HPV Vaccines bring hope for cancer struck people

A study conducted by the Department of Obstetric and Gynecology at the University Central Hospital revealed that the human papillomavirus (HPV) vaccine, also called Gardasil, apart from blocking cervical cancer may also help to immune human bodies against vulval and vaginal lesions, that cause cancer and account for approximately six percent of all gynecological cancers, as published in this week’s edition of British journal, The Lancet.

The analysis was done on data involving more than 18,000 women in age groups 16-26 yrs in 3 trials in 24 countries across the United States, Europe and Asia by Professor Jorma Paavonen, M.D., of University Central Hospital and his compeers in Helsinki, Finland, injecting the woman with either 3 doses of quadrivalent vaccine against HPV genotypes 6, 11, 16, and 18 or the placebo and following for an average of 3 years.

Placebo consisted of the aluminum hydroxyphosphate sulfate adjuvant used in the vaccine. The three doses were given to the women in three shots over six months. The physical check ups were scheduled before receiving their first shot and again two months and six months later. After that, they got two checkups per year.

The researchers said that in the analysis, 64% of cases of high-grade vulval intraepithelial neoplasia in the placebo group were due to HPV16. The participant also underwent repeated anogenital examination for over two years. Any suspect lesions were tested with Biopsy and HPV type-specific DNA testing.

The findings concluded that HPV vaccines could prevent vulval and vaginal cancers in 71% of women previously exposed to HPV16 or HPV18 as well as in 100% of women who had not been exposed to the four strains of the virus prior to using the vaccine.

Out of the lot only 0.1% of participants discontinued due to adverse events, and 0.06% reported a serious systemic adverse event judged to be vaccine related. Vaccine related adverse reactions were fever, nausea, dizziness, injection site pain, swelling, erythema and pruritus.

According to the researchers such cancers have been increasing at a rapid pace for the past 30 years and are a cause of worry as they can prove to be very dangerous and lethal. These HPV cancers that spread through sexual intercourse and are predominantly present in the female genital tract adopt a necrotic nature as they can often not be detected. And the treatment i.e. surgery can be stressful for the victims leaving them with problems like anxiety, depression, sexual dysfunction and poor self image etc.

“This trend is worrying because these cancers are not amenable to a screening (program),” the authors wrote in the study. “Whereas, previously vulval cancer was seen almost exclusively in older women, recent studies have shown that 20 percent of these cancers now occur in women under 50 years (of age).”

The experts have recommended girls to be vaccinated before they attain puberty. The researchers have also stated the less effectiveness of these vaccines in already sexually active women due to the prevalence of HPV.

In January 2007, the National Advisory Committee on Immunization (NACI) recommended that all Canadian girls and women aged 9 to 26 be routinely vaccinated.

The researchers concluded saying, “"In summary, these combined studies provide substantial evidence that a quadrivalent HPV L1 VLP vaccine is highly effective in preventing high-grade vulval and vaginal lesions associated with HPV16 or HPV18.”

On an average 436 Canadian women, accounting for the maximum number of HPV cases in the world, are diagnosed with vulval or vaginal cancer each year and approximately 128 women die from this disease out of which 80% can be blamed on HPV. The HPV vaccine, Gardasil, in Canada was approved by Health Canada in July 2006. Overall in the U.S. this disease proves fatal for around 3900 women each year. Also between 1973 and 2000 such cases jumped 400 % in US and invasive vulval cancer increased by 20%.

The vaccine is indicated for the prevention of cervical cancer (70% caused by HPV 16 ad 18), vulval cancer, vaginal cancer, precancerous lesions at these sites and genital warts (90% caused by HPV 6 and 11). All such types of HPV cause a large number of "abnormal" Pap test results and low-grade cervical lesions.

The study was sponsored by Merck who is also the maker of Gardasil along with Sanofi Pasteur.