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How to fight a silent killer

The late Sharon Humphrey and her friend Angela Ferguson, who founded Dance for a Cure, dedicated to fighting cervical cancer, in her honour.

The late Sharon Humphrey and her friend Angela Ferguson, who founded Dance for a Cure, dedicated to fighting cervical cancer, in her honour.

Published Aug 6, 2013

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Durban - When Angela Ferguson lost her friend and fellow dancer, Sharon Humphrey, to cervical cancer in 2007 she founded Dance for a Cure, a community-driven, volunteer-based organisation dedicated to the fight against cervical cancer.

She understands why cervical cancer and the human papillomavirus (HPV) go hand in hand and, while she says the imminent administration of the HPV vaccine to schoolgirls next year is a coup, there is much more that people need to understand about HPV.

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Cervical cancer is the second most common form of cancer among South African women. Research shows that 70 percent of cervical cancers are caused by HPV. Genital warts and some cancers in males are also related to HPV, and most anal cancers, and some cancers of the penis, head and neck are caused by HPV.

But what is HPV and how is it transmitted?

HPV is a hardy, easily transmitted virus that many people are not aware of. It is a common infection, with eight out of 10 adults coming into contact with it.

Lorraine Becker, who specialises in sexual health, says HPV may clear on its own, but no one can predict who will succumb to active HPV disease.

Becker says the virus can cause a variety of diseases in males and females – including but not limited to cervical cancer, vaginal cancer, vulva cancer and genital warts.

It can survive undetected on the skin or under fingernails. It is resistant to heat and drying, and is able to survive on inanimate objects such as clothing and laboratory equipment that have been in contact with infected people. However, the precise survival time of the virus is unknown.

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People who have HPV infections may have no symptoms, but the virus can still be transmitted. People can acquire HPV from others who are infected, but who don’t have visible disease or lesions.

It may take only one encounter to be infected with HPV. Several years may elapse before lesions develop and before they can be clinically detected.

There is no way to know who has been in contact with the virus based on history of relationships or activities.

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The virus is spread from person to person through genital skin contact. It is so common that it could be considered a normal part of being sexually active.

More than 100 types of HPV have been identified, of which about 40 affect the genital area.

HPV infects the skin, often causing irregular cell growth or warts. Genital skin-to-skin contact is believed to be the most common way of transmission. Most sexually active people get at least one HPV infection in their lifetime, usually without ever knowing it. It is very difficult to determine whether a partner who has been sexually active in the past is infected. Transmission is possible even when there are no visible signs of infection. Non-sexual transmission of HPV has been reported.

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HPV has been found quite frequently in young women without previous experience of sexual intercourse.

A mother with HPV can pass the infection to her child during birth, which would be detected in the linings of the nose and mouth of the child.

The HPV vaccine triggers the formation of antibodies to produce immunity and, therefore, protects the body from disease.

Two HPV vaccines have approval in South Africa, namely Gardasil and Cervarix. But they do not offer the same cancer protection. Neither protect against all types of HPV diseases.

Cervarix protects only against two types of HPV, while Gardasil helps protect against four types of HPV – and prevents infection with HPV types 16, 18, 6 and 11.

HPV 16 and 18 are responsible for the majority (about 70 percent) of cervical cancers. HPV 6 and 11 are responsible for 90 percent of genital warts. Gardasil also protects against 70 percent of vaginal cancer cases and up to 50 percent of vulvar cancer cases.

The HPV cancer vaccine is recommended for girls and boys – children and adolescents – aged nine to 17. It’s important for boys and girls to receive the vaccine before they are sexually active and are exposed to HPV. Once infected with HPV, the vaccine may not be as effective.

If not fully vaccinated at ages nine to 17, it is recommended that older girls and women receive the vaccine. Speak to a health-care professional to find out if it would be of value to be vaccinated.

Vaccination is via injection, given as a series of three injections over six months. The second dose is given one to two months after the first dose, and the third dose is given six months after the first dose.

For the vaccine to be effective, it is essential that all three doses are given timeously.

Besides getting vaccinated, there are a few things you can do to decrease the chances of contracting cervical cancer:

* Papanicolaou smears (Pap smears) are the best known way to detect cervical abnormalities, and the vaccine is not intended to replace routine screening for cervical cancer through regular pelvic examinations. Because the progression of the disease is slow, it can take 10 to 20 years for it to become invasive. It is imperative that women get screened regularly.

* Stop smoking or preferably never start. Women who smoke are more susceptible to contracting it. In fact, it doubles their chances.

* Use condoms every time you engage in sexual activity to prevent the spread of the HPV virus.

* Postpone sexual activity to an older age.

* Limit sexual partners because the more sexual partners you’ve had, the greater the chance of having been exposed to multiple strains of HPV. - The Mercury

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