Cervical Cancer and Human Papillomavirus

Reading through The Philippine Star, I bumped into an advertisement which presents a husband lying in bed and trying to feel the presence of his deceased wife. What makes this interesting is the question flashed below which goes Naisip mo na ba kung gaano kasakit matulog at gumising na mga-isa?. Apparently, this seeks to inform readers that a woman has an eighty percent chance of already being infected with human papillomavirus (HPV) when she reaches fifty and that there are ten women who die of cervical cancer hence, ten new widowers everyday.

This advertisement brought me back to an article entitled A survivor’s battle with cervical cancer by Annie A. Jambora which was released last August fifth in Philippine Daily Inquirer. This highlights the experience of Josefina de la Cruz with cervical cancer, country’s second leading cause of death among Filipino women. Other than her menstrual period which takes much longer than usual, sometimes going for full ten days, she was feeling fine. In August 2001, exactly ten years after her mother succumbed to the same disease, she was diagnosed with multiple myoma.

Although the diagnosis is not a life-threatening condition, she nevertheless pushed through with all the necessary medical procedures. However, it was just last year when she figured out that the cancer was actually caused by HPV which she, unknowingly, had acquired from her husband.

Cervical Cancer
The Harvard Guide to Women’s Health defines cervical cancer as a disease that develops gradually starting with abnormal cell changes called preinvasive lesions (also called low-grade squamous intraepithelial lesions, or SIL; or dysplasia). These sometimes revert to normal cells. Nevertheless, these cell changes are considered a precancerous condition. In time (sometimes a full decade), some precancerous cells may develop into localized cancer, called carcinoma in situ, which affects the outer surface of the cervix (Carlson, Eisenstat, Ziporyn, 1996, p. 130).

World Health Organization states, in its website, that all cervical cancer cases (99%) are linked to genital infection with HPV, which is the most common viral infection of the reproductive tract.

Human Papillomavirus (HPV)
Cervical cancer, human papillomavirus (HPV), and HVP vaccines-Key points for policy makers and health professionals provides main points on this virus.

 HPVs are a family of viruses that are extremely common worldwide. There are more than 100 types.
 They are deoxyribonucleic acid (DNA) viruses that infect skin or mucosal cells.
 At least 13 of these types are oncogenic (cancer-causing).
 HPV is estimated to cause
-100% of cancer cases,
-90% of anal cancer cases,
-40% of cases of cancers of the external genitalia (vulva, vagina and penis),
-at least 12% of oropharyngeal cancer cases, and
-at least 3% of oral cancer cases.
 HPV types 16 and 18 cause approximately 70% of all cervical cancers worldwide.
 Almost 500 000 cases of cervical cancer and 274 000 cervical cancer deaths occurred in 2002.
 About 80% of cervical cancer deaths occur in developing countries.

In the article which was mentioned earlier, it is stated that HPV, affecting both men and women, can be acquired only through skin contact. Men are generally spared from the deadly virus and only serve as carriers even if they use condoms. These do not protect a woman from contacting the said virus since the scrotum is still exposed.

It is wonderful knowing that newsprint media have started realizing the importance of writing on cervical cancer and human papillomavirus (HPV) as one of its causes. Untold stories of women, we can now finally conclude, are beginning to be told.


Citations:
• “Naisip mo na ba kung gaano kasakit matulog at gumising na mga-isa?”. The Philippine Star: September 24, 2008, page 13.
• Jambora, Annie A. “A survivor’s battle with cervical cancer”. Philippine Daily Inquirer: August 05, 2008, page C1.
• Carlson, Karen J., Eisenstat, Stephanie A., Ziporyn, Terra. The Harvard Guide to Women’s Health. Cambridge, Massachusetts: Harvard University Press, 1996.
• World Health Organization. September 29, 2008 .
• “Cervical cancer, human papillomavirus (HPV), and HVP vaccines-Key points for policy makers and health professionals”. September 29, 2008 .

Original article by Amanh B Lao, research associate, HAIN.

One Best Medicine

Amidst the soaring prices of medical commodities world wide, there constantly remains one best, yet, inexpensive medicine: laughter.

Despite the idea that consumers might have taken for granted the significance of laughing these days, researchers are continuing exploring further on how laughter - combined with an active sense of humor - helps from relieving stress to combating diseases.

Laughter and the brain
An article, published in Wikipedia, states that modern neurophysiology links laughter to the activation of the ventromedial prefrontal cortex and other parts of limbic system. The latter, which is considered to be a primitive part of the brain, is involved in emotions and helping us with basic functions necessary for survival. There are two known structures in the limbic system that involve in producing laughter: amygdale and hippocampus.

Cardiovascular disease
According to the research (May 11, 2007) spearheaded by Michael Miller, M.D., director of the Center for Preventive Cardiology at the University of Maryland School of Medical Center and associate professor of medicine at the University of Maryland School of Medicine, cardiovascular disease - today’s leading cause of death (World Health Organization) - can be prevented by laughter. He admitted that the team does not know yet why laughing protects the heart but stated that mental stress is associated with impairment of endothelium, the protective barrier lining our blood vessels, causing a series of inflammatory reactions that lead to fat and cholesterol build-up in the coronary arteries and ultimately to a heart attack. Hence, the need for a regular hearty good laugh is recommended.

Other areas
Melissa B. Wanzer, EdD, professor of communication studies at Canisius College in Buffalo, NY, looked, in her new research, at how humor helps medical professionals cope with their difficult jobs. She found out that if employees view their managers as humor-oriented, they also view them as more effective. She also added that self-disparaging humor, making fun of oneself, is a very effective form of humor communication especially when it is done appropriately with available props. Humor, she noted, is indeed beneficial in other areas as well.

Laughter as part of its culture
Ranked second by Axa Life Outlook Index (November 28, 2007) as happiest and optimistic people in Asia, it is not that surprising to know that Beethoven del Valle Bunagan, popularly known as Michael V, is featured on Reader’s Digest Asia in commemoration for its 5th Annual Humour Special alongside two other foreign comedians (Readers’ Digest, September 2008).

“Filipinos are able to find even the slimmest silver lining in a tropical thunderstorm. There isn’t one scandal in government which hasn’t been made into a joke. Instead of being horrified, we laughed about Imelda’s shoes. Instead of cringing in shame at Joseph Estrada’s incompetence as President, we made legions of Erap jokes. Hello, Garci? A ringtone was made out of it! (Maricar, 2008)”.

In his article entitled Power of Laughter, Jose Javier Reyes went deeper by explaining this behavior based on socio-cultural and historical aspects. “Caught between a rock and a hard place, Filipinos say "bahala na." Literally, it means "come what may." Figuratively, it means much more. The phrase derives from Bathala, the ancient Filipino's Supreme Being, caretaker of life on earth and beyond, from whom all providence comes. The invocation of "banal na" affirms a trust in divine wisdom. Filipinos know that the natural order of events will take their course, leaving no room for angst nor the predilection to take each event apart and delve for spiritual malaise . . . After all, at earlier times in their past, they have witnessed similar upheavals. And to what end? The Spaniards came and the Spaniards went. So did the Japanese and the Americans. Like the land itself, only the Filipinos, with their passionate Christian belief that suffering is but a stepping stone to a happy ending, endures. Ambition, politics, and men who try to control deserve the reception they get, laughter. Natural forces receive a similar reception. If one listens closely though, it becomes apparent that Filipino humor does not jeer at nature's destructiveness but rather expresses an optimism in its healing powers. Having lived closed to the earth, they know that nature gives and takes in a cycle as eternal as life and death.”

As what Robert R. Province, Ph.D. said, laughter is genetic. It is a mechanism everyone has and is part of universal human vocabulary. There are thousands of languages, hundreds of thousands of dialects, but everyone speaks laughter in pretty much the same way. Thus, everyone can laugh.

-Amanah Busran Lao, HAIN

Citations:
•
• Murray, Michelle “Laughter is the "Best Medicine" for Your Heart” May 11, 2007 < http://www.umm.edu/features/laughter.htm>
•
• “Go Ahead and Laugh” January 26, 2008
• Siti Rohani “Three Funny Men” Readers’ Digest, September 2008
• Cheryl Arcibal “Filipinos 2nd happiest people in Asia-study” November 28, 2007 GMANews.TV
• Maricar “Filipino Humor a Hindrance?” February 5, 2008
• Jose Javier Reyes “The Power of Laughter”