Cervical cancer is caused by a virus called HPV.

The full name of the virus is human papillomavirus. (“Papilloma” is pronounced “pap-ah-LO-mah.”) But from now on we’ll simply call it HPV.

There are over a hundred types of viruses called HPV – it’s a very common virus.

Most HPV types can cause warts – usually in the genital area, sometimes in the mouth or throat. Though wart-causing HPV types aren’t exactly welcome guests, they do not lead to cancer.

However, some HPV types on your cervix can lead to cervical cancer. These types of HPV are called high-risk HPV. Going forward, when we use the term HPV, unless we say otherwise we’re talking about high-risk HPV. Two HPV types in particular are the worst. These two – HPV types 16 and 18 – are responsible for about 70% of all cervical cancers.

High-risk HPV itself is not cancer. And, having high-risk HPV doesn’t mean you’ll get cancer.

In fact, as women, 8 out of 10 of us carry high-risk HPV at some time in our lives. Nothing bad happens – it just quietly goes away. To say this another way: While most women have HPV at some point in their lives, few women will get cervical cancer.

But sometimes high-risk HPV sticks around. For years. The medical term is persistent HPV infection.

And persistent high-risk HPV infection can lead to trouble. The virus can start causing changes in healthy cells. The cells become abnormal cells that can eventually lead to cancer. It takes about 10-15 years for cervical cells to change to abnormal cells and then into cervical cancer.

And persistent high-risk HPV infection can lead to trouble.

The virus can start causing changes in healthy cells. The cells become abnormal cells that can eventually lead to cancer. It takes about 10-15 years for cervical cells to change to abnormal cells and then into cervical cancer.

Frequently Asked Questions About HPV

How does someone get HPV?

Most people get HPV through vaginal or anal intercourse.
HPV can also be transmitted by skin-to-skin contact in the genital area (the area around the vagina and penis).
How can I avoid getting HPV?

• The best way to avoid HPV is not to have sex or sexual contact.
• If you choose to have sex, have your partner use condoms. Condoms can help protect against HPV. But since you can get HPV from skin-to-skin contact in the genital area, even people who use condoms can get HPV.
• Agree with your partner to only have sex or sexual contact with each other. But remember, even if you both swear total fidelity, you still have to be tested, like everyone else.
• If you are 26 or younger, you can get an HPV vaccine. It’s approved for girls and boys ages 9 through 26, but is recommended specifically for ages 11 and 12. The vaccine helps protect against the 9 types of HPV that cause cancers like cervical and other HPV-related cancers and diseases.

Does anything make HPV more dangerous to me?

Yes. If any of these factors are in your life, you and your healthcare provider must pay special attention.

• Smoking. Yet another reason to stop now! See quitsmoking.about.com
• A compromised immune system. Many diseases can compromise the immune system – making it difficult to fight off infection such as HPV. These diseases include lupus and HIV/AIDS. When you are tested, make sure your medical provider knows if you have a compromised immune system.
• An infection with chlamydia or herpes simplex virus type 2.
• Multiple pregnancies. The more babies a woman has given birth to, the greater her risk of cervical cancer. Researchers suggest that this could be a result of hormonal changes during pregnancy or changes in the immune system during pregnancy.
• A first-degree relative (mother or sister) with a history of cervical cancer. Research reports that this increases personal risk three-fold.
• Low levels of folic acid (a type of Vitamin B). Ask your health care provider if you need to be tested for this, and how you can increase your intake of this vitamin.
• Possibly, the use of oral contraceptives for over 10 years. The jury is still out.
• Exposure while in the womb to a medication called DES, which was prescribed to many women to prevent miscarriage between 1938 and 1971. The daughters of women given low-dose DES are at risk.

What are the symptoms of HPV infection?

The high-risk HPV types that can cause cervical cancer don’t cause any symptoms. No warts. No blisters. Nothing. The only sure way to know if you have HPV is to get tested!

What is cervical cancer?

Cervical cancer is cancer of the cervix, which is the opening from the vagina to the uterus. Cervical cancer is caused by high-risk HPV (the human papillomavirus). For more information on high-risk HPV, go to the section called HPV.

Is cervical cancer preventable?

Cervical cancer is preventable! You just have to know what to do.

• An HPV vaccine is available for girls, boys, young women and young men 26 years of age and younger.

The section called Prevention explains in detail what the vaccine is and why, even if you are vaccinated, you still need to be tested.

• Two tests provide an early warning system.

A Pap test looks for abnormal cells. If needed, these can be treated before they become cancerous.

An HPV test looks for high-risk HPV that can cause abnormal cells. This lets your healthcare provider monitor you more closely for cell changes.

Find out more in the Prevention section.

• Safe, widely available treatments can remove abnormal cells.

The Understanding Abnormal Cells section describes the procedures your healthcare provider uses to get rid of abnormal cells before they turn into cancer.

What are the symptoms of abnormal cell changes or cervical cancer?

Just like HPV, abnormal cell changes don’t cause symptoms. In fact, the early stages of cervical cancer often don’t cause symptoms either. The path to cervical cancer – HPV infection, abnormal cells and early cancer – is a silent one. Over a period of years your cervix may be developing a problem without you suspecting a thing. That’s why it’s so important to get tested regularly.

If there are any cervical cancer symptoms, they may include:

• Pain during sex
• Unusual vaginal discharge or bleeding – especially after sex
• Lower back pain
• Painful urination

If you have any of those symptoms, contact your healthcare provider.

Does a diagnosis of cervical cancer mean I’m going to die?

No! Check out our Cervivor Stories to read about all of these great women who have survived cervical cancer. There are many effective treatment options available. There’s also lots of support available, like us! We are here to help you regain control of your life.

An interesting fact about cervical cancer treatment: Only 3 new cervical cancer treatments have been approved over the last 20 years. Surprising, isn’t it?

The treatments that we have happen to work well for many patients. But there are patients who have a high risk of recurrence, regardless of their stage. Recurrence depends more on lymph node involvement than stage of cancer. So women with stage 1 may be harder to treat than women in stage 4 because of their lymph nodes. And we don’t have medications that work well in women once they’ve had a recurrence. So there is work to do!

All this being said, in order to develop new treatments, we need to have clinical trials. The truth is, clinical research is the only way we ever can get any medications for any of our health conditions.

• We need clinical trials to drive progress.
• We need trials to determine the safety and effectiveness of every type of treatment.
• And in order to determine that safety and effectiveness, we need volunteers.

According to the American Cancer Society, “The biggest barrier to completing clinical trials is that not enough people take part in them. Fewer than 5% of adults (less than 1 in 20) with cancer will take part in a clinical trial.”

You may be asking, “doesn’t that just make me a guinea pig for some pharmaceutical company?” The answer is no! It makes you an important part of medical research, a person who is helping to further the science and develop new treatments.

“I decided that if this clinical trial was good enough for Jimmy Carter, it was good enough for me!” Teolita Rickenbacker

But what’s the benefit to the patient? There are a few:

• Access to innovative treatments: Clinical trials can give you access to innovative treatments that aren’t available to other patients. Only treatments that have been through clinical trials and are approved by the Food and Drug Administration (FDA) are available to patients.
• Dedicated care: When you are in a clinical trial, your clinicians are committed to providing high quality care and monitoring. They are also committed to finding new and advanced cancer treatments.
• Hope for success: Some patients run out of treatment options and clinical trials offer them hope. New and innovative therapies can be successful when other treatments stop working.
• Possible coverage of medical expenses: Some study sponsors may provide payment for your medical care and any expenses (such as travel or accommodations during your treatment).

“I think being on a trial saved my life. I wasn’t nervous about being on the trial. I was hopeful I would be accepted. At the time, the trial increased my odds by 16%. I had to travel from FL to Houston for treatment to participate but it was worth it to me. When I hear about trials and the research that is being done, I am grateful for the scientists committed to finding treatments that will save lives.”
Linda Ryan

Clinical Trials 101

There are four phases of clinical trials. These all occur after research has already been completed in the lab and the drug is ready to be given to a human being.

Phase I: Phase I trials find the highest dose of the treatment that can be used without causing serious side effects. Phase I studies often involve a small number of patients and are trying to determine the safety of the drug. Patients may have different kinds of cancer in Phase I.

Phase II: After a drug is shown to be safe in Phase I, it is tested in Phase II to figure out the optimal dose and provide data to show whether the drug works. Patients usually have the same type of cancer but it may be at different stages.

Phase III: After making it through Phases I and II, a drug can move onto Phase III if the earlier results are good. Phase III trials are large studies with hundreds or thousands of patients in multiple study centers around the U.S. and often around the world. Patients often have a specific type and stage of cancer. Phase III trials are used to produce evidence to support FDA approval of the drug. Note: Sometimes you hear about global randomized studies. This means that there are sites around the world and that patients are randomly assigned to either the treatment being studied or the standard of care treatment.

Phase IV: Phase IV trials are called post-marketing trials as they occur after a drug is approved. They follow patients for many years to determine long-term side effects.

How will I be protected in a clinical trial?

Anyone who enrolls in a clinical trial will have to provide informed consent. What this means is that the doctor explains the trial, the procedure, the costs (if any) and the potential benefits and risks. You will have to read through and complete a lot of paperwork and sign a lot of forms. During the informed consent process, you want to be prepared with any questions. This is the time to ask the doctor what the logistics of the trial are, what will happen during the trial, and what you need to be prepared for during the trial. This is the time where you decide whether the trial is right for you.

Should you participate in a clinical trial?

There are many factors you should discuss with your clinician, review with your family, and think through for yourself.

1 – Understand the risks.

2 – Know what the benefits are.

3 – Find out if there are costs involved or if everything will be covered.

4 – See if the logistics will work for you and your family (including appointment schedule, transportation and lodging requirements if necessary, etc.)

5 – Think about your goals and expectations for the trial. Are they realistic? What do you hope to get out of the trial?

“My next treatment will probably be through a clinical trial. Scientists know that with recurrent cervical cancer, traditional treatments stop working sooner or later. And doing too many chemotherapy treatments could diminish the chances of being accepted in some clinical trials, so I need to choose each treatment strategically.”
Marilou Gougeon

Important Facts About Clinical Trials:

1. Participation in a clinical trial is voluntary.
2. There are very specific eligibility criteria for each trial. You may or may not be able to participate depending on your circumstances.
3. You must give your written, informed consent before you take part in a trial.
4. You have the right to leave the study at any time for any reason.

To find clinical trials, visit:

www.clinicaltrials.gov
www.emergingmed.com

Here are some statistics to help you put cervical cancer into perspective:

• Each year, more than 500,000 women worldwide develop cervical cancer and about 275,000 women die from the disease. The majority of these deaths occur in developing countries.
• The American Cancer Society estimates that about 12,900 new cases of invasive cervical cancer will be diagnosed in the United States in 2015.
• About 4,100 women are estimated to die from cervical cancer in 2015.
• In the United States, Hispanic women are most likely to get cervical cancer, followed by African-Americans.
• In 2011, African-American women were more likely to die of cervical cancer than any other group, followed by Hispanic, white, Asian/Pacific Islander, and then American Indian/Alaska Native women.
• Most cases of cervical cancer are found in women younger than 50. It rarely develops in women younger than 20.
• More than 15% of cases of cervical cancer are found in women over 65.

Sources:
American Cancer Society. Accessed online July 2015
Centers for Disease Control. Accessed online July 2015