New cancer vaccine targets cervical disease

By MAE LORRAINE S. RAFOLS

Cervical cancer remains as the second leading cause of cancer deaths among women in the Philippines because its symptoms are very subtle, that most patients are unaware of having the disease until it’s in its later stages.


This was recently pointed out by Dr. Efren Domingo, president of the Society of Gynecologic Oncologists of the Philippines (SGOP) during a press conference recently held at the Crowne Plaza Galleria Manila, to announce the approval of the first cervical cancer vaccine by the Bureau of Food and Drugs (BFAD).

Dr. Domingo explained that most women are not aware that they already have cervical cancer since most of those infected show no signs of having the disease until it’s too late.

"Usually, they know about the disease when they are already in stage 3 of their cancer. This is because cervical infections don’t normally show any kind of symptoms. Not everyone who has Human Papillomavirus (HPV) automatically gets diagnosed with cervical cancer," he said.

Cervical cancer is caused by the HPV virus, a very common virus that infects the genital areas of women. Most types of the virus are relatively harmless, do not cause any noticeable symptoms, and usually go away on their own through the body’s natural immune response. There are about 630 million people infected with HPV worldwide.

It is the high-risk types of HPV – types 16, 18, 31, and 45, among others, which leads to cervical cancer and other genital disease.

"It’s a sad fact that despite the prevalence of cervical cancer in the country, only a few people seem to be aware of its danger," said Dr. Domingo.

According to the 2005 Philippine Cancer Facts and Estimates published by the Philippine Cancer society Inc., there were 7,277 new cases recorded in 2005, and 3,807 died because of the disease. Approximately 10 Filipino women have died each day because of it. Worldwide, there is an estimated half a million cases of cervical cancer, 240,000 of which, led to death.

Meanwhile, Dr. Susan Nagtalon, president of the Philippine Obstetrical and Gynecological Society, Inc. (POGS), said that women who are considered sexually active are those at high-risk of contracting the disease.

"One needs to understand that cervical cancer is a sexually-transmitted disease. It is not caused by genetics like other cancers. It is caused by the virus, HPV," she said.

Symptoms of cervical cancer are: Bleeding at a time when she’s not supposed to; unilateral heat pain that radiates down the pelvic bone; cramps; and discharge of foul smelling liquid.

The best way to detect cervical disease is through the Pap test or pap smear. This detects abnormal or cancerous cervical cells. Not only can pap smear detect cancerous cells, it can also detect minor cervical abnormalities such as genital warts caused by low-risk HPV types such as types 6 and 11.

Dr. Nagtalon said that women who are already sexually active or had sex already should have constant pap smear tests.

"Those who are sexually active should have regular gyne check-ups. On the other hand, monogamous women aged 18 to 35 can have their pap smear test every two to three years, and women 40-50 years old can have it every five years," she said.

During the event organized by pharmaceutical company Merck Sharp & Dohme (MSD) Philippines, it was also announced that BFAD has approved the Quadrivalent Human Papillomavirus Recombinant Vaccine, the first vaccine designed to prevent cervical cancer and vulvar and vaginal pre-cancers caused by HPV types 16 and 18; and to prevent low-grade and pre-cancerous lesions and genital warts caused by HPV types 6, 11, 16, and 18.

"The vaccine is the best way to prevent cervical cancer, and can be administered to women from age nine to 28 years old," said Dr. Domingo.

"This is a breakthrough vaccine, as it is the first vaccine made for cancer. There are no side effects, and it doesn’t affect women’s fertility and womanhood," explained Dr. Nagtalon.

The vaccine is given in three doses – zero month, after two months, then after six months.

The efficacy of the MSD vaccine, was evaluated in four placebo-controlled, double-blind, randomized Phase II and Phase III clinical studies.

Together, the studies evaluated 20,541 women aged 16 to 26 years old. Study participants were followed for up to five years after enrollment.

Results showed that the MSD vaccine prevented 100 percent of HPV 16 and 18-related cervical pre-cancers and non-invasive cervical cancers. The vaccine also prevented 95 percent of low-grade lesions and pre-cancers caused by HPV 6,11, 16 and 18; and also prevented 99 percent of cases of genital warts caused by HPV 6 and 11.

The studies also showed that administration of the vaccine to women who are already infected with one or more vaccine-related HPV types prior to vaccination protects them from clinical disease caused by the remaining vaccine types but may not alter the course of an infection that is already present.

More information is at www.merck.com