Vaccination against cancer

School-age children can be protected from a dangerous disease with a vaccine

Maria Golubkova, Rossiyskaya Gazeta

In St. Petersburg, you can get vaccinated against cancer. And it's not fantastic. Back in the twentieth century, scientists figured out that cervical cancer in women causes the human papillomavirus (HPV) and developed a preventive vaccine against it. In many countries of the world, HPV vaccination has been included in the national vaccination calendar, and a gender-neutral approach is used, that is, both girls and boys are vaccinated. The president of the Russian Society of Gynecologists-Oncologists (RSGO), a leading researcher at the Department of Oncogynecology of the N. N. Petrov National Research Medical Center of Oncology, Professor Adel Urmancheeva, told about how to take care of their health and the health of their children at a business breakfast in the St. Petersburg edition of "RG".

Insidious as the flu, dangerous as cancer

– Adele Fedorovna, please tell us what is the human papillomavirus and how is it dangerous?

– Adel Urmancheeva: At one time, the German scientist Harald zur Hausen received the Nobel Prize when he was able to prove that up to 99 percent of women who developed cervical cancer were carriers of HPV. Other forms of cancer have a non-viral origin, but everything is pretty clear here.

There are more than a hundred strains of the human papillomavirus, but the attention of doctors is primarily required by those that are sexually transmitted, there are more than 30 of them. The peculiarity of HPV is that some strains cause benign neoplasms, and some – oncological diseases. The clinical manifestation of the first type of strains is warts and papillomas, and simply put, warts. In other words, in most cases, if a person finds such neoplasms in himself, then you can calm down a little – he is infected with a strain of HPV of a non-oncological type. Although there are cases of malignancy (degeneration into a malignant tumor – Approx. "RG").

We don't know much about this infection because it is often asymptomatic. That is, you can get the HPV virus and not even know about it. If a person has a strong immune system, self-healing is possible. However, reinfection is also possible.

– So it's like the flu?

– Adel Urmancheeva: The flu manifests itself – fever, cough, aching joints, but HPV does not. And with a decrease in immunity – for various reasons – the disease can become chronic, the virus will remain in the cell and integrate into its nucleus. If the body does not cope, then first there is a precancerous lesion of the mucous membrane, which must be surgically removed. But if you do it in time, the patient is completely cured.

In women, the risk is significantly higher than in men: HPV most often causes cervical cancer, in men, cancer of the oropharynx is associated with an oncogenic virus. Risk factors – early onset of sexual activity, frequent change of partners, that is, in principle, a high risk of infection with sexual infections.

In general, breast cancer is in the first place in terms of the prevalence of oncological diseases among women. However, cervical cancer often affects the very young, up to 30 years old.

Both girls and boys

– How can I protect myself from HPV?

– Adel Urmancheeva: The first and most important thing a woman should do is to carefully monitor her health, undergo examinations on time. However, I want to say right away that HPV treatment is non–specific, that is, it does not guarantee a cure. Therapy is aimed at strengthening the general immunity, a special HPV drug has not yet been invented.

The most reliable way is vaccination. There are no curative vaccines, but preventive ones have already proven their effectiveness all over the world. It's like with childhood infections like measles or even smallpox: the vaccine allows you to develop immunity, antibodies appear in the body, and when an infection enters the body, it does not develop.

HPV vaccines began to be developed at the end of the twentieth century, but a long time passed before these drugs were allowed to be used. The research followed the same path as when developing the polio vaccine, but then it seemed fantastic to us that it would be possible to invent a vaccination against cervical cancer. At the beginning of the XXI century, it began to be put into practice, first with the use of control groups. It turned out that in vaccinated women, the precancerous condition was practically not manifested, the immune system copes.

– But after all, vaccination is essentially a weakened strain of the virus. Isn't it dangerous to launch a substance into the human body that can provoke cancer?

– Adel Urmancheeva: I want to reassure you right away: the HPV vaccine does not contain viruses, that is, no one infects you with cancer even in a weakened form, as it happens with the same flu. The drug is based on virus–like particles that cannot cause infection. But in response to their appearance, the necessary antibodies are produced in the body.

– If HPV vaccination is so effective, then why hasn't it become mandatory yet?

– Adel Urmancheeva: In Russia, HPV vaccination is not yet included in the national vaccination calendar, while in Europe, America, and Australia it is included in the state vaccination program for school-age girls. Because it is important to get vaccinated before the beginning of sexual life, before sexual debut. In different countries, it occurs at different ages, so an interval from 9 to 13-16 years is chosen for vaccination. Vaccination is done three times (sometimes twice).

By the way, in Spain, Australia and a number of other countries, boys are also vaccinated, although they have fewer problems with cancer caused by HPV. But, as with any vaccination, coverage is important here – if 70 percent of the population is vaccinated, the virus will not spread, the risks of infection fall by several orders of magnitude.

HPV vaccination is done intramuscularly in three stages: a month and then six months after the first vaccination

And here we have to talk about the price of the issue. Now in St. Petersburg, vaccination costs about 10 thousand rubles. Of course, generics will appear over time, the cost will decrease, but so far budget problems do not allow us to widely distribute HPV vaccination.

Parents can make the appropriate decision. But in our country, mothers either do not know about this possibility, or deliberately refuse it. You can find a lot of ominous information on the Internet, but you need to understand that undesirable phenomena can manifest themselves with any vaccination. There is no evidence that HPV vaccination may affect a woman's reproductive health in the future. And there is protection against cancer, and research shows this. Contraindications are standard – allergic reactions, severe diseases, such as cystic fibrosis.

By the way, my former patients, whom I operated on and saved, often come to me with the question of whether the child should be vaccinated. And I tell everyone: absolutely. One of them vaccinated her daughter as a pre-wedding gift.

– Have you been vaccinated against HPV yourself?

– Adel Urmancheeva: When the vaccine came into widespread practice, it was already too late for me in age. But my granddaughter is vaccinated. And many of my colleagues have vaccinated their children.

"Take care of yourself, love yourself"

– It is increasingly becoming clear that viruses are the cause of serious diseases. Stomach ulcer is caused by helicobacter pylori, cervical cancer – HPV. Is it possible to dream that humanity will invent vaccination against all forms of cancer?

– Adel Urmancheeva: From all one vaccination or even from every form of cancer – probably not. Different tumors are caused by different factors, including hormonal and hereditary. But I can say, by the way, that cervical cancer is not hereditary. So, if there were such cases in the family, they do not pose an immediate threat. But if there was ovarian cancer, breast cancer in the pedigree, then the probability of hereditary forms is high, and this requires an appropriate genetic examination of the patient and her family members.

– What are the prognoses for patients with cervical cancer?

– Adel Urmancheeva: Unfortunately, in the later stages, patients cannot be saved, only palliative treatment is possible. But in the early stages of cervical cancer, patients can be radically cured by both surgical and radiation methods. In some young patients, it is even possible to preserve the childbearing function. Although these are mostly unique situations, we even keep photos of such children.

There are no miracles. Take care of yourself, love yourself, take care of yourself – and it should not be just makeup and physical form – a timely examination is mandatory. A woman should come to the gynecologist at least once a year. And parents should think about the future health of their children entering adulthood. One form of protection may be preventive vaccination of adolescents against HPV.

It is important to know Within the framework of the CHI, an HPV analysis is not provided, only a cytological examination is done, which can reveal atypia – precancerous or cancer.
Such a study is carried out as part of a medical examination once every three years in women from 30 to 60 years old. If the virus is detected, screening is sufficient to take place once a year. If HPV is not detected, then vaccination can be done at any age.
In Russia, cervical cancer in severe stages is detected annually in 16 thousand women. In general, with invasive forms of cervical cancer, slightly more than 60 percent of patients are saved.

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