gynecological cancers

Gynecological Cancers

HPV vaccine
The drug, which was introduced to the society as a cervical cancer vaccine, is actually a vaccine developed against the microorganism called Human Papilloma Virus (HPV). The importance of HPV is that it is responsible for almost all cervical cancers.

What is HPV?
Human papilloma virus is a virus that has more than 100 different types and some types can be transmitted sexually and cause cancer in some body parts such as genital warts in both men and women, cervix, penis, anus, nasopharynx (throat).
The most common cause of cancer is cervical cancer, and other types of cancer are much rarer. Among nearly 40 types that cause infection in the genital area, some of them carry a high risk in terms of the potential to cause cancer. Among the high-risk group, HPV type 16 and type 18 are responsible for approximately 70% of cervical cancers. HPV types 6 and 11, which are in the low-risk group for cancer, are the cause behind 90% of genital warts. HPV infections that cause cervical cancer almost never show symptoms, do not cause any complaints and are only detected in routine screening tests.
Whether a woman has HPV virus or not, and if so, which type it is can be determined by examining the secretion sample from the vagina.

Cervical cancer?
Cancers of the cervix, which is the neck of the uterus (uterus) in the vagina, cause many women to die every year in the world. In the United States alone, 10,000 new cases of cervical cancer are diagnosed each year, and 3700 women die from this cause. In many developing countries, cervical cancer ranks first or second among cancers that cause death in women. The only known cause of cervical cancer is high-risk HPV. In other words, cervical cancer is a sexually transmitted disease, a virus infection. Although it is so easily transmitted and so deadly, cervical cancer is a preventable disease. The most effective way to prevent is PAP smear. Every healthy woman should have this test done at intervals that her doctor deems appropriate.

What is the HPV vaccine?
Studies on the fight against HPV infections, which are a serious health problem in the world and which we encounter with increasing frequency due to more free sexuality, started in the early 1990s. It took the 2000s to develop a vaccine that could effectively prevent these infections. As a result of studies on more than 10,000 women all over the world, the HPV vaccine was made available in the United States in 2006 with the approval of the American Food and Drug Administration (FDA). This was followed by some European countries and Australia. It has been in use in our country since April 2007. Currently, 2 different vaccines produced by two different companies are used.
HPV vaccine is actually an application that provides protection against 4 types of HPV. The vaccine, which is sold in our country with the trade name Gardasil, is a vaccine developed against HPV types 16 and 18, which are responsible for 70% of cervical cancer, and types 6 and 11, which are responsible for 90% of genital warts.
HPV vaccine is a preventive vaccine and has no curative properties. In other words, the vaccine does not have the feature of curing the disease in people who have previously encountered Type 6,11,16 and 18 HPV. When it is done before encountering these viruses, its protection approaches 100%.

Who should get the HPV vaccine?
The FDA recommends that HPV vaccine be administered to all women between the ages of 9-26 who have not been exposed to these viruses before. For now, it is not recommended to be applied to women over the age of 26, as there are no trials on older women and there is not enough data available. The ideal is to complete the vaccination program before sexual life begins.

The Turkish cervical cancer study group specified 11-12 year old girls as the target population, 13-26 year old girls for catch-up vaccination and women up to 55 years old for personal vaccination.

Since its effects on men are not fully known, it is not recommended to be administered to boys in many countries, but it is included in the vaccination program for boys in some countries. In some states of America, it is included in the routine vaccination program.

How is the HPV vaccine administered?
HPV vaccine is administered as a total of 3 injections within 6 months. After the first dose, the second dose is administered 2 months later, and the last dose 6 months later. Rarely, pain, swelling and redness may be seen at the application site. It may cause weakness, fatigue or nausea in some patients. It would be appropriate to perform HPV typing on the sample to be taken from the vagina before vaccination. There is no need for typing in children and those who have not had a sexual life before.

How long does the HPV vaccine take effect?
There is no definite information on this subject. Studies show that 5-year protection is complete. Whether the effect lasts longer than 5 years and whether an additional dose is needed at the end of 5 years will be revealed after studies to be carried out over time.

What is the relationship between HPV vaccine and annual PAP smear?
Since the vaccine is only effective against some HPV types for now, it definitely prevents cervical cancer. Therefore, people who have been vaccinated should continue their annual smear checks.

Can people with HPV infection be vaccinated?
It is important to perform HPV typing in women with changes in smear controls. If any of the HPV types 6,11,16 and 18 are not detected as a result of typing, it is beneficial for these women to be vaccinated. There is not enough data on the effectiveness of the vaccine in women with HPV types 6,11,16 and 18 positive.

Can HPV vaccine be given to pregnant women?
There are insufficient data on the effects of the vaccine in pregnant women and their babies. Although the limited data do not indicate any adverse effects, HPV vaccination is not recommended in pregnant women. Women who become pregnant after starting the vaccination program should wait postpartum to complete 3 doses. On the other hand, it is not recommended for these women to terminate the pregnancy with abortion just because of the vaccine.

Is unprotected intercourse allowed after HPV vaccination?
The HPV vaccine only protects against conditions caused by related viruses. It has no effect on other sexually transmitted diseases such as AIDS, herpes, gonorrhea, Hepatitis B. Condoms are the only and most effective way to prevent these diseases.

How much does the HPV vaccine cost?
The total cost of 3 doses in the United States, where the vaccine is produced, is around $360. This is one of the most expensive vaccines ever produced. Considering that cervical cancer ranks first or second among cancers seen in women among underdeveloped or developing countries where the PAP smear screening program is not widely used, these countries should be the main target population of the vaccine. However, the high price unfortunately limits the availability of the vaccine in these countries. It is hoped that in the very near future, his salary will be reduced to achievable limits. Some large foundations and charities, especially the Gates Foundation, provide considerable assistance for the vaccination of children in underdeveloped countries.

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