HPV follow up decreases chances of cervical cancer
By Glenna Picton
When a woman is diagnosed with the human papilloma virus (HPV), it may take years to get rid of the infection.
Don't panic, said Matthew Anderson, M.D., assistant professor of obstetrics and gynecology and a gynecologic oncologist in the Dan L. Duncan Cancer Center at Baylor College of Medicine. Regular doctor visits to monitor the infection can reduce the risk of developing cervical cancer later. Cervical cancer is associated with HPV infection.
Body's job to fight infection
"There really are no treatments for HPV," said Anderson. "It is a viral infection, much like the flu, that your body has got to fight off on its own."
Some types of HPV are more closely associated with developing cervical cancer than others. Women infected with these types of HPV should have more frequent Pap smears than usually recommended, he said. This allows physicians to monitor the infection more closely.
"Depending on what the cells in the Pap smear have to say about the severity of cervical dysplasia (abnormal cells in the opening to the uterus), we might need to perform more diagnostic procedures," said Anderson.
Dysplasia means there are abnormal, precancerous changes in the cells of the cervix, the opening to the uterus. Anderson said these abnormalities can become cancer decades down the road.
Treatment options
"If the cervical cytology (study of cells) is normal, and you're just infected with HPV, we may just follow you closely. It may not be necessary to do anything more than just wait for your body to clear that infection," said Anderson. "But if you have severe dysplasia, more intervention might be necessary to make sure we are not missing a cancer. The same procedure may enable us to eliminate the precancerous cells from your body."
These diagnostic procedures may include a colcoscopy (an illuminated view of the cervix), small biopsies on the cervix or a loop electrosurgical excision procedure to remove a larger piece of tissue, Anderson explained.
The follow-up Pap smears can determine whether or not the worrisome lesions have been eliminated and stay gone, Anderson said. If this is the case, it decreases the risk that these abnormal cells will turn into cancer.
Anderson suggests a follow-up Pap smear about every six months. It can take months to even years to eliminate the infection, he said. For some, it can take even longer. Some women never get rid of the infection. No one knows for sure why this is.
Promising research
Research is ongoing at BCM for a gene therapy trial for women who may have cervical precancers and are unable to clear the infection.
"We are currently in phase II of the trial and have experienced successful results," said Anderson. "I think this method of treatment holds great hope for these patients."
"The introduction of the HPV vaccine has generated a lot of questions about the infection," said Anderson. "This is a very common disease that infects as many as half of all sexually active women."
