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BOTTOM LINE: Vaccine for a Cancer You Can Catch



 
 
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Old August 19th 07, 10:46 PM posted to misc.kids.health,misc.health.alternative,talk.politics.medicine,ca.politics
Ilena Rose
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Default BOTTOM LINE: Vaccine for a Cancer You Can Catch

http://ilena-rosenthal.blogspot.com
http://www.bottomlinesecrets.com/blp...ticle_id=37413

Vaccine for a Cancer You Can Catch
Cervical and Penile Cancer
Eliav Barr, MD
Merck Research Laboratories, Merck & Co., Inc.
Tung T. Nguyen, MD
University of California
Keerti V. Shah, MD, DrPH
Johns Hopkins School of Hygiene & Public Health

reprinted from Daily Health News, January 23, 2006
URL:
http://www.bottomlinesecrets.com/blp...ticle_id=37413

According to the American Cancer Society, 10,520 US women developed
cervical cancer in 2004, and 3,900 are expected to die from it. Now, a
new vaccine for preventing many cervical cancers (and cancers of the
penis) shows promising results, according to a recent study published
in the British medical journal The Lancet Oncology. Merck & Co., the
developer of this experimental vaccine, called Gardasil, sponsored
this Phase II study. The results were so good, Merck has filed for FDA
approval. Of course, the great results for Merck were based on
research funded by Merck -- and as we have seen all too often in the
recent past, it is dangerous when the fox guards the research
henhouse.

Is this an incredible "magic bullet?" Or are there risks involved? Or,
is it missing the mark altogether?

A VIRUS IS THE CULPRIT... AFFECTING MEN AND WOMEN

A common form of cervical cancer is often induced by the sexually
transmitted human papilloma virus (HPV) -- the same virus that causes
genital warts. In men, HPV is a risk factor for cancer of the penis
and may play a role in some throat cancers. Infection usually occurs
in the early years of sexual activity, but can take up to 20 years to
morph into a full-blown malignant tumor.

Infection with HPV is very common (an estimated 20 million American
men and women are infected with it), though being infected with HPV
does not mean you will get cancer. About half of sexually active women
and men are infected with HPV during their lifetime. The Centers for
Disease Control and Prevention (CDC) estimates that 6.2 million
Americans get genital HPV every year. Most cases clear up, thanks to
the immune system's antibodies produced to respond to virus. The
antibodies persist in you even after you recover from it. Sometimes,
however, the infection lives on, occasionally causing cancer decades
later in both men and women. Having more than one sex partner can put
a woman at greater risk due to potentially more exposure to the virus
and multiple strains of it. Additionally, women's internal tissue is
more susceptible to cell mutation caused by the HPV.

IS A VACCINE THE ANSWER?

Vaccines have become a very controversial subject in the medical world
-- so, is this vaccine a silver bullet for a deadly disease? To find
out, I spoke with three experts -- the lead developer for Merck's
vaccine, Eliav Barr, MD... Keerti Shah, MD, DrPH, a noted Johns
Hopkins cancer specialist... and Tung Nguyen, MD, from the department
of medicine of the University of California, San Francisco.

All three doctors agree that all girls should get this vaccine before
they become sexually active, ensuring that they are not already
exposed to and/or infected by the virus. "It's probably the right
thing to do," said Dr. Shah. Dr. Barr recommends it for all girls ages
10 to 12.

I asked the three doctors who was at greatest risk for getting
cervical cancer and it turned out to be the one area of disagreement.
While Dr. Barr and Dr. Shah feel that all women have equal risk -- no
matter what their ethnicity or socio-economic background, Dr. Nguygen
said, "that's just not true." He said "Vietnamese-American women, have
a rate of cervical cancer that is five times that of white women, and
African-American and Hispanic women have rates around two times that
of white women."

I asked Dr. Nguygen if Merck's slant on who was at risk might have
anything to do with how much vaccine Merck hoped to sell. After all, I
said, they'll sell more vaccine if it affects all women, rather than
just a minority. Dr. Nguygen replied, "As a doctor, I would never say
anything bad about a pharmaceutical company." And he does feel it
would benefit all women to be vaccinated and it would make the Pap
test obsolete, which would save millions of dollars in health-care
costs.

Pressing on, I asked whether he feels at all uncomfortable about the
fact that Merck funded the study. He said it was "a good point and
something to think about. But what's important is whether it's a valid
study or not." And Dr. Nguygen thinks it is. He added, "Vaccine-based
prevention is always the most desirable mode of prevention... " Beyond
abstinence, or use of barrier contraception such as condoms, that is.

I asked Merck's Dr. Barr about the risk of getting the virus from the
vaccine. "There is no possible way, because it is not a live vaccine,"
said Dr. Barr. Dr. Shah agreed, saying, "There is zero chance, since
it has no DNA." However, there is a chance that the vaccine won't take
and therefore won't protect against the virus.

Is there any downside? For Dr. Barr there is only one... temporary
soreness at the injection point. Dr. Shah believes one negative is
that "no one knows how long it will last." That will only come with
time. And, since the vaccine is thimerosol-free, it does not carry the
risk of mercury poisoning.

According to Dr. Barr, the vaccine was 90% effective in preventing
transmission of the virus in tests over the course of the six-month
study and two-and-a-half year follow-up. Of course, since the vaccine
has only been around a short time, long-term effects are not yet
known.

A SHOT IN THE ARM FOR MEN, TOO

The vaccine is currently being tested on men, where it can benefit in
three ways...

1. Prevent genital warts. While not cancerous, they are "embarrassing
and disrupt relationships," said Dr. Barr. He also noted that current
treatments are painful, because the lesions are burned off. Plus, the
treatments are not very effective, requiring three or four treatments
if effective at all.
2. Protect from anal cancer -- a cancer that is seeing a growing
number of cases.
3. Help prevent their female partners from infection, because most
women get it from men. Same-sex transmission between women is
possible, although far less common.
IS IT MISSING THE MARK?

After my conversation with the doctors, the vaccine seems like a
slamdunk, right? Not so fast. Critics of the vaccine argue that
vaccines are not without some risks, especially brand-new ones without
a long track record. Some in the religious community argue that
abstinence is the way to go for young people. And what about the 10%
for whom it just doesn't work? Good points. Whether it's right for you
or not is for you to decide for yourself.


--------------------------------------------------------------------------------

Sources

Eliav Barr, MD, senior director of clinical research, Merck Research
Laboratories, Merck & Co., Inc., Whitehouse Station, New Jersey.
Tung T. Nguyen, MD, associate clinical professor, department of
medicine, University of California, San Franciso.
Keerti V. Shah, MD, DrPH, professor, Johns Hopkins School of Hygiene &
Public Health, Baltimore.
 




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