I have been working as a family physician for over 27 years now and feel it is a privilege to be an integral part of my patients’ healthcare. I try my best to give my patients the best care that I can and base my decisions on facts and medical evidence. So I had to do some soul searching when I realized that I haven’t been offering my patients the chance to prevent 90% of a certain type of cancer. I don’t hesitate to offer mammograms, colonoscopies, pap smears, or skin exams. It has been gratifying to detect cancer early on when the treatment is so much more effective, but it would be so much better to be able to prevent cancer rather than treat it. I think the reason I didn’t offer this 90% preventative treatment was because of two things: One, it is a vaccine and two, it is cancer that is spread sexually. I’m talking about cervical cancer and the HPV vaccine.
I have rethought my reluctance to offer this preventative treatment, and I now realize that I was basing my actions on emotions and not evidence. No one likes to think that his or her son or daughter would ever be exposed to a sexually transmitted virus, even transmission through a marriage partner. If I hesitated to screen for any cancer, I would miss the opportunity to save many lives.
I’ve decided that I can never know what my patients or their future partners will be exposed to in their entire lifetime. Rather than passing judgement and denying patients a 90% probability that they’ll never get cervical cancer, I’ll offer the vaccine to everyone. There have been reports online that the HPV vaccine causes infertility and an increased risk for HPV. When I researched this further I found that the source for these findings was a non-scientific article published by an oncology nurse. When I went to the actual study, the conclusion was that the vaccine actually helped prevent HPV. I couldn’t find a single study linking the HPV vaccine to infertility. The most serious side effect that I found was fainting or an allergic reaction to the components of the vaccine.
This past year I have had patients that have been diagnosed with cervical cancer, one passing away months after diagnosis in the prime of her life. The other being treated with the uncertainty for a cure. How much better would it have been to prevent that cancer rather than treat it?
So I have decided that rather than trying to predict the future experiences of my patients, I’m going to recommend the HPV vaccine to all patients. The guidelines is that both BOYS and girls between the ages of 11-12 get it with only two doses needed 6 months apart. After the age of 15 to age 26, three doses of vaccine are needed. From now on I’ll be trying to use scientific evidence rather than emotionally based decisions to help improve the lives of my patients.
January is National Cervical Cancer Prevention Month. For more information go the website, http://www.nccc-online.org/hpvcervical-cancer/cervical-health-awareness-month/ or just do a Google search for National Cervical Cancer Awareness Month. I hope that this will clear up any misconceptions and judgements about the HPV vaccine because I think it is a good thing to prevent disease rather than try to treat it after it is already present.
Roman Takasaki, MD
Canyon View Family Medicine