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GYN Doctors serving patients in Virginia Beach, Chesapeake, Norfolk & Portsmouth

A Gynecology Specialists note: Below is an excellent article on the HPV vaccine that ran in the Virginian-Pilot.

Our GYN doctors agree that the HPV vaccine has a proven safety record and we recommend the vaccine for girls starting as young as 9 years old. It is important to note that we are not condoning early sexual activity; we are trying to prevent cervical cancer for women as well as head and neck cancers for their future partners. We also recommend that boys get the vaccine through their pediatricians or family practitioners.

Our GYN clinic has administered the HPV vaccine to girls and teens since 2008. If you have any questions, please call our GYN Clinic at (757) 312-8221 or reply to this email.


HPV-linked head and neck cancers on the rise, but HPV vaccination rates are low

By Elizabeth Simpson, The Virginian-Pilot – 2/12/2016

Four years ago, Tony Arnold couldn’t have told you much about HPV, other than the vague notion that it stood for human papillomavirus.

But that was before the Virginia Beach man was diagnosed with Stage 4 head and neck cancer in the fall of 2012, linked to HPV.

Now, he’s not only a cancer survivor but an advocate for the vaccine for HPV, the most common sexually transmitted infection. He started by making sure his own four children were vaccinated against the virus, which can lead to cervical, anal, and head and neck cancers.

The 54-year-old director of facilities for the Virginia Beach school division has his work cut out for him. Although Virginia was one of the first states to enact a law requiring sixth-grade girls to receive the three-shot vaccine, the state’s HPV vaccination rates are no better than the rest of the country – and for girls, it’s worse.

In Virginia, the rate of girls 13 to 17 who have had all three of the shots was 36 percent in 2014, according to the latest statistics available, compared with 40 percent across the country. About 22 percent of Virginia boys in that age range have had the shots, compared with 21 percent nationally.

The Virginia law didn’t really have much teeth to it because it had a clause allowing parents to opt out. Also, the law didn’t include boys. A federal advisory committee has recommended the vaccine for girls since 2006 and added boys in 2011.

Recent studies have shown that rates of HPV-related head and neck cancers are rising dramatically for men ages 40 to 50. The rate of head and neck cancers linked to alcohol and tobacco use are decreasing, but those caused by HPV, typically transmitted through oral sex, are going up. A study in the Journal of the American Medical Association’s JAMA Oncology last month found the risk high enough that head and neck cancer is on pace to beat out cervical cancer as the most common HPV-related cancer in the next five years. Although screenings such as Pap smears are in place for early detection of cervical cancer in women, there’s nothing like that to identify HPV-related cancer in early stages for men.

A coalition of the country’s top cancer centers launched a campaign last month to improve the HPV vaccination rates in light of those numbers. The Centers for Disease Control and Prevention recommends the vaccine for girls and boys starting at age 11 to 12, but even earlier, 9 or 10, for children with a history of sexual abuse. The vaccine works best if given before someone becomes sexually active. Studies have also shown that the immune response to the HPV vaccine is better in children ages 9 to 15 than in those ages 16 to 24.

Dr. Douglas Mitchell, medical director for Children’s Hospital of The King’s Daughters Medical Group, cites many reasons for the slow uptake of the HPV vaccine.

When Virginia first passed a school mandate in 2007 for rising sixth-grade girls to receive the vaccine, it was controversial because some felt that it would condone teen sex. Mitchell said there are also people who have concerns about adverse effects of vaccines, particularly newer ones. But he said this vaccination is no longer new and has a proven safety record.

It’s a three-shot series, so that makes it harder to administer as well, especially at an age when the number of doctor visits usually drops off.

“It’s disconcerting that the rate is still so low,” Mitchell said. “There’s stigma and misinformation.”

Rather than focus on the fact that HPV is a sexually transmitted disease, parents need to see the vaccination as a cancer deterrent for their children in the future, Mitchell said. It’s estimated that more than half of the population will have HPV at some time in their lives.

Dr. Daniel Karakla, an ear, nose and throat specialist at Eastern Virginia Medical School, has seen a rising tide of cases in his practice, mostly among men 40 to 60. The ones that are linked to HPV far outpace those related to tobacco and alcohol. It’s frustrating for him to see the low rates of HPV vaccination.

“People need to stop considering it a moral issue or as something to feel uncomfortable about and instead look at it as a prevention measure against cancer,” said Karakla, who treated Arnold’s cancer.

Dr. Dean McGaughey at Virginia Oncology Associates also has seen a dramatic increase in the cancers, typically showing up at the base of the tongue or in the tonsils. He’s seen the increase during the past six years among men in their 40s and 50s. Previously, the tobacco- and alcohol-related head and neck cancers were in patients who were a little older.

The good news for Arnold was that HPV-related head and neck cancer has a more favorable prognosis than the same cancer linked to smoking and drinking alcohol.

The first sign for Arnold was a painless bump on his neck in the spring of 2012. He went to see a family practice doctor, who thought it could be an infected salivary gland. Arnold was prescribed an antibiotic.

By fall, though, the bump was still there. That led to a closer look that revealed a cancer tumor at the base of his tongue. In October 2012, he was diagnosed with Stage 4 head and neck cancer. Treatment sometimes entails surgery, but Arnold agreed to participate in a clinical trial of HPV-linked cancer that used a combination of radiation and chemotherapy, without surgery.

He lost 40 pounds. His saliva glands stopped working. But the cancer disappeared. He has annual scans, and the latest one in January was clear. He buys gum by the box, to make up for his lack of saliva.

“If there’s a blessing, it’s that the HPV-related type is more treatable,” he said.

Now he talks up the HPV vaccine whenever he can, speaking with neighbors, friends, whoever will listen. There’s a small window of opportunity for young people, before they become sexually active, and he doesn’t want them to miss it. The vaccines can be given to people as young as 9 and through age 26.

“Mainly, it’s a lack of knowledge, not just in the general public but in the medical community,” Arnold said.

Actor Michael Douglas also brought attention to HPV-related cancers when he revealed in 2011 that his throat cancer was linked to the virus.

Arnold concedes Douglas may have had a wider audience, “but I’m better looking.”

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Please contact our GYN Clinic at (757) 312-8221 or by clicking here if you have any questions about the HPV vaccine. 

About our GYN doctors

Our all-female practice covers a wide spectrum of health issues, including the HPV vaccination   Since 2004 each GYN doctor at Gynecology Specialists has been caring for women and teens in Virginia Beach, Chesapeake, Norfolk, Portsmouth, Peninsula, Eastern Shore, Hampton Roads and North Carolina.

Gynecology Specialists  |  516 Innovation Drive, Suite 305, Chesapeake, VA 23320  |  Ph: (757) 312-8221 Fax:(757) 312-8382  |  Medical Disclaimer
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