PINN POINT ON WOMEN'S HEALTH
Transcript
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PODCAST ON MONDAY, MARCH 19, 2007
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ANNOUNCER: From the National Institutes of Health in
DR. PINN: Welcome to the first episode of Pinn Point on Women's Health. Each month on this podcast, we'll take a look at the latest developments in the area of women's health and the medical research that affects our lives. For the first podcast, I'm happy to welcome Dr. Allan Hildesheim who will talk about that vaccine we're hearing so much about, the HPV vaccine and what it means in terms of cervical cancer. But first some hot flashes from the world of women's health research coming up in 60 seconds when we continue with Pinn Point on Women's Health.
ANNOUNCER: Want to know more about the important cancer research going on at the National Cancer Institute? Would you like to hear from the experts and ask questions and take part in NCI's toll-free teleconference series? All you need is a phone. There's no registration and it's free. Coming up Tuesday, April 24th from 1 to 2 p.m. Eastern, the topic will be "Resources for Understanding Cancer Risk" with Ms. Felicia Solomon, Public Health Advisor with the Office of Education and Special Initiatives at the NCI and Dr. Michael Gale (Phonetic), Chief, Senior Investigator of the NCI's Biostatistics Branch, Division of Cancer Epidemiology and Genetics. Call toll-free, 800/757-6584 and enter the password “risk.” For more information about the toll-free teleconference series, call the NCI Office of Liaison Activities at 301/594-3194 or visit online ola.cancer.gov.
DR. PINN: Welcome back to Pinn Point on Women's Health. As promised, it's time to take a look at some of the hot flashes in the news regarding women's health research. I'm going to just tease you with a few thoughts about some of the latest developments of research that has been funded by the NIH and later on this show and in other podcasts, we will approach some of these in more depth.
First of all, I want to tell you about a study that was conducted at the University of Arizona College of Medicine and funded by the National Institute of Biomedical Imaging and Bioengineering here at NIH that can help bring about results from breast biopsies in a faster time, something that women who have had to undergo breast biopsies have really had to live with and deal with. This study is helping us to learn how to use telepathology, that means being able to look at a past specimen, that is the biopsy from your breast across the distance using modern technology and then to have that diagnosis developed and the diagnosis back to the patient in record time, sometimes within a day or so rather than the usual week or two that sometimes women have to wait to get their results. More on this at a later time.
Another hot flash, the NIH, specifically the National Heart, Lung and Blood Institute of NIH is partnering with professional societies, health, and advocacy organizations to launch a study of chronic obstructed pulmonary disease, learning how to breathe better. This is a national campaign to improve awareness among those who are greatest risk for the disease. Now while it is the fourth leading cause of death affecting one in four Americans over the age of 45, many don't recognize how important chronic obstructive pulmonary disease or COPD, as it's called, is for women. Why is this important? Because chronic obstructive pulmonary disease is affecting more and more women, especially older women. We need to be aware of it. We need to know how to prevent it. And we need to know how smoking can be a contributor to this debilitating disease in our later lives.
And my final hot flash of today, as we're talking about women's health research and the NIH, I want to remind you that if you have ever been curious about what clinical trials exist or how you can be a part of a research study, now it's easy for you to do, just go to your computer, go on the NIH Web site or just enter clinicaltrials.gov. That's G-O-V for government; clinicaltrials.gov. At this site, which is sponsored by the National Library of Medicine, you can find out about every clinical study, every research trial involving humans, that is currently being conducted by or funded by the NIH. Go to that site, help your friends and your neighbors learn about it, tell your physicians about it and learn about how you can or those near and dear to you, can also participate in research. We'll have more updates in the next podcast and coming up next I'll visit with Dr. Hildesheim for a discussion about the new vaccine and what it means in relationship to cervical cancer. We'll be right back with more Pinn Point on Women's Health.
ANNOUNCER: Maybe you've heard of Tai Chi, an ancient
form of Chinese exercise. The National
Institutes of Health is conducting a clinical research study to see if Tai Chi
improves physical fitness and well being for cancer survivors in the
DR. PINN: Welcome back to Pinn Point on Women's Health. My first guest on this very first podcast is Dr. Allan Hildesheim. He is a Senior Investigator of the Division of Cancer Epidemiology and Genetics at the National Cancer Institute of the National Institutes of Health. And I'm very excited to have him with us for this very first podcast because he's going to tell us about the very exciting news related to a new vaccine that is said to be against cervical cancer.
So I'd like to turn to Dr. Hildesheim and ask him, tell us, we're hearing about a vaccine that has to do with something called HPV that may prevent cervical cancer. Can you explain what this is about and why it's exciting?
DR. HILDESHEIM: Yes, first of all, thank you for giving me the opportunity to speak today. It's really a pleasure to be here and to share with you some developments that we really feel are quite exciting and could really impact women's health in future years.
Before we can really understand the vaccine and how it can prevent cervical cancer, I think it's important to understand some of what we have learned from all of the research that we have done over the past two decades and I think that that will form the basis so that we can understand this vaccine, how it works and how it should be used.
So the first thing that we know about this vaccine is that it's against a family of viruses called papillomaviruses. And papillomaviruses are very common sexually transmitted infections. We have learned from our research that this infection occurs fairly early on in the first few months or years after initiation of sexual activity. And that is an important point.
There are more than 100 types of papillomaviruses. They're very common and of these papillomaviruses, there's a group of about 15 of them that are now known to cause, to be able to cause cervical cancer. Now a very important thing we have learned from our research is that these HPV types which we call oncogenic HPV types because they can lead to cancer, are very common but typically the human body is extremely good at dealing with them. So very often these infections come and they go away by themselves. We don't even know we've been infected. And it's only in the very rare instance where this infection persists for many years that one has the risk of developing over the course of multiple years of developing cervical cancer.
And in fact, that is what the Pap smear screening program has been all about all of these years. Pap smears have been around for many decades and have done a terrific job at reducing rates of cervical cancer already within this country. And what Pap smears do is they detect the abnormalities in cells that are caused by this viral infection and by detecting it early on before they become cancer you can treat them and prevent cervical cancer that way.
DR. PINN: So what you're saying in summary is that we've learned about HPV or the Human Papillomavirus. We know it's a sexually transmitted disease. We know that it can result in cervical cancer and is probably the leading cause of cervical cancer. And now we have a vaccine that may help prevent the transmission of HPV, therefore preventing cervical cancer. Did I summarize it correct?
DR. HILDESHEIM: Yes, wonderful.
DR. PINN: Well, tell us about this vaccine. Why is it so exciting and what do we expect this vaccine to do? Why should women or girls even think about getting this vaccine?
DR. HILDESHEIM: Right, so this vaccine was really developed to block infection with two HPV types. They're called HPV-16 and HPV-18, which cause up to about a quarter of all the severe Pap smear abnormalities and up to 70 percent of all cervical cancers in this country and worldwide really. It is called a prophylactic vaccine because it's designed to prevent the infection before it happens.
DR. PINN: This is very exciting because it means we may be able to eliminate those close to 4,000 deaths from cervical cancer that occur in this country every year.
Dr. Hildesheim, you've made comments about how important this vaccine may be in preventing the transmission of Human Papillomavirus and therefore preventing cervical cancer, but is it the ideal answer? Is it perfect or are there some limitations that we should know about?
DR. HILDESHEIM: Like any vaccine or any public health measure, this vaccine is not perfect. It's a wonderful vaccine, but it is not perfect. There are two important issues that are currently being discussed and studied. One has to do with vaccine use for young adult women, those women who have already initiated sexual activity. And for this group, it's not really whether taking the vaccine will be of much help to them and this is because, as we've discussed, this vaccine was not designed to treat infections after they occur or to treat the lesions that are caused by the infections. It's designed to prevent the infection before it happens.
The other area that is discussed quite a bit is the issue of duration of protection. So we have recommended vaccination of young girls, ages 11 to 12, so that we can target vaccination before sexual debut because it is a preventive vaccine, but we do not yet have the data to tell us whether this vaccine has extended duration of protection. The data does suggest that the vaccine works for at least five years and it may very well work for longer than that, but we just don't know for sure. And therefore, there is the possibility in the future that girls who receive this vaccine now might need to receive a booster vaccine. And at this point we don't know for sure what this means with respect to the efficacy of the vaccine long term, its long-term safety as well as cost associated with vaccination.
DR. PINN: So Dr. Hildesheim, what you're saying is that this vaccine has great potential, but it needs to be used before a woman becomes infected with the HPV virus. It is not effective as a treatment measure?
DR. HILDESHEIM: Right, that is correct.
DR. PINN: Research related to this vaccine to me is some of the most exciting news that has come forward in recent years. It demonstrates what we can learn through research that can not only help us to better understand about the causes of diseases that affect women, but may be how to even prevent them.
Think about cervical cancer. In the
So I think this research is so exciting and I really am so pleased with the research and the work you're doing in this area. You've told us that the vaccine we expect to be effective in women who have not been previously infected by HPV or who have not yet started sexual activity. What about for other women who want to make sure that they don't suffer from cervical cancer? What are the recommendations?
DR. HILDESHEIM: Well, as we alluded to earlier in this conversation, Pap smear screening programs have been around for a long time and if done routinely can be a very effective tool of reducing rates of cervical cancer. And I think really this applies to women who are not getting the vaccine, but also to the young girls who are going to begin taking the vaccine. Why is that? Because the vaccine is designed to protect against two HPV types and although these are the two types that cause the majority of cervical cancers, there are about a dozen other HPV types that have also been linked to the development of cervical cancer. So even if you do get protected by this vaccine against these two HPV types, it's still important that you consider screening on a routine basis so that you can detect, diagnose and treat early any infections and lesions that might be caused by these other HPV types that are not included in the vaccine.
DR. PINN: So women, it's important to remember, that even with the vaccine that might prevent ever developing cervical cancer, the onus is on all of us to make sure that we continue to be screened and to get a Pap smear, one of the easiest cancer screening tests ever made available. It's not difficult. It's not expensive, but it can be life saving.
And Dr. Hildesheim, I have one final question. This is a show about women's health, but you said that cervical cancer resulting from HPV virus is essentially related to sexually transmitted disease. What is research saying about this virus and men? Is there any work going on there? Or what can we expect in the future?
DR. HILDESHEIM: There certainly is research that is going on in men. And I can tell you that Papillomavirus infection is as common in men as it is in women. However, we do not yet have data on whether this vaccine will work for men as well it has been shown to work for women.
There are biological reasons why the vaccine may operate differently in men than women and that is why there are ongoing trials to look at exactly this issue, to try to determine whether this vaccine might also be helpful for men, not just to reduce rates of HPV infection in men, but to help reduce transmission of infection from men to women. But at this point we don't have the answer to that question which is why the vaccine is only recommended for use by women.
DR. PINN: Well, I think that's an important point to make. We are learning about how to prevent cervical cancer in women by being able to prevent the transmission of the HPV virus, but it's also important that we do pay attention to men because if that's where we're getting the virus through sexual contact, we need to know how to help protect ourselves by looking at both men and women. But that's a topic for another time, as we talk about sex and gender issues in women's health.
Let me thank Dr. Allan Hildesheim of the National Cancer Institute who is a researcher in this area, who is currently conducting research on the HPV vaccine and I'm just delighted that he was willing to join us today.
Thank you for helping to clear up some of the questions that we have about the HPV vaccine and cervical cancer.
DR. HILDESHEIM: Thank you.
DR. PINN: Coming up next, a few final thoughts for this month when Pinn Point on Women's Health continues.
ANNOUNCER: If you have the key to unlock the secrets of
medical science, you'd use it, wouldn't you?
At the
Do you have the key? Log on to clinicaltrials.gov or call 866/999-1116 for more info. The National Institutes of Health is a nonprofit government agency, part of the U.S. Department of Health and Human Services.
Got a youngster around the house who is on the heavy side, but is otherwise healthy? The National Institutes of Health would like to talk to you to see what they can learn from your child. Not only are all study-related tests and treatments provided for free, but all participants are compensated. Check out clinicaltrials.gov or call 866/999-1116 for more info. NIH is a nonprofit government agency part of the U.S. Department of Health and Human Services.
DR. PINN: And now a few final thoughts. I hope you enjoyed and learned a lot today hearing Dr. Allan Hildesheim discuss this exciting new breakthrough in the discovery of a vaccine that can help prevent transmission of a sexually transmitted disease, the Human Papillomavirus that can result in the development of cervical cancer. How more exciting can things be?
But keep in mind that even with the breakthrough information related to this vaccine, it's important, girls and women, that once you've initiated sexual activity or even if you haven't and you are an adult woman, that you should continue to have a Pap smear to make sure that you're being checked so that you don't become one of our statistics related to cervical cancer.
Thank you for joining us on our
first episode of Pinn Point on Women's Health.
In a moment, the announcer will tell you where to send your comments and
your suggestions for future episodes.
I'm Dr. Vivian Pinn, Director of the Office of Research on Women's
Health at the National Institutes of Health in
ANNOUNCER: You can email your comments and suggestions
concerning this podcast to Marsha Love at lovem@od.nih.gov. Pinn Point on Women's Health comes from the
Office of Research on Women's Health and is a production of the NIH Radio News
Service, News Media Branch, Office of Communications and Public Liaison at the
Office of the Director, National Institutes of Health,
(Whereupon, the podcast concluded.)