opened up avenues for prevention and protections. 

HPV is the most common sexually transmitted infection in adults. There are more than 100 types of HPV. About 30 of the subtypes are known to be associated with genital infections, contracted through skin-to-skin contacts during physical sexual intimacy. Although many would want to believe they contracted HPV through dirty towels or toilet seats, in reality, the chance of such transmission is near impossible (nice try!). 

The vast majority of such contagions will not result in any symptoms or disease. However, certain “High Risk” HPV can lead to abnormal cell transformation and may result in genital or cervical cancers. The most common of the High Risk strains of HPV are types 16 and 18. 

In 2006, the US FDA approved the first preventive HPV vaccine, followed by a second vaccine in 2007. Both vaccines protect against HPV that cause 70% of cervical cancer, 80% of anal cancers, 60% of vaginal cancer and 40% of vulvar cancers.

With the vaccines recommended for adolescent girls and also approved in men in some countries, I remember the air of optimism of the potential of wiping out cervical and other genital cancers within a generation. Although the use of the HPV vaccine protects against one form of STI, it is naïve to believe such protection would extend to HIV, Syphilis or Chlamydia transmission (so, no substitution of condom, boys). 

In reality, nearly a decade later, the true impact of the HPV vaccination in cancer prevention is not fully evident. Of course, the success is truly dependent on the acceptability of the intervention. Many are fearful of the safety of the inoculation. The fact is, the vaccine is used in over 100 countries with more than 100 millions doses delivered. Although there were some adversities associated with the injections, the clinical data indicated that the treatment is safe and well tolerated. 

In 2012, Australian Government had extended the National HPV vaccination programme to include males, with the intention to reduce the incidence of genital warts and other HPV associated cancers. Some critiques argue this may be over-protection for men. In my opinion, when it comes to cancer protection, should there be gender inequality? 

Every year, about 12,000 women are diagnosed with cervical cancer and 4,000 women die from this disease in the United States. There were an estimated 275,000 deaths from cervical cancer in 2008 worldwide. According to the National Cancer Institute, widespread vaccination has the potential to reduce cervical cancer deaths by as much as two thirds.

> The views expressed are entirely the writer’s own.

 

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Human Papilloma Virus , HPV , vaccination , sex

   

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