Monthly Archives: March 2009

Debate Over Genetic Screening of Embryos as New Tests Emerge

As more families opt for pre-implantation genetic diagnosis to screen embryos for inherited diseases, determining the regulatory and ethical guidelines to govern such screenings is “proving difficult,” the Chicago Tribune reports. Although the field of embryonic testing initially focused on identifying genetic defects that are certain to cause suffering or death early in life, it has broadened to include tests for genes linked to breast and ovarian cancer, which are not always fatal, occur later in life and affect 50% to 85% of those who carry the gene, according to the Tribune. The leading U.S. genetic diagnosis clinic, which is the largest in the world, conducted more than 1,800 screenings in 2008 “aimed at weeding out embryos that carried worrisome family conditions, from sickle cell anemia to cystic fibrosis,” the Tribune reports. Different countries vary in their regulation of PGD. In the U.S., doctors are allowed to select embryos for a particular sex, a practice that is not allowed in Great Britain, where each instance of PGD must be registered with the British Human Fertilization and Embryology Authority. BFEA has approved the use of PGD for about 70 genetic defects “after intensive public consultation about what is a serious enough problem to justify trying to eliminate it,” the Tribune reports. It is “significantly easier” to conduct PGD in the U.S. because the government only licenses clinics, not individual procedures, the Tribune reports. Mark Hughes, director of the Detroit-based Genesis Genetics Institute, said his company has tested for 171 genetic defects. In the U.S., “there is no approval mechanism,” Hughes said, adding, “No one is saying you can do this to save a sibling but you can’t do this for BRCA1,” a gene linked to breast cancer. According to a John Hopkins University study, nearly 40% of individuals surveyed believed that embryo screening should be regulated more closely for ethical reasons. An additional 19% said the screening should be banned altogether, for reasons ranging from the belief that discarding an embryo is immoral to concerns that selecting against certain diseases will devalue the lives of people already living with those conditions. Clare Williams, a bioethics specialist at Kings College London, said that during public hearings in Britain, “quite a lot of people felt there could well be treatment (for some conditions) by the time these children grow up, and then (their condition) won’t be an issue.” Some experts say it would be beneficial to place limits on the type of genetic defects doctors are allowed to screen for in the U.S., the Tribune reports. The Hopkins study found that, as of 2006, 65% of about 200 U.S. clinics offering embryo screenings allowed clients to choose the gender of the implanted embryo, regardless of the gender of existing children or whether the child was their first. The Tribune reports that such data and a California-based genetics lab’s recent announcement that it would be able to select eye and hair color have raised public concerns about genetic selection of embryos. The lab’s claims have been “disproved,” and many experts believe that expanded embryo screening “probably is not a slippery slope toward designer babies” because PGD is “costly and difficult,” there are a limited number of embryos to choose from and “finding one that includes a number of desired traits would be very difficult,” the Tribune reports. Hughes said the “things you might want to select for in a child — intelligence, athletic prowess, body stature — involve not single genes but many, many genes.” According to the Tribune, PGD, used in conjunction with in vitro fertilization, costs about $3,500 in the U.S. and twice that in Britain (Goering, Chicago Tribune, 3/25).


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Clients of Surrogacy Agency Missing Millions of Dollars After Company Suddenly Closes

The Web site was impressive. An agency called SurroGenesis listed 60 locations worldwide where infertile couples and individuals could find women willing, for a fee, to serve as gestational surrogates. Aspiring parents put up tens of thousands of dollars hoping the agency could help them start families.

Today, SurroGenesis’ main office, in Modesto, Calif., is closed. So is an escrow company, Michael Charles Independent Financial Holding Group, that was supposed to be safeguarding the clients’ money. It turns out that many SurroGenesis locations were post-office boxes. An FBI spokesman, Steve Dupre, said the agency was evaluating the case but had not opened an investigation.

U.S. and international clients of SurroGenesis are missing as much as $2 million after the company suddenly shut down without explanation, according to lawyers familiar with the case, the New York Times reports.

Money gone

SurroGenesis told clients March 13 via e-mail that their money was gone. The shutdown affected about 70 people, some of whom had paid as much as $90,000 for promised gestational surrogacy services. “Many of them have lost their savings, and any chance of having a family is completely destroyed,” said Andrew Vorzimer, a lawyer working with those affected. “We’ve got couples in the midst of pregnancies with no ability to pay the surrogate, or even make insurance payments, which have gone unpaid.”

On the heels of the birth in January of octuplets, conceived by in vitro fertilization to a single California woman who has six other children, the case highlights the lack of oversight in the business of creating babies. There is no licensing requirement for egg-donor and surrogacy companies.

According to the Times, several couples learned about SurroGenesis on the Internet. As part of the agreement for surrogacy services, parents were instructed to deposit money to cover costs in an escrow account. SurroGenesis in a March 13 e-mail told clients that their money was gone and advised them to hire lawyers. The e-mail also said that clients should contact the Modesto Police Department because the escrow company that was supposed to be holding clients’ money — the Michael Charles Independent Financial Holding Group — was no longer paying its bills. California records show that SurroGenesis founder Tonya Collins is also listed as the registered agent for the Michael Charles group, even though it “was supposed to be an independent and bonded escrow company,” according to the Times. FBI spokesperson Steve Dupre said the agency is evaluating the case but has not launched an official investigation. Andrew Vorzimer, a lawyer working with some of the clients, said, “Many of them have lost their savings, and any chance of having a family is completely destroyed.” He added, “We’ve got couples in the midst of pregnancies with no ability to pay the surrogate, or even make insurance payments, which have gone unpaid.” According to the Times, Vorzimer said there is one surrogate carrying twins for a couple who lost more than $50,000. The surrogate is on bed rest, but the couple now is unable to reimburse her for lost wages.

Sources: New York Times, 3/21/2009

Seattle Times, 3/22/2009

Reproductive Health News, 3/24/2009

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Fresh Lemon Grass Drink Causes Cancer Cells To Commit Suicide

Citral =Citral is the key component that gives the lemony aroma and taste in several herbal plants such as lemon grass (Cymbopogon citratus),melissa (Melissa officinalis) and verbena (Verbena officinalis.)

Apoptosis=a type of cell death in which the cell uses specialized cellular machinery to kill itself; a cell suicide mechanism that enables metazoans to control cell number and eliminate cells that threaten the animal’s survival. A drink with as little as one gram of lemon grass contains enough citral to prompt cancer cells to commit suicide in the test tube.

At first, Benny Zabidov, an Israeli agriculturalist who grows greenhouses full of lush spices on a pastoral farm in Kfar Yedidya in the Sharon region, couldn’t understand why so many cancer patients from around the country were showing up on his doorstep asking for fresh image001image002. It turned out that their doctors had sent them. ‘They had been told to drink eight glasses of hot water with fresh lemon grass steeped in it on the days that they went for their radiation and chemotherapy treatments,’ Zabidov told ISRAEL21c. ‘And this is the place you go to in Israel for fresh lemon grass.’

It all began when researchers at Ben Gurion University of the Negev discovered last year that the lemon aroma in herbs like lemon grass kills cancer cells in vitro, while leaving healthy cells unharmed. The research team was led by Dr. Rivka Ofir and Prof. Yakov Weinstein, incumbent of the Albert Katz Chair in Cell-Differentiation and Malignant Diseases, from the Department of Microbiology and Immunology at BGU. According to Ofir, the study found that citral causes cancer cells to ‘commit suicide: using apoptosis, a mechanism called programmed cell death.’ A drink with as little as one gram of lemon grass contains enough citral to prompt the cancer cells to commit suicide in the test tube.

The BGU investigators checked the influence of the citral on cancerous cells by adding them to both cancerous cells and normal cells that were grown in a petri dish. The quantity added in the concentrate was equivalent to the amount contained in a cup of regular tea using one gram of lemon herbs in hot water. While the citral killed the cancerous cells, the normal cells remained unharmed. The findings were published in the scientific journal Planta Medica, which highlights research on alternative and herbal remedies. Shortly afterwards, the discovery was featured in the popular Israeli press.

Why does it work? Nobody knows for certain, but the BGU scientists have a theory. ‘In each cell in our body, there is a genetic program which causes programmed cell death. When something goes wrong, the cells divide with no control and become cancer cells. In normal cells, when the cell discovers that the control system is not operating correctly – for example, when it recognizes that a cell contains faulty genetic material following cell division – it triggers cell death,’ explains Weinstein. ‘This research may explain the medical benefit of these herbs.’

The success of their research led them to the conclusion that herbs containing citral may be consumed as a preventative measure against certain cancerous cells. As they learned of the BGU findings in the press, many physicians in Israel began to believe that while the research certainly needed to be explored further, in the meantime it would be advisable for their patients, who were looking for any possible tool to fight their condition, to try to harness the cancer-destroying properties of citral. That’s why Zabidov’s farm – the only major grower of fresh lemon grass in Israel – has become a pilgrimage destination for these patients. Luckily, they found themselves in sympathetic hands. Zabidov greets visitors with a large kettle of aromatic lemon grass tea, a plate of cookies, and a supportive attitude. ‘My father died of cancer, and my wife’s sister died young because of cancer,’ said Zabidov. ‘So I understand what they are dealing with. And I may not know anything about medicine, but I’m a good listener. And so they tell me about their expensive painful treatments and what they’ve been through. I would never tell them to stop being treated, but it’s great that they are exploring alternatives and drinking the lemon grass tea as well.’

Zabidov knew from a young age that agriculture was his calling. At age 14, he enrolled in the Kfar Hayarok Agricultural high school. After his army service, he joined an idealistic group which headed south, in the Arava desert region, to found a new moshav (agricultural settlement) called Tsofar. ‘We were very successful; we raised fruits and vegetables, and,’ he notes with a smile, ‘We raised some very nice children.’

On a trip to Europe in the mid-80s, he began to become interested in herbs. Israel , at the time, was nothing like the trend-conscious cuisine-oriented country it is today, and the only spices being grown commercially were basics like parsley, dill, and coriander. Wandering in the Paris market, looking at the variety of herbs and spices, Zabidov realized that there was a great export potential in this niche. He brought samples back home with him, ‘which was technically illegal,’ he says with a guilty smile, to see how they would grow in his desert greenhouses. Soon, he was growing basil, oregano, tarragon, chives, sage, marjoram and melissa, and mint just to name a few.

His business began to outgrow his desert facilities, and so he decided to move north, settling in the moshav of Kfar Yedidya, an hour and a half north of Tel Aviv. He is now selling ‘several hundred kilos’ of lemon grass per week, and has signed with a distributor to package and put it in health food stores. Zabidov has taken it upon himself to learn more about the properties of citral, and help his customers learn more, and has invited medical experts to his farm to give lectures about how the citral works and why. He also felt a responsibility to know what to tell his customers about its use. ‘When I realized what was happening, I picked up the phone and called Dr. Weinstein at Ben-Gurion University , because these people were asking me exactly the best way to consume the citral. He said to put the loose grass in hot water, and drink about eight glasses each day.’

Zabidov is pleased by the findings, not simply because it means business for his farm, but because it might influence his own health. Even before the news of its benefits were demonstrated, he and his family had been drinking lemon grass in hot water for years, ‘just because it tastes good.’


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First Israeli gay man gets ‘maternity’ leave

o-eimg_0107omer-yonatan-evyatarThe National Insurance Institute authorized Israel’s first-ever “maternity” leave for a male couple on Thursday. Yonatan Gher, director of Jerusalem’s nonprofit Open House Pride and Tolerance organization, has received institute approval of a 64-day leave from work on the occasion of the birth of his biological son, born of a surrogate mother in India. His partner of seven years commenced formal adoption procedures, so that the child will be formally recognized as his as well.
Despite confirmation of the leave, Gher has not received an answer to his request for reimbursement of NIS 10,000 in hospitalization costs (Gher and his partner also stayed in the hospital prior to the delivery) from the NII.
The process began two years ago, when the couple realized formal adoption by a single man or two gay men was not an option here. They did not want to agree to joint parenthood with an Israeli woman, because they said it would expose the child to a situation similar to divorce.
They opted instead for IVF treatment through Rotunda-CHR, a Mumbai clinic(, and chose the donor of the egg and a surrogate mother. They returned to Israel with their son in November 2008, and Gher took leave. Earlier this month he requested that his leave be acknowledged by the NII, and says he was “surprised” to have received a positive reply within a few weeks, without needing to take any additional action or submit an appeal. Gher sees the decision as a significant achievement. “What we have here is the establishment taking responsibility for a process that had been forced upon us,” he explained. “We have no legal possibility of having a child with a surrogate mother in Israel. Because it won’t allow that, the state is obliged to share with us the costs of the alternative, by the very fact of recognizing the maternity leave.”
The overall cost of the IVF procedure, including all expenses, is estimated by Gher to be over NIS 130,000. Meanwhile, his partner’s request for a leave is presently being debated at a labor court.
New Family organization lawyer Irit Rosenblum, who represents the couple, praised the NII decision. “This is an important milestone on the way to equity for the rights of the same-sex family in Israel. Up to now, the approach of the institute was detrimental to the rights and welfare of children in such families,” she said.
“The purpose of maternity benefits is to allow a devoted parent to answer the most important basic needs of an infant during the first months of its life,” Rosenblum added. “The needs of a male and female parents are identical in this situation, and the time has come for the legislator and the authorities to face reality and prevent gender discrimination in basic family rights.”
Tel Aviv’s District Labor Court is presently debating a precedent-setting lawsuit by two men seeking leave following the birth of their daughter from a surrogate mother in the United States.

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Lavasa Rules!

I was on my last egg-pickup procedure & it was already 2:00pm. The ribbon cutting ceremony was scheduled for 5:00pm. I left the clinic immediately after the patient was settled and got into a big traffic pile-up at Chembur! The express-way was empty at that time of the afternoon & I clocked just over 80 minutes to reach the end of the expressway. Once you turn right from the expressway, it is exactly 20 kms to the Chandni Chowk underpass which leads to the Pirangut-Paud tollgate. Taking the short-cut from just before Pirangut passing the Indai Lawns, I cruised onto the Lavabahn at 4 pm.It would have taken me just 30 minutes more to reach Lavasa, but I was hypnotized by the shades of green, rust & reds.dsc00520dsc00528 March was a different spectacle altogether from February! The Jowar crop had just been harvested & the dried fields were being converted to bundles of hay. I would have thought that the heat would have turned everything around into shades of brown, but I was surprised to see nascent green all around. The 30 minute jouney now took two hours & I fell in love with the wild flowers all over again. dsc00530These were a completely new set of species, which were not seen in the past six months. The majestic trees on both sides of the Lavabahn were swathed with a sheet of exotic red flowers. The helipad appeared around a curve in the road & seeing the helicopter, I realized how late I was. I reached the lobby bang in the middle of the Inaugural ceremony. Hugged my buddies & rushed up to freshen up. Another pleasant surprise – a WOW room!!! ITC has again excelled itself & have created a lovely hotel with ultramodern comforts. Rushed down, but the ceremony was over. Decided to visit Jimmy Shaw’s Waterfront Serviced Apartments. Fida & Jimmy took us for a sneak preview – “WOW-WOW”- this was a whopper surprise. Beautiful & spacious serviced apartments with every imaginable five star amenity in these 43 apartments! The future of Lavasa had arrived. We had time to kill & decided to “experience’ the LEC (LAVASA EXPERIENCE CENTER) next to the Fortune building. Another architectural masterpiece – Elegant straight lines, a airy majestic atrium & a superlative auditorium. This indeed is the showcase of modern India! dsc00540

Around me I hear my friends Deepak & Jimmy remarking on the several species of birds that have congregated on the broken limbs of what at one time must have been beautiful proud trees.  And that’s when it hits me.  This wasn’t always a dried up grove.  At some point this was probably a full and lush grove of trees.  They once claimed this space for themselves.  They lived here, providing a safe haven for countless generations of creatures.  Somehow over the course of time these trees became a casualty of the elements to which they were exposed. Slowly, they succumbed, one by one to the inevitable effects of being deprived of water.  The little collection of trees, that had managed to survive for years unattended, died.  Now only a few brave soldiers still stand tall and proud.  You can see them trying so hard to maintain their dignity as all around them life goes on. At first glance it’s easy to overlook them.  We tend to get so caught up on the hustle and bustle of the life we see all around them.  This bird or that one going about their daily life with the same nearsightedness from which we all suffer.  Each keeping to themselves, going about their day and following their own urgent agenda. It’s not so difficult to understand.  We are ourselves a reflection of the nature we came out here to be with.  At one point or another all of us have been exposed to loss and grief.  Though we might think we’ll never survive such losses; we inevitably do.  As is in the human spirit, we survive and overcome and manage to live day to day in spite of it all. dsc00576dsc00583dsc00596dsc00597These once magnificent trees are a testament to the frailty and beauty of life.  They have struggled through many changes and managed to remain standing through many seasons.  And though they stand here before me; I know they are dying.  Life is no longer theirs to have.  They are destined to keep struggling everyday for that last shred of sunlight to touch their trunks before finally giving in to the red caked earth below. They have so much they would like to tell us.  But it’s hard to hear them over the squawking migratory white birds nearby.  It’s only when we stop and find some stillness that we can hear their tale.
All of us had congregated at Lavasa to witness the grand opening of the ITC Fortune select Dasve Hotel.dsc00609 Our honorable MP Sou Supriya Suleji had inaugurated the hotel & the celebratory party was a few hours down the evening. A group of us friends decided to take a walk around the lake & that is where we discovered this dead patch of trees. The most visionary project taken up by Team Lavasa is the re-forestation of barren slopes & the re-greening of the hillsides which have been cut to make way for the Lavabahn that is the connecting artery to the outside world. This is such a serene world by the lakeside. A beautiful blend of nature & its eco-friendly environment. We walked ahead from this barren area towards the dam and on towards the Portofino street. Jimmy had also inaugurated his out-of-the-world American Diner (A replica of the successful restaurant from India Habitat Center, New Delhi)  that afternoon. We were in for a pleasant surprise… our first onion rings & peanut butter smoothies in Lavasa. We were joined by Dr & Mrs Suri who had also come in from Mumbai for the Fortune launch.dsc00532
The Fortune Select Dasve looked resplendant & bedecked in shimmering lights like a newly wed bride. The glitter of the sparkling lights reflected off the serene waters of the lake. We walked across the “venetian” bridge & joined the party on the lawns of this magnificient building.


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Lavasa Is Red

Red Translations

red in Afrikaans is rood
red in Dutch is rood, blozend
red in Finnish is punainen
red in French is rouge
red in German is rot
red in Italian is vermiglio, rosso
red in Latin is rutilus, puniceus, rufus
red in Portuguese is vermelho
red in Spanish is tinto, rojo

dsc00587dsc00591dsc00626dsc00633Color is an intense experience on its own.
-Jim Hodges

Lavasa is gorgeous. The sunshine in Lavasa is gorgeous red in March. Red is any of a number of similar colors evoked by light consisting predominantly of the longest wavelengths of light discernible by the human eye. In human color psychology, red is associated with heat, energy and blood, and emotions that “stir the blood”, including anger, passion, and love! Lavasa in March is the season of Love. The word red comes from the Old English rēad. Further back, the word can be traced to the Proto-Germanic rauthaz and the Proto-Indo European root reudh. This is the only color word which has been traced to an Indo-European root. In Sanskrit, the word rudra means red. In the English language, the word red is associated with the color of blood, certain flowers (e.g. roses), and ripe fruits (e.g. apples, cherries). Fire is also strongly connected, as is the sun and the sky at sunset. Red is frequently used as a symbol of guilt, sin and anger, often as connected with blood or sex. A biblical example is found in Isaiah: “Though your sins be as scarlet, they shall be white as snow.” The association with love and beauty is possibly related to the use of red roses as a love symbol. Both the Greeks and the Hebrews considered red a symbol of love, as well as sacrifice.

Red is the ultimate cure for sadness.
-Bill Blass

I was having my “missing-Lavasa” pangs & drove down Friday afternoon to my destination of dreams. Had my usual addictive “batata-wada-pao” on the express-way & zoomed onto the Lavabahn, which was as inviting and pristine as ever. The “short-cut” from just before Pirangut towards Lavarde has been tarred & widened for 3/4ths of its length. The Beamer slipped over the top of the Lavabahn like “makkhan”! On the ascent, I noticed the forest covered in red!! The color red is associated with lust, passion, love, and beauty as well. These 4 words describe Lavasa as well. The trees were swathed with red flowers (genus unknown!).The usual drive from the beginning of the Lavabahn takes just 30 minutes, but this time I took all of 75 minutes to reach the Lavasa Dwaar; making many short halts on the way admiring & photographing nature in its full glory. The red flowers on the trees were mesmerizing. The flowers were glowing in the radiant sunlight like fireflies around a bright flame! This was in stark contrast to the jowar fields which were enveloped in rust-brown shades with a little green of dried grass peeking through. This was hay-making time & the villagers along the route were making bundles of hay. The jowar pods reminded me of how life begins from earth & ends there too. The wild shrubs by the sides of the Lavabahn were also sprouting flowers in shades of purple. Nature seemed to be smiling in March.
I got out of my car and decided to take a walk on the wild side.  As I walked and thought about what to spot that resembled nature, I would notice trees with palm-like fronds, flowers, grass, and birds of assorted kinds.  Some of these trees were as high as a third floor building. Nature is amazing no matter how it is created.These huge trees with the red flowers were the predominant feature of my tryst with Lavasa this time.

And then I passed through the Lavasa Dwaar. The landscape here was well organized.  I mean if nature had done it by itself, I know it would not look the same.  Since man organized it, it was different.  It was different in a pretty way though.  The different plants organized in such a manner.  One kind of flowers was in a row and another kind was in a row in back.  The way they placed vines to spread in a certain manner around the plants made it more colorful.  All this was close to the helipad and not a forest, yet it was nature. The sun shone however, it seemed that its rays never quite made it to the deep nature trail created by the Ekaant team which leads to the Dwaar.  Nonetheless, my surroundings seemed to have no complaints at all.  The wild bush, medicinal plants and trees, and flowering shrubs danced merrily to the tune of the wind.  It was then that I realized that even though it was Indian summer time, the area was filled with a colorful scenery.  Adding to the hues of nature were some birds who hung out nonchalantly waiting for a bite to eat.  As I stood there feeling the  wind against my cheeks, I couldn’t help but admire nature’s unique way of taking care of its creatures. I think what impressed me the most was the number of different species that shared the same abode without threatening each other’s territory.

I now spend my days at Lavasa fleeting from flower to flower, photographing these miracles of nature and I’ve discovered that I am not alone. There are hundreds of butterflies out there, in all the hues of nature. For now, it is enough that I have become what I was meant to be and the flowers seem equally happy.

The true color of life is the color of the body, the color of the covered red, the implicit and not explicit red of the living heart and the pulses. It is the modest color of the unpublished blood.
-Alice Meynell

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Facts About Cervical Cancer, HPV Infection

An average of 30 women in the United States are diagnosed with cervical cancer each day. Here‚ is what you need to know about the disease to protect yourself:

Q: What is cervical cancer? What is HPV?

A: Cervical cancer is cancer of the cervix (the lower part of the uterus that connects to the vagina). Cervical cancer is caused by certain types of HPV. When a female becomes infected with certain types of HPV and the virus doesn’t go away on its own, abnormal cells can develop in the lining of the cervix. If not discovered early and treated, these abnormal cells can become cervical precancer and then cancer. HPV is short for human papilloma virus (pap-uh-LO-muh). HPVs are a group of over 100 related viruses. Each HPV virus in the group is given a number, which is called an HPV type. HPVs are called papilloma viruses because some of the HPV types cause warts or papillomas, which are non-cancerous tumors. Of the more than 100 strains of HPV, about 60 HPV types cause warts on non-genital skin, such as on the hands and feet. These are the common warts. The other 40 HPV types are mucosal types of HPV. The mucosal HPV types are also called the genital (or anogenital) type HPVs because they typically affect the anal and genital area. The mucosal HPVs prefer the moist squamous cells found in this area. They do not grow in the skin of the hands and feet. Low-risk HPV types Some types of genital HPVs can cause cauliflower-shaped warts on or around the genitals and anus of both men and women. In women, warts may also appear on the cervix and vagina. These low-risk types can also cause low-grade changes in the cells of the cervix that do not develop into cancer. High-risk HPV types Other genital type HPVs have been linked with genital or anal cancers in both men and women. These types are called “high-risk” because they can cause cancer. They also cause low-grade and high-grade changes in the cells of the cervix and pre-cancers. Doctors worry more about the high-grade changes and pre-cancers, because they are more likely to grow into cancers. In 90% of cases, the body’s immune system clears the HPV infection within 2 years. This is true of both high-risk and low-risk HPV types. In summary, low-risk HPV types can cause genital warts and low-grade changes in the cells of the cervix. High-risk HPV types can cause low-grade changes, high-grade changes, pre-cancer, and cancer in the cells of the cervix. Here is a diagram showing the different groups of HPV types and the problems each group can cause.


Q: Who can get cervical cancer?

A: Women remain at risk for developing HPV infection throughout their lives. Approximately 80 percent of women will have been infected with genital HPV in their lifetime. Most infections clear on their own, but for an estimated 30 women a day in the United States who don’t clear certain types of HPV, cervical cancer develops. About half of all females diagnosed with cervical cancer are between 35 and 55 years old. What many of these women may not realize is that they could have been exposed to HPV as early as their teens or 20s.

Q: How do you get cervical cancer?

A: Almost all cases are caused by the human papillomavirus, or HPV. Genital HPV is spread mainly by direct genital contact during vaginal, oral, or anal sex. It is not spread through blood or body fluids. HPV is passed from one person to another during skin-to-skin contact. It is a sexually transmitted disease, but it’s nothing to be ashamed of‚ HPV is so common that three out of four people will get it at some point in their lives. In one study, more than 50% of college-aged women were found to have gotten an HPV infection within 4 years of first having sex. (There are more than 100 types of HPV, a handful of the most dangerous strains lead to cervical cancer. Some strains also cause genital warts.) In the majority of cases, HPV is no big deal since your immune system can usually fight off the virus before it causes any ill-health effects.

Q: Who gets Cervical Cancer or HPV Infection?

A: Genital HPV is a very common virus. Some doctors think it is almost as common as the common cold virus. In the United States, over 6 million people (men and women) get an HPV infection every year. Almost half of the infections are in people between 15 and 25 years of age. About one-half to three-fourths of the people who have ever had sex will have HPV at some time in their life.

Q: Are there any signs or symptoms I should be looking for?

A: That’s where cervical cancer gets tricky: Many women don’t have any symptoms until the disease progresses. (Even then, symptoms like vaginal bleeding after sex or between periods and pelvic pain or pain during intercourse may be overlooked.) Most people will never know they have HPV because they have no symptoms and the body’s immune system causes the virus to become inactive. A small number of people with HPV will have the virus for a longer time. These people can develop cell changes that over many years may lead to cervical or other genital or anal cancers. That’s why doctors say routine Pap tests are so important.

Q: Who is at high risk of getting Cervical Cancer / HPV Infection?

A: People with the following risk factors are more likely to have genital HPV:

– having many sex partners

– being younger than 25 years of age

– starting to have sexual intercourse at age 16 or younger

– having a partner who has had several different sex partners.

Still, a person who has had sex with only one partner can get HPV if that partner already has the virus. HPV can also be picked up from having sex with an infected person at any age.

Q: How do you test for cervical cancer?

A: A Pap smear can detect abnormal cells in the cervix that could be a precursor to cervical cancer and is your best bet for catching the disease at an early stage.

Q: My Pap test came back normal. Am I off the hook?

A: For now. But cervical cancer is so slow-growing that it may take years for abnormal cells to show up on your Pap test or become cancerous. It’s yet another reason to get tested regularly.

Q: My Pap test was abnormal. Does this mean I am going to get cervical cancer?

A: Not necessarily. The most common abnormal Pap is known as ASC-US or atypical squamous cells of undetermined significance. That doesn’t mean you have cancer‚ it is just that there are some changes in the cells that deserve a second look. Often, doctors will take a wait-and-see approach and have you come back in six months.

Q: What if I go back, and my Pap is still abnormal?

A: If you are not in the clear at your next exam, your doctor may recommend a colposcopy, a simple in-office procedure that makes it easier to spot cancerous changes of the cervix. Should the test pick up changes, your gynecologist will do a biopsy to detect cancer. If the lab finds any traces of cancer, your doctor will freeze or cut away the affected area of your cervix during an in-office procedure. In some cases, doctors recommend a hysterectomy, which is the removal of the cancer, the cervix and the uterus, and possibly radiation and chemotherapy. Any time you get an abnormal Pap test result, ask your doctor if she uses the new HPV DNA test, which detects high-risk strains of the virus from the same sample as your Pap. This test is not recommended for all women, but it can determine whether your Pap results are due to a high-risk strain of HPV.

Q: Is there any way to prevent cervical cancer?

A: Getting the HPV vaccine before being exposed to HPV will prevent some HPV. Limiting the number of sex partners and avoiding sex with people who have had many other sex partners decreases a person’s risk of exposure to HPV. HPV infection is so very common, though, that even these measures are no guarantee that a person will not get HPV. Still, these measures may help reduce the number of times a person is exposed to HPV. Condoms provide some, but not total, protection against HPV. Since nothing is a failsafe, it is crucial to get routine Pap tests if you are sexually active.

Q: Is there a vaccine to prevent HPV Infection/ Cervical Cancer?

A:In 2006, the Food and Drug Administration (FDA) approved a vaccine that prevents the 2 types of HPV (HPV 16 and 18) that cause 70% of all cervical cancers. The vaccine also prevents 2 types of HPV (HPV 6 and 11) that cause 90% of all genital warts. This vaccine is named Gardasil. There is another vaccine that is still being studied to see if it safely prevents HPV 16 and 18. It is called Cervarix, and it is not yet approved by the FDA for use in the United States. Unlike Gardasil, it does not target the wart-causing HPV types.

Q: Is the HPV vaccine safe?

A: Before it was approved, the HPV vaccine was tested in more than 21,000 girls and women in many countries around the world. There were no deaths due to the vaccine, and almost no serious side effects reported during those trials. The most common side effect was brief soreness at the injection site. The FDA has determined that the vaccine is safe and effective for females aged 9 to 26 years. However, CDC and FDA doctors and scientists continue to review all reports of serious side effects reported to watch for potential new vaccine safety concerns that may need further study.

Q: Who should be vaccinated and when?

A: To be most effective, the HPV vaccine should be given before a female has any type of sexual contact with another person. It is given in a series of 3 doses within 6 months. Here are the recommendations for each age group:

girls ages 11 to 12  – The vaccine should be given to girls ages 11 to 12 and as early as age 9.

girls ages 13 to 18  – Girls ages 13 to 18 who have not yet started the vaccine series or who have started but have not completed the series should be vaccinated.

young women ages 19 to 26  – Some authorities recommend vaccination of women ages 19 to 26, but the American Cancer Society experts believed that there was not enough evidence of the benefit to recommend vaccinating all women in this age group. It is  recommended  that women ages 19 to 26 talk to their doctors or nurses about whether to get the vaccine based on their risk of previous HPV exposure and potential benefit from the vaccine.

Q: What about women over 26 years of age? Should they get the vaccine?

A: Women over 26 years of age were not included in the studies that were done to test the vaccine. That means the FDA could not approve the vaccine for this age group. Studies are now being done in women ages 27 to 55. When those study results are known, a decision can be made about whether to vaccinate women in this age group. Keep in mind to HPV  that the risk of HPV exposure is highest soon after women become sexually active. So it is likely that women over 26 have already been exposed, and would not benefit much from the vaccine.

Q: Are there some girls or women who should not get the HPV vaccine or who should wait?

A: Yes. Anyone who has ever had a life-threatening allergic reaction to yeast or anything else in the HPV vaccine, or anyone who has had a reaction to an earlier dose of HPV vaccine should not get the vaccine. Tell the doctor if the girl getting the vaccine has any severe allergies. Pregnant women should not get the vaccine. Even though it appears to be safe for both mother and the unborn baby, it is still being studied. If a woman who is pregnant does get the vaccine, this is not a reason to consider ending the pregnancy.

Q: What are the benefits of the vaccine?

A: The vaccine will prevent the 2 types of HPV that cause most cervical cancers (about 70%) and the 2 types of HPV that cause most genital warts (about 90%), but only in women who have not already been exposed to these types of HPV. It also helps prevent vulvar and vaginal cancers related to these 2 types of HPV. The vaccine will not prevent HPV in women who have already had these HPV types.

Q: Will women and girls who have been vaccinated still need Pap tests?

A: Yes. People who get vaccinated will still need Pap tests because the vaccine will not prevent all types of HPV that can cause cervical cancer

Q: What can you do?

A: Thanks to the availability of Pap tests, and the vaccine, cervical cancer is one of the most preventable cancers. It is important for every woman to know her cervical cancer facts! Talk to your health care professional today about ways to help protect yourself from the disease.

Sources: American Cancer Society, Mayo Clinic


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