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What Your Dentist Should Be Telling You About Oral Cancer and HPV

April 6, 2018 2 comments

oral-cancer-monthI had my teeth cleaned yesterday, and while I was at the dentist I remembered that April is Oral Cancer Awareness Month. 

The dentist never mentioned it, but I knew just what she was doing when she put her gloves on and started rolling her fingers around the inside of my checks, under my tongue and on the outside of my neck and jaw.  She was doing what all oral health professionals should do – a thorough examination that could help with early detection of oropharyngeal cancers (also known as cancers of the throat and tongue) which are commonly caused by the human papillomavirus (HPV). 

As someone who has been diagnosed with two different cancers in the past, I no longer think “not me”.  Quite honestly, knowing how prevalent HPV is (it’s estimated that 80% of sexually active people will contract HPV at some point in their life) it’s probably more likely that I would be diagnosed with an HPV related cancer than many other types of cancer. Although most cases of HPV resolve without incident, the fact remains that approximately 14 million new cases of HPV occur in the U.S. each year, with at least 79 million people estimated to be currently infected and about 31,500 cases of HPV related cancers diagnosed in men and women each year in the U.S.. This includes cancers in the oropharynx, cervix, vagina, vulva, penis, and anus.  

While HPV can cause up to six different types of cancer, oral cancers are on the rise.  It’s estimated that HPV-associated oropharyngeal cancer affects about 16,400 people each year, and that by year 2020, it will become the most common HPV-related cancer in the US, surpassing cervical cancer.  

Here are a few other details to consider:

While I’m pleased that my dentist took the time to closely examine my neck, throat, mouth and tongue for any abnormalities, I’m disappointed that she didn’t take the opportunity to discuss the importance of HPV vaccination with me. 

Education of the public regarding the risk factors which lead to oral cancer, recognition of the early signs and symptoms, and the development of patient awareness, are primary responsibilities of the dental community.  

In 2017, the American Academy of Pediatric Dentistry (AAPD) issued a policy statement on HPV vaccination that encourages oral health care providers to educate patients and parents on the relationship of HPV to oral and oropharyngeal cancer and to counsel them regarding the HPV vaccination, in accordance with CDC recommendations. Currently, the CDC recommends two doses of HPV vaccination for girls and boys beginning at ages 11 or 12, but vaccination can be started at age 9 and can be administered through age 26 for females and age 21 for males.

Screen Shot 2018-04-06 at 10.36.56 AMWhile oral health professionals should be recommending HPV vaccination to all age-eligible patients, it would be prudent to also provide that information to patients who are parents. Although my dentist is not a pediatric dentist, my five children are also patients and we all get our regularly scheduled dental cleanings twice each year. 

At no point has anyone at this particular dental practice ever discussed oral cancer or HPV with me or any of my children, despite the fact that all five of my children are  considered “age-eligible”. (I know this because after my appointment yesterday, I asked my kids.)

Yesterday, my dentist failed to discuss HPV vaccination as a potential way to prevent oral and oropharyngeal cancers, which I consider to be a missed opportunity. However, during our collective twelve appointments each year for the past five years, it’s actually more like 60 enormous missed opportunities!

I get it.  Dentists may not be comfortable discussing vaccines. Or HPV.  But how comfortable can it be for them to have to tell their patients they may have oral cancer? How comfortable can it be for those patients who will end up having to suffer through an oral cancer that may have been preventable?

Fortunately, there are tests that can help detect HPV in women before they develop cervical cancer.  However, the same is not true for HPV-related head and neck cancers. These cancers typically develop in the throat at the base of the tongue, in the folds of the tonsils or the back of the throat, making them very difficult to detect. That is why regular dental exams can be vital. But prevention is always preferred to treatment, and HPV vaccination represents our best chance at prevention. 

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Since my dentist didn’t provide the information I feel all parents and patients deserve to know, I plan to bring them this action guide for Dental Health Providers, created by the National HPV Vaccination Roundtable when I return next week for my daughter’s visit. 

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According to the Oral Cancer Foundation, there are over 100,000 dentists in the U.S., each one seeing between 8 and 15 patients per day. If you include those patients who come to a practice and see someone other than the dentist, such as the hygienist, the number of patient visits is significantly higher. If they each did their part to educate their patients, imagine what a huge difference they could make in boosting HPV vaccination rates and reducing oral cancers.

Until we start seeing more dentist taking these types of actions,  please help spread the word about the association between HPV and oral cancers, during Oral Cancer Awareness Month and all throughout the year.

Below you will find additional resources regarding HPV vaccination and HPV-related head and neck cancers.  Here’s hoping that you never have to deal with an oral cancer diagnosis, like Jason Mendelsohn, Scott Vetter, Frank Summers and others.   


 

 


 

 


Other Resources:

Head and Neck Cancer Alliance

Oral Cancer Foundation

National HPV Vaccination Roundtable

Vaccinate Your Family Website: HPV Information

Research Article: Reduced Prevalence of Oral Human Papillomavirus (HPV) 4 Years after Bivalent HPV Vaccination in a Randomized Clinical Trial in Costa Rica

 

 

How One Teen is Engaging Her Peers to Help Eliminate HPV Related Cancers

February 27, 2018 1 comment

By Allyson Rosenblum

What if you could save a life or prevent someone from the devastation of cancer simply be providing them with information, would you do it?  What if it was someone you knew or cared about, would you do it then? 

IMG_3767 6.17.55 PMMy name is Allyson and I am a 17 year-old high school student living in Southern California. Earlier this year, I set out to do something that I hope will make a difference in the lives of others. I would like to encourage teenagers who care about their health and the health of future generations to join me.

What I’m asking is fairly simple. I am requesting high school and college students to pass along valuable information about HPV infection and prevention to those they know and care about.  

I have personally seen HPV and cancer devastate the lives and dreams of people I love. Beginning in October of last year, I witnessed my mother’s difficult battle with cancer every day as she endured three surgeries and eight months of chemotherapy. Two months later, my cousin informed me that she was diagnosed with cervical cancer resulting from an HPV infection she acquired as a teenager. At just 35 years old, she has now had to accept the fact she will never be able to have biological children of her own. Seeing all this pain and needless suffering has moved me to take action.

I decided to start a social media campaign on Facebook and Instagram, which I called “Two Shots To Beat Cancer.”

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My goal is to enlist high school and college students throughout the U.S. to help in passing along information about the importance of early HPV vaccination to other high school and college students using various social media platforms.

Let me emphasize that this campaign is not about teen sex.  Rather, it’s about prevention of HPV prior to sexual activity. If people can avoid acquiring the strains of the HPV virus that are linked to cancer, they will be less likely to suffer with an HPV related cancer later in life or pass the virus on to others.  This is why the CDC recommends the HPV vaccine to 11-12 year olds. However, if a child did not get vaccinated in their pre-teens, it’s not too late. The vaccine is recommended up to age 26 for women and age 21 for men.

Unfortunately, most people my age do not want to talk about health related issues. We’re often uncomfortable talking about such topics, especially with adults, and reticent to share private information about ourselves. As such, many of us remain unaware of the dangers and prevalence of HPV, and questions and concerns often go unaddressed. However, it is precisely the lack of education and informed knowledge that allows the HPV epidemic to persist. By sharing timely and credible information among peers, I hope to empower my generation to take responsibility for their health and to help encourage better health practices among our peers.

I started this campaign in January and through the power of social media have already been able to get 1807 high school and college students to join me in all 50 states. With an average of 600 followers per student, that gives us the potential of reaching 1,084,200 students and counting!  However, I’m not content with that. I believe we can do far better! In fact, if high school and college students were aware that there are 14 million new people acquiring HPV in the U.S. each year and over 50% of them are teens and young adults who are just becoming sexually active, than I believe they may see their important role in this mission.

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I would encourage any high school or college student who cares about their own health, or the health of future generations, to find out more by visiting my website at TwoShotsToBeatCancer.org and joining the Two Shots To Beat Cancer Facebook Page and following our Two Shots To Beat Cancer Instagram account.

By joining me in this worthwhile endeavor, we can be the generation that puts an end to HPV related cancers. By posting to social media and sending letters to politicians, newspapers and school board administrators, we can make a difference and help to stop the spread of HPV. It takes little time, costs no money and by encouraging students to engage in important and life-changing conversations, we can save lives and prevent needless suffering.

Stories of Polio, Meningitis, HPV, Hepatitis and Pertussis Top 2016 List

December 28, 2016 Leave a comment

Every Child By Two’s online platforms have reached over 11 million people with evidence based vaccine messaging in 2016.  As we look back at the record number of views and shares there have been on Shot of Prevention blog posts this past year, we’re especially grateful to our blog readers, contributors and subscribers.  

Whether you have shared a post, shared your story, or shared your expertise, know that our growth and success would not have been possible without your support.  Thanks to you, people are referencing our content before making important immunization decisions for themselves and their families.  In these final days of 2016, we hope that you will revisit these top five posts from the past year and share them with others in your social networks.  Together, we can continue to engage more people in these important immunization discussions.

 

1. My Polio Story is an Inconvenient Truth to Those Who Refuse Vaccines


Judy Post Polio with SisterIn 1949, Judith contracted polio along with 42,000 other people in the U.S. Judith survived five months in the hospital and multiple surgeries, but sadly 2,720 people died from polio that year.  As Judith bravely shares her story, she explains that it represents an inconvenient truth to people who are in denial about the risks of polio. She is continually shocked by people who refuse vaccines, who refuse to believe she ever suffered with polio, or who actually believe the polio vaccine is part of a government or “big pharma” conspiracy.  By sharing Judith’s story we hope to encourage continued polio vaccination and support of polio eradication worldwide and applaud people like Judith who are courageous enough to speak out in support of vaccines.  To read Judith’s story, click here.

 

2. How My Vaccinated Daughter Died From Meningitis and What I’m Doing About It  


EmilyStillmanEmily Stillman was pronounced brain-dead just 30 hours from the onset of a severe headache.  What they though was a migraine turned out to be meningococcal disease. In this post Emily’s mother Alicia explains that although Emily received a meningococcal vaccine, the MCV4 vaccine she received only protected her against meningococcal serogroups A, C, W and Y.  It did not protect her against serogroup B, which is what caused Emily’s death.  Since Emily’s death, a MenB vaccine has been approved for use.  However, most parents still don’t know it exists and therefore, most students are still not protected.

As the Director of The Emily Stillman Foundation, Alicia Stillman helps educate people about the importance of “complete and total” protection against all serogroups of meningococcal disease.  This means ensuring that teens and young adults receive both meningococcal vaccines; the MCV4 vaccine that protects against serogroups A,C, W and Y, as well as a MenB vaccine series.  To learn more about fully protecting our youth against meningococcal disease, read Alicia’s guest blog here.

 

3. Questioning Whether to Get Your Child the HPV Vaccine? Read This


hpv-fact-vs-fiction-series-1Although the HPV vaccine is one of the most effective ways we have to prevent numerous types of cancer, it is still being grossly underutilized.  As a result of persistent but inaccurate myths circulating on the internet, some parents are more fearful of the HPV vaccine than the human papillomavirus itself.  This is causing them to refuse or delay HPV vaccination for their children.

In this popular blog post, we highlight ten critical facts that address the most common misconceptions about HPV infection and the vaccine that can help prevent this very common infection. To learn more, be sure to read the post here.

 

4. Understanding Why Your Baby Needs a Hepatitis B Vaccine at Birth  


 

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There are many misconceptions about hepatitis B and how the infection is transmitted.  Because of this, many parents don’t consider their children to be at risk of infection and so they question the need for a hepatitis B vaccine at birth.  In this post, the Prevent Cancer Foundation explains the connection between hepatitis B and liver cancer and discusses ways in which infants and children can unknowingly contract hepatitis B.  Their Think About the Linkeducation campaign suggests that vaccinating infants before they leave the hospital is a critical first step in protecting your newborn from a virus that can lead to cancer later in life.  To learn more about Hepatitis B and the vaccine to prevent it, click here.

 

5. Barbara Loe Fisher is Right.  She’s Also to Blame. 


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Back in the 1980’s, Barbara Loe Fisher claimed that the whole cell pertussis vaccine (DTP)  was dangerous and causing too many adverse events.  Her complaints prompted the development of the more purified (acellular) pertussis vaccines that we use today; DTaP for infants, and Tdap for adolescents and adults. While studies have shown that these newer vaccines are not as effective as the old whole cell pertussis vaccine, they are the best protections we have against the dangers of pertussis.

Unfortunately, those who need protection the most are those who are too young to be vaccinated.  Infants are at high risk of severe complications from pertussis, to include hospitalization and death, but babies don’t begin receiving pertussis vaccine until two months of age.  After newborn Calle Van Tornhout contracted pertussis from a hospital nurse at birth, she died at just 37 days of age.  Callie’s death has had her home state of Indiana considering a bill that would mandate pertussis vaccination among health care workers.  But Barbara Loe Fisher is opposed to that as well.  To read more about the history of pertussis vaccines, click here.

 

If you have suggestions for topics you would like us to address in 2016, or you would like to contribute a guest post for publication, please email shotofprevention@gmail.com.  

Don’t miss any of our new posts.   Subscribe to Shot of Prevention by clicking the link at the top right of this page.  You can also “Like” our Vaccinate Your Family Facebook page to receive updates on important immunization news and join in our online discussions.   

Thanks again for your continued support and best wishes for a happy and healthy new year!

Questioning Whether To Get Your Child the HPV Vaccine? Read This

January 21, 2016 7 comments

iStock_000039978628_Double.jpgIn June 2006, the first human papillomavirus (HPV) vaccine was licensed for use in the U.S.  Rather than celebrate the development of a vaccine to prevent a deadly form of cancer, many parents have instead been misguided by fear.  As a result of persistent internet stories and inaccurate myths that question the safety of HPV vaccines, parents continue to refuse or delay HPV vaccines for their children, and one of the most effective ways to prevent cancer is being grossly underutilized.

Although millions of doses of HPV vaccines have been administered in the past 10 years, some parents still fear what may happen if their child gets an HPV vaccine. 

What they should fear is what may happen if they don’t.

I offer the following information about HPV because everyone should understand where their fears ought to be directed: at the disease, not the vaccine designed to prevent it.

1)  It’s not about sex, it’s about cancer.

Regardless of what parents choose to teach (or not teach) their kids about sex, abstinence or contraception, the HPV vaccine is vital to the health of our children because it protects them from cancer.

By preventing people from contracting certain strains of a highly prevalent infection, we can then prevent the possibility of HPV infections turning into cancerous cells. An HPV infection is often contracted shortly after sexual debut, and can eventually lead to cancers of the cervix, vulva, vagina, penis, anus or throat. Since the majority of these cancers have no formal screening measures, they often go undetected until they are well advanced.

2)  Nearly all sexually-active individuals will contract HPV at some point in their lives. 

HPV is the most common sexually transmitted infection in the United States and is often referred to as the common cold of the genitals. HPV is not a new virus, but many people are unfamiliar with how dangerous and prevalent it is. Consider these staggering statistics:

Not only is HPV infection common, but most people rarely know they’re infected because it typically occurs without any symptoms.  Since it’s possible to develop symptoms years after first being infected, it’s especially difficult to diagnose exactly when a person first became infected.

In about 90% of cases, an HPV infection will eventually clear in about a year or two. However, during that time, those infected with HPV are often unknowingly spreading the infection to others.

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3)  As many as 10% of those infected will eventually develop cancer. 

While 90% of people may clear the infection, the other 10% end up developing cancerous cells years, or even decades, after initial exposure.  Since there is no way to determine which cases will clear and which will lead to cancer, universal vaccination is the most effective means of prevention.

The following data reveals just how many cancer cases are linked to HPV each year:

Cervical cancer: Almost all cervical cancer cases are caused by HPV and more than 11,000 women in the U.S. alone get cervical cancer each year.  When looking at the bigger picture, 528,000 new cases of cervical cancer were diagnosed worldwide in 2012.

Anal cancer: About 91% of anal cancers are caused by HPV and there are approximately 4,300 anal cancers diagnosed each year.

Oropharyngeal cancers(cancers of the head, neck, throat, mouth, tongue, and tonsils) About 72% are caused by HPV and an estimated 8,400 of these cancers are diagnosed each year.

Vaginal cancer: HPV causes about 75% of vaginal cancers and there are about 500 vaginal cancers diagnosed each year.

Vulvar Cancer: HPV causes about 50% of vulvar cancers and an estimated 2,100 vulvar cancers are diagnosed each year.

Penile Cancer: About 63% of penile cancers are linked to HPV and there are about 600 penile cancers diagnosed each year.

Genital Warts: There are more than 40 types of HPV that specifically affect the genital area. However, 90% of genital warts are caused by HPV types 6 or 11 and about 360,000 people in the U.S. get genital warts each year.

Since there is no test to check one’s overall HPV status, and no standard screening to detect HPV in the mouth or throat, getting an HPV vaccine is an effective way to prevent illness rather than leave people vulnerable to infections that can lead to cancer.

Some argue that since there is a test to screen for cervical cancer that this eliminates the need for vaccination among women.  While cervical cancer screenings are vitally important, they don’t prevent infection.  Instead, they help identify precancerous lesions. Once lesions are discovered, women may then need to endure various invasive and painful procedures.  These may include cone biopsies used to help diagnose precancerous or cancerous cells, and a loop electrosurgical excision procedure (LEEP) often used to burn off precancerous lesions.  Additionally, cervical cancer screenings don’t help identify other HPV related cancers or help screen of men or adolescents for HPV.  With the vaccine we can prevent cancers before they exist.

4)  Surprise…you don’t have to have sex to get HPV.

Read more…

HPV Epidemic – Someone You Love Film – Watch It, Share It!

July 16, 2015 1 comment
Every Child By Two is pleased to welcome Linn to our social media team. Linn is a student intern who will be sharing her perspectives on vaccines with us through the eyes of a PhD candidate.  We hope you enjoy her first piece of the summer.

The HPV vaccine is recommended for all girls and boys ages 11-12.

This vaccine has the potential to prevent 70% of all cervical cancers and 90% of genital warts.

Why then is there such a low rate of vaccine uptake?

Only about 1/3 of girls aged 13-17 have been fully vaccinated and less than 14% of boys are fully vaccinated.

One study looked to identify the barriers to uptake of HPV vaccine and found that it was not the lack of perceived risk or vaccine safety that kept parents from vaccinating their children, but the perception that it would increase risky sexual behavior in adolescents even though there is no evidence that this will occur.HPV

As a young student, I remember learning about the HPV vaccine in high school. HPV was a sexually transmitted disease that was relatively unknown, but we learned that the vaccine would prevent certain cancers and genital warts. The knowledge that I gained about the ability for this vaccine to prevent these potential diseases prompted me to learn more about the HPV vaccine and increased my desire to receive it.

However, when I discussed it with my mother, an interesting process began to occur. She did not know any information about the HPV vaccine and when I spoke to her about the fact that it prevents a sexually transmitted disease, I could see a shift in her gaze as she narrowed her eyes. I sensed that she was hesitant because of the social stigma that surrounded a female who would get a vaccine that was related to sexual contact.

All of these opinions are related to a negative stigma around sexual behaviors that are not true.  And yet these are the thoughts I sensed were running through my mother’s head as she also considered what her own peers would think, as I am sure many others do.

Back then I perceived that the assumptions that are made about females that get an STD vaccine were:

a) She is promiscuous.

b) She is about to become promiscuous.

c) She wants to be promiscuous.

At the time, I even remember having a discussion with a teacher about the HPV vaccine and her speaking about how she refused to give her child the HPV vaccine because “they should not be giving 11-12 girls a vaccine to prevent a sexually transmitted disease”.   Now I understand that the 11-12 year old visit is the optimal visit, as it eliminates the connection of the vaccine with future sexual contact by integrating it within the routine vaccine schedule, which includes meningitis vaccines and a Tdap booster. In addition, I’ve learned that by waiting to provide the vaccine at a later date, many children fall through the cracks because they do not receive routine health care in their teen years. Read more…

Why Early HPV Vaccination is Beneficial

April 29, 2015 99 comments

Since the human papillomavirus (HPV) is transmitted from one person to another through sexual activity, many parents question why the CDC recommends the vaccine be administered to boys and girls as young as 11 or 12 years of age.  HPV vaccination is critical if we are to prevent the 27,000 cases of anal, mouth/throat, penile, cervicalvaginal, or vulvar cancers that are diagnosed each year in the U.S.  However, since some parents have difficulty acknowledging that their teenage children may be engaging in activity that puts them at risk of HPV, they’re often reluctant to vaccinate at the recommended age.

If you’re a parent who is questioning whether your preteen child should get the HPV vaccine, it’s important to realize the benefits of vaccinating at an early age.  

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The vaccine works best prior to exposure to the HPV virus.

The fact is that almost all sexually active people will get HPV at some point in their lives.  While most of these infections go undetected and may even clear up on their own, we know that one in four people in the U.S. are currently infected and that initial infection typically occurs in the teens or early 20s.

While most parents are hopeful that their teenagers will refrain from sexual activity until later in life, research tells us otherwise.  The data suggests that 5% of 12-year-olds, 10% of 13-year-olds and 20% of 14-year-olds are sexually active. And the likelihood of sex continues to escalate with each school grade level with 32% of 9th grade students to 62% of 12th grade students.  And since HPV can be transmitted through oral sex as well, it’s important to note that as many as 51% of 15-24 year-olds are having oral sex before they have their first sexual intercourse.

Since it’s entirely possible to get HPV the very first time that a person has sexual contact with another person, the question we must ask ourselves is why should we wait until a child is sexually active to offer vaccination? As we can see by the data, even a child as young as 12 years old can be at risk.  Even if a child should abstain from sex until marriage, there is no guarantee that their partner did the same, and they can still contract HPV that may one day lead to cancer.  However, if a child should complete the three dose series of HPV vaccination before they begin any type of sexual activity, then they’ll be better protected if they get exposed to the virus, at whatever age that may be.

The HPV vaccine produces a higher immune response in preteens than it does in older teens and young women.

Read more…