<p>dancersmom, I am so very sorry about what happened to your daughter. I don’t have information to share about HPV, though I’m sure some of the MDs on the board will chime in again. I just wanted to send you and your daughter prayers and my best wishes. Life is ridiculously unfair. I do hope the criminal gets what he deserves.</p>
<p>Frazzled1,</p>
<p>Thank you for your kind words. I am working to keep my husband and D on an even keel at the moment, so I need all the support I can get :).</p>
<p>Dancersmom - my thoughts and prayers are with your daughter, I know that all of you are going through a difficult time coming to terms with this. </p>
<p>I don’t want to trivialize what has happened to your daughter, but it sounds as if she is getting proper care. It is quite rare for someone to develop the typical kind of invasive cervical cancer any sooner than 10-15 years after infection - the youngest patient I personally have ever seen was in her late 20s, and she had become sexually active around age 13. This long delay is the reason why Pap smear surveillance works - Pap smears have up to a 25% false negative rate (patient has dysplasia not seen on the Pap), but it takes so long for the dysplasia to progress to invasive cancer, that if the patient is screened with any regularity, the dysplasia will be found in time.</p>
<p>Also, it is extremely rare for a patient to go from dysplasia, even severe dysplasia, to invasive cancer in between follow-up visits. </p>
<p>Cervical cancer is the model of a cancer that proceeds through a stepwise progression of dysplasia over a period of many years. There are rare outliers, but I emphasize RARE, the statistics are definitely on your D’s side. </p>
<p>Now that’s not to say that she can skip her visits or her treatments, and this may mean that she needs a cone or even other therapy down the line, but she should be fine in the long run.</p>
<p>As for the infectivity of the young man - he may or may not be infected right now, but please, understand that by age 30, 70-75% of EVERYONE has been infected - I probably had HPV, you probably had/have HPV. We in the cytopathology community and medicine in general, resisted the public labelling of HPV as an STD. We know that it is sexually acquired, but it is so very, very infective that it strains the “societal” definition of a sexually transmitted disease - it is essentially normal to have come into contact with the virus, just as it is normal to get a cold.</p>
<p>I don’t know if this would help, but if my D was in this situation, I would try to separate the HPV from the rape, and deal with them separately on an emotional level. She, and you, have very good reasons to be angry, and tearful, and any one of a number of emotions, including hatred toward this young man, but the disease is just a disease, and could be dealt with as such. In the long view, I would be more concerned about the emotional damage to my D from such a traumatic event, than from the physical damage of the HPV - the disease can be treated, and she will move on from that, the emotional impact is harder to fix.</p>
<p>Cangel,
Thanks for your explanation of how cervical cancer develops. I knew that it was a type of cancer that normally had a very slow progression, but I did not know exactly how slow. I do feel better now that I’ve read your post.</p>
<p>I understand what you are saying about separating the HPV from the rape. I think that up until my D’s latest round of doctor appointments we were doing a pretty good job of keeping the two things separate. My D spent 9 months in psychological therapy in 2005. Her psychologist helped her work through the emotional damage caused by the rape at that time. By the time I found out about the incident this past spring, D seemed to have mostly put it behind her. I think that this most recent scare at the gynecologist’s office has brought the rape to mind again. D was a virgin before she was raped and was diagnosed with HPV shortly afterward. It is hard for her not to link the two. However, I will pass along your 70 - 75% statistic when I think she is able to process it. It did help ME to read that the medical community has resisted labelling HPV as an STD. I hope that it will help my D to learn that getting infected with HPV is almost as inevitable as getting infected with a cold. I am a firm believer that knowledge is power, so I am gathering information on HPV and I will be passing it along to my D.</p>
<p>I am keeping my fingers crossed that my D’s condition will simply call for more watchful waiting, but I want to know what her options are if more aggressive treatment is necessary. This thread has been helpful. D should hear from her doctor sometime this coming week.</p>
<p>Think I’ll bring up a side note regarding how my D was notified that there was a problem with her Pap results. Because D has a rather packed schedule this semester and had been in rehearsal for a musical at her school, she is hard to get hold of. Apparently a nurse from the physician’s office where she had her Pap done had been unsuccessfully trying to get hold of her for a few days. When she finally did get her on the phone, she said she was from **** and demanded that my D give her her social security number to verify her identity. I understand that the nurse did not want to give personal medical information to just anyone, but my D had no way of knowing that she really was who she said she was. My D told her that she was not comfortable giving out her S.S. number over the phone and said that she preferred to call the nurse back so that she could be sure she really was speaking to someone from the doctor’s office. The nurse made it clear that she did not appreciate having her word questioned, but she gave my D a phone number where she said she could be reached. D said she immediately called the number, but was told the nurse was busy and could not speak with her. It was a couple of days before D heard from the nurse again. When they next spoke, the nurse informed D that she had scheduled an appointment for a colposcopy at a women’s center. When D said that she had a class at that time and that she needed a different appointment time, the nurse got quite nasty. She got on her high horse and told D that her health was more important than any college class and that she would just have to drop everything and get to the clinic. D says her tone of voice was very hostile. The nurse told D that her Pap results were very serious and left her with the impression that she might have cervical cancer. D says she thinks that the nurse believed that she did not understand that HPV can be serious and that she was trying to blow off her appointment. D has been aware for 3 years that HPV is serious business. She was not trying to avoid speaking with the nurse or blow off her appointment. I think that the nurse was angry that my D would not her her S.S. number, so she decided to exact a little petty revenge. Instead of offering any kind of emotional support for a patient who got a scary test result, she decided to turn the screws! Thankfully, the personnel at the women’s center where my D had her colposcopy done were much more supportive.</p>
<p>Many thanks to everyone on this board. I am reading this with my 20 year old D in mind. She has mild cervical displasia, diagnosed in May and confirmed with a culposcopy in July. She went for a follow-up pap smear in October and still has the mild displasia. The funny thing is she is HPV negative. (tested negative twice) I’m wondering what else causes cervical displasia besides HPV? Thanks again.</p>
<p>Dancersmom, when her treatment is finished, I would suggest to my D that she write a letter outlining her experience with the nurse, and send it to the nurse’s employer. Often college girls, especially those at a large school or a college with a med school, will end up at a clinic whose typical clientele is ahhhh, not the most compliant, best educated women in the world - but that is no excuse at all for out and out rudeness - there is a difference between being firm and being rude. (Sounds like the scheduling people at my dentist or at any dermatologist in our city…, oh never mind!)</p>
<p>MMom, that’s an easy one, if she has been repeatedly positive on Pap, and confirmed by a culposcopic biopsy, there are at least 2 reasonable explanations.
First, some women, especially young women, have very severe inflammatory reactions that are hard to distinguish from dysplasia. There are criteria for dysplasia, but this is definitely a continuum, an art of assimilating many different visual clues into a diagnosis. </p>
<p>Secondly, and more likely, she has one of the low risk HPV types that is not included in the standard HPV testing. There are many strains of HPV. The usual high risk HPV test covers 7-9 serotypes, but these account for almost all cancers - but not all dysplasias. There is another, much more expensive test that covers about 18-20 serotypes, but I wouldn’t worry about having it at this point. She should have careful follow-up with regular smears (definitely she should have liquid-based Pap smears), consider asking about the extended HPV testing prior to having a cone or other definitive therapy. Even though these HPV types rarely cause cancer, if she has one of them and has dysplasia, that means her immune system is not clearing the infection, and she needs appropriate monitoring. Sunny Florida can chime in, but at one time it was very acceptable to just watch mild dysplasia, and with the improvements in Pap smears, I would feel safe if that was recommended to my daughter under these circumstances - repeatedly negative HPV testing.</p>
<p>cangel and sunny florida, et. al.<br>
Thank you so much for taking the time explain all this. We all appreciate the information. </p>
<p>Any idea of how long it will be before the next generation Gardisil will be
available?</p>
<p>Karen, Sunny may have better info than I do, I don’t get detailed, but the last thing I read said “a year or two”, which could mean anything from next year to never. I believe the vaccine has been submitted to the FDA.</p>
<p>I am a proponent of the vaccine, and would not wait if my child was 13 or older.</p>
<p>Thank-you Cangel and everyone on this board. I can’t tell you how helpful you have been. : )</p>
<p>I am so sorry about your D. That is truly unfair. My friends daughter was recently diagnosed with severe dysplasia aling with aedocarcinoma in-situ enocervical. She is heartbroken and her daughter is naturally very upset. It is a very confusing situation. She feels that compared to alot of people she knows she was careful. Her realtionships(3 of them) had been that relationships, not one night flings or hookups. She had the unfortunate luck to be with someone who must have been carrying the virus a very agreessive strain. Now she is facing a cold knife cone procedure and she is only 20. Hers is cin 3. Her mom brought her to talk to another doctor and was told anything less than the cold knife procedure would be considered malpractice. She is lokoing at possible infertality or worse. Her parents are walking zombies. It just seems so unfair and I wonder too what about the guy? They asked about testing him and the Md did not seem to think that does any good. The Md also said that even with a condom the virus can still get through. So what do you do to protect your daughters? She was told that they can not remember anyone at her age having this at this level. She had reg. yearly pap smears and they were all normal. Life is not fair.</p>
<p>Debbym,</p>
<p>I am sorry to hear about your friend’s D. As you said, life is not fair. I hope that that the girl’s doctor is able to preserve her ability to bear children.</p>
<p>To Cangel, Frazzled, and Everyone else who expressed their concern,</p>
<p>My D received the results of her colposcopy. She says that she has cervical dysplasia that is on the low side of moderate. Her doctor says that no further treatment is necessary at this time. Instead, it will be watchful waiting, much as it has been for the past 3 years. I think that D is somewhat relieved. She’s dodged the bullet once again, but she wishes that her immune system would vanguish the HPV. The doctor told her that she has the most dangerous strain of HPV - not what she wanted to hear. I am hopeful that eventually her body will rid itself of the virus. I am passing along the information that was shared by Cangel to D.</p>
<p>Thanks to all who sent their good wishes :).</p>
<p>Good news Dancersmom.</p>
<p>I am not excusing the incident of date rape, but</p>
<p>As a Mom of a boy and a girl, do not blame the boys. HPV is an incredibly contagious virus that can be spread by genital contact that is much less “extensive” than what is necessary for pregnancy or transmission of any other STD. The only true protection is abstinence - when a person has sex, they have had sex with every person their partner has come into contact with, AND with every person those unknown people have had contact with - for the purposes of transmission of HPV.
Also, the persistence of the virus and subsequent development of dysplasia depends to a great extent on the infected woman’s immune system, but not in any predictable way. It is not something you can take vitamins or somehow boost your immune system, you are either able to clear it, or live in symbiosis with it or not - we cannot predict who will or will not clear it.</p>
<p>That’s why I’m such a big proponent of the vaccine - getting your D vaccinated does not mean you condone premarital sex, it just means you want to protect her from a virus that is more contagious than almost any other we can vaccinate people against, except perhaps flu irus. That’s why I want the vaccine to move down to young children, then there is no hint of morality in the decision, it is more of a health call.</p>
<p>Rant over.</p>
<p>Oh and DON’T SMOKE - smoking is a risk factor for cervical cancer that probably acts in concert with HPV.</p>
<p>Good news. My freinds daughter had the cone biopsy and it went as good as it could. All of the aedancocarcinoma has been removed and the margins are clear. She will be monitered every 6 months.</p>
<p>Debbym, Glad to hear the good news. Thanks for letting us know.</p>