Questions from Readers: Risk of Cervical Cancer

Eri asks:
Hi, I was told I had a low risk case of HPV and the pap came back abnormal. I was never told if I should stop having sex or how I can prevent passing it to my partner. What about having sex with someone of the same sex. What ways could I prevent spreading it to her?

The abnormal Pap test reveals that you may have an HPV infection.  Over time this HPV may cause changes to your cervix that could eventually cause cancer.  Having sex has no bearing on your risk of these cervix cells becoming affected or of having the HPV clear up.

Jackie asks:  
I just found out I have HPV high risk cancer cell. Can I have unprotected sex with my boyfriend? Can he get a different kind then me? I’m kinda freaked out. My doctor just said I now take a yearly pap.

Take a breath.  There’s no need to freak out!  The whole point of Pap and HPV testing is to find HPV, which just about everyone has sometime in their lives.  If it is found early, it can be followed with additional screening and treated if necessary. The fact that your doctor says you can wait a year for your next Pap test is a good sign.  Most HPV infections will clear on their own and won’t lead to cancer.  Chances are that your boyfriend already has the HPV type that you have. It will not turn into another type.  The most important thing for you to do now is to follow your doctor’s recommendations for follow up and take good care of yourself. Eat well, exercise and if you smoke, Stop Smoking.  Good luck.

Dan asks:  
My wife has cervical cancer and we were wondering if it could spread if we have intercourse with a condom. Thanks

Having sex while you have an active HPV infection does not increase the risk of cancer or the spread of cancer.

H asks:  
I have been married for 17 years and we have both been monogamous throughout. I have always had a normal smear but had an abnormal one for the first time and received LLETZ treatment. Can the virus lie dormant for over 17 years ? Is this not checked for in yearly smear tests?

Researchers are learning new information about the HPV virus all the time.  Currently, it is thought that the HPV lays dormant in your body after it is cleared, but never actually goes away. It can then re-occur if you have additional risk factors, like a weakened immune system, you smoke or you are exposed to additional high risk viruses.   So yes, it is possible that it could be dormant for that long and then come back.   The best way to fight it is to make sure you follow your doctor’s recommendations and get checkups as recommended.

Linda asks:  
I have HPV, several numbers including 16-18, consider high risk. I have had a cervical basic biopsy. I have Mild Dysplasia & Atypical Endocervical Glandular Cells. I have been referred to a GYN, 5/16/2011. What should I expect and does this mean cancer?

Linda:  Good luck with your doctor’s visit today.  The diagnosis of high risk HPV infection and mild dysplasia is not cancer. So don’t freak out.  It is a condition that could progress to cancer if you don’t see your doctor regularly and follow recommendations for treatment, however. So get answers to all your questions from your doctor and don’t delay any recommended follow up.   Your HPV infection could clear up on its own or it may need some treatment. In either case, if you stay on top of it, it shouldn’t turn into cancer and you should be fine. Take a list of questions to your doctor’s visit. And stay healthy.

Louise asks:  
Hi. I had a baby two years ago. Every time I have sex with my partner it’s sore and feels as if there is a lump or something.  Could that be cervical cancer?

Anytime something in your body doesn’t feel right, it’s a good idea to pay attention to it.  The only way to tell what is going on with your cervix is for you to see your healthcare provider and get a medical checkup. Tell your doctor exactly what you’ve asked this blog and have that soreness checked out.  If this soreness is something new that you’ve just noticed, it is likely not cervical cancer. But get it checked out soon.

Katherine asks:  
I have been diagnosed with several types of high risk HPV. Is normal to have many types of HPV? There aren’t any cancer cells according what my doctor says.  However, abnormal cells have been found. Is that dangerous? Can these cells affect me if I don’t start a treatment?

Recent studies have shown that women infected with multiple types of HPV are a higher risk of developing cervical cancer than women infected with only one type. While you do not yet have cancer, you should not put off getting the treatment recommended by your doctor in a timely manner.  Please follow your doctor’s advice and continue with all the follow up recommended.  Take care of yourself.

Nikki asks:  
I have just been diagnosed with high risk HPV. If it’s high risk, could I have had it for a long time and not known? Also, is it ok to have sex? If so. Am I making my chances of my cells turning cancerous when having sex? So can I get more than one kind of HPV at one time? I’m scared.

Don’t be scared. As long as you follow your doctor’s plan for managing your HPV infection, it is not likely to develop into cancer.  Having sex is not likely to increase the chances of your infection developing into cancer if you are in a mutually monogamous relationship.  Take charge of your HPV infection, stay informed and you won’t be so scared.

Michelle asks:  
I have been with my husband 15 years now. 12 years ago I had a cone loop biopsy. Just recently my doctor called me back for a test as the smear I had 6 months ago showed signs of HPV. I thought the procedure got rid of the virus. How can it come back? Am I at greater risk of developing a cancer?

A LEEP or cone biopsy of the cervix eliminates cells that have been infected with HPV and are precancerous.  This procedure does not clear HPV.  However, in most people that have this procedure, their immune system keeps the HPV in a dormant state.  Sometimes, the HPV can reactivate and be clinically detectable.

There currently are no therapies available that get rid of HPV once a woman is infected.  Luckily, most women can clear their infection on their own.  On a more positive note, there are a lot of therapies in clinical trials now that offer the promise of targeting HPV.

A. Pierson asks:  
Is it true that a conventional PAP/ThinPrep test will NOT diagnose cervical adenocarcinoma since this cancer originates in the cervical glands and a sample of cells is only taken from the endocervical outer layer during the test? Thank you for your assistance!

Chances for a false negative Pap test are higher for adenocarcinoma than for standard squamous lesions.  This is due to a number of issues, including the likelihood sampling is less adequate due to these lesions often being further up in the cervical canal and thus harder to reach and collect. It does not mean that a Pap test never diagnoses adenocarcinoma, however. It is important for women to see their healthcare provider every year for an annual checkup and to get regular Pap tests and HPV tests as recommended.

Kimbo asks:  
I have precancerous cells caused by HPV & I have an appt. for LEEP Surgery in one month. Is it ok to have sex with my boyfriend before I have the LEEP? Will sex aggravate my HPV condition before the surgery? Are there negative consequences for my boyfriend for having sex with me before the surgery?

Chances are that your partner has the same HPV types that you have.  Most experts think that the HPV virus doesn’t ‘ping-pong’ back and forth between the same partners, so you shouldn’t make it worse by having sex before the LEEP procedure.  But please talk to your doctor about these questions and how you can reduce your risk of having the HPV infection return.

J asks:  
Can smoking increase your chances of getting cervical cancer if you have HPV?

A woman who smokes has a higher chance of getting cervical cancer. Research has shown that the cervix is affected by the nicotine in cigarettes in much the same way as the lungs.  It is also known that cigarettes can impair the immune system’s ability to fight infection.  So if you have HPV, you should definitely think about quitting. It will help you prevent that HPV infection from developing to the stage of cancer.

Brooke asks:  
I am 45+, tested HPV positive 2 years ago along w/Pap that showed mild dysplasia. Have been followed every 6 months, including colposcopy. After 2 years of watching, HPV test was negative but mild dysplasia continues. Does this negative HPV test improve my chances that dysplasia will clear on its own?

While there are no good prospective trials to support this, the simple answer is likely yes- this is a good sign your body is clearing the infection on its own and the dysplasia will likely regress as well.  However, you still need to have regular follow-up checkups with your provider and follow his/her recommendations.

Ali asks:  
Does the virus increase as a result of sex with my boyfriend ? Should I avoid having sex with him anymore if I want my immune system to clear it off?

No, there is no scientific evidence that increased sexual exposures with the same partner will increase your risk for cervical cancer.

Clnchr asks:  
I was just diagnosed with HPV…Dr. told me it is one of the types that are high risk for cancer. She couldn’t tell me what type for some reason..but my pap was normal. What can I do besides my annual pap (that I will never forget to do every year) to make sure I do not get abnormal cells??

HPV is a really common virus. Nearly 80% of all women will have an HPV infection during their lifetime.  Our knowledge of how HPV acts in your body is not yet entirely clear.  It can clear up and not show up again. It can clear up and then return. And it can just hang around as a persistent infection.  In any of these cases, your best bet for reducing your risk of having the HPV infection grow into cancer are similar.  You can reduce your risk by practicing healthy lifestyle habits like eating well, exercising and not smoking. If you smoke, quit.  Smoking has been shown to significantly increase the likelihood of a persistent HPV infection turning into cancer. And make sure you follow your doctor’s advice and have regular checkups.

Rondalynn asks:  
If a woman had mild dysplasia, had cryotherapy for treatment, then 10 years later had her cervix removed during a hysterectomy, can she still develop cervical cancer?

The answer to your question depends on why you had a hysterectomy. 
> If you had a hysterectomy to treat cervical cancer, you should continue to have regular Pap tests to make sure the cancer hasn’t come back.

> If you had a hysterectomy to treat pre-cancerous changes in your cervix, you should continue to have regular tests for at least a few years after the surgery.

> If you had a hysterectomy where your cervix was not removed (called a subtotal or supracervical hysterectomy), you should have regular tests until you are at least 70 years old. Since your cervix wasn’t removed, there is still a chance, albeit small, that you could develop cervical cancer.

> If you had a total hysterectomy (the entire uterus, including the cervix was removed) for a reason other than cancer or pre-cancer, you may not need to have the Pap or HPV test any more. Check with your doctor first, since some conditions may mean that you should continue to be tested.

> If you had a hysterectomy and have an immune system disease (such as infection with HIV) or are taking medicines that suppress your immune system (such as after a kidney transplant), you may be more likely to develop diseases as a result of your HPV infection. You should be tested regularly.

You should discuss your situation and your risk factors for HPV infection with your health care provider. No matter what you decide about the Pap and HPV tests, you should continue to have regular pelvic exams.

Dionne asks:  
What can be done to boost the immune system to fight off the virus &/or cell changes?

The obvious ways to make sure that your immune system is strong are to take care of your health by eating a well-balanced diet, exercising and not smoking.  Those healthful behaviors affect us in so many ways.

Marte asks:  
I have most of the symptoms of cervical cancer. What do I do?

Your question sounds urgent!  In its early stages, cervical cancer or early cervical pre-cancerous abnormalities usually have no signs or symptoms. That’s why it’s important to get Pap tests regularly. Symptoms usually do not show up until the cancer becomes invasive and grows into nearby tissue.

The most common symptoms at this stage are: 
 
> Unusual discharge from the vagina 
> Blood spots or light bleeding when you’re not having your period 
> Bleeding or pain during sex

Additional symptoms may occur. These include: 
 
> Anemia because of abnormal vaginal bleeding. 
> Ongoing pelvic, leg, or back pain. 
> Urinary problems because of blockage of a kidney or ureter 
> Bleeding from the rectum or bladder. 
> Weight loss

If these are the symptoms you are experiencing, speak to your healthcare provider right away!  Don’t ignore the symptoms. Don’t waste any time in contacting your physician. Ignoring the symptoms can give the cancer time to grow into a more advanced stage and lower your chance for the treatment to be effective.
 
However, you should realize that just because you have these symptoms doesn’t mean you have cervical cancer. You can have these symptoms for other reasons. Nevertheless, it is important to check with your healthcare provider to find out what’s causing them. Finding cervical cancer early means you have a better chance of the treatment being successful.

Spotlight

This special section in Self Magazine features a GYN surgeon and 34-year-old (at the time of diagnosis) patient.

Awareness

This year’s National Race to End Women’s Cancer aims to spread the word that all women should Love Your Ladyparts! Check out site’s new features and join the MOVEMENT.

Research

The Foundation’s research award winners will be notified in January. Thank you to all who sent in their applications.

Education

The next Gynecologic Cancer Survivors Course will be February 7-8 in Anchorage, Alaska. For more information on educational events and courses, click here.