In cancer fight, thank Gar­dasil

An up­graded vac­cine and its free ad­min­is­tra­tion will greatly ben­e­fit count­less men and women

The Australian - - LIFE - RACHEL BAXENDALE

One af­ter­noon last week I found my­self ly­ing on a gy­nae­col­o­gist’s op­er­at­ing ta­ble, black fumes and the smell of burn­ing flesh ris­ing from my nether re­gions.

The doc­tor was us­ing an elec­trode to cau­terise my cervix, hav­ing ear­lier sliced off a small pre­can­cer­ous chunk that the nurse mat­ter-of-factly popped into a spec­i­men jar.

Thanks to a de­ci­sion an­nounced by Health Min­is­ter Greg Hunt on Sun­day, thou­sands of Aus­tralian women will avoid hav­ing to un­dergo the same uned­i­fy­ing pro­ce­dure and, more im­por­tant, the in­fin­itely worse even­tu­al­ity of a cancer di­ag­no­sis.

I’m an oth­er­wise healthy 30year-old. In 2007, when Aus­tralia be­came the first coun­try in the world to roll out the Gar­dasil hu­man pa­pil­lo­mavirus vac­cine free of charge, I was young enough to be el­i­gi­ble and took my­self off to the GP to get my three jabs.

The orig­i­nal Gar­dasil vac­cine pre­vents four of more than 120 strains of gen­i­tal HPV, most of the rest of which are rel­a­tively harm­less.

Ac­cord­ing to the US Cen­tres for Dis­ease Con­trol and Preven­tion, 80 per cent of sex­u­ally ac­tive peo­ple will have con­tracted at least one strain by age 50.

Any­one who has ever had sex is at risk and con­doms don’t of­fer full pro­tec­tion. Most peo­ple re­main bliss­fully ig­no­rant of ever hav­ing been in­fected, their im­mune sys­tems hav­ing fended off a be­nign bug with­out in­ci­dent. Some of us aren’t so lucky. This year a ThinPrep pap test showed that although I had tested neg­a­tive to the two strains of cancer-caus­ing HPV that are cov­ered by the orig­i­nal vac­cine and cause 70 per cent of cer­vi­cal cancer cases, I had con­tracted one of 12 other high-risk strains.

Of those 12, five strains — which be­tween them are re­spon­si­ble for an­other 20 per cent of cer- vi­cal can­cers — will be cov­ered by the Gar­dasil 9 vac­cine. The new gen­er­a­tion shot will be rolled out next year to 12 to 13-year-old boys and girls through the school vac­ci­na­tion pro­gram.

Like the old Gar­dasil, which was extended to boys in 2013, Gar­dasil 9 will also pre­vent two HPV strains that cause gen­i­tal warts as well as vagi­nal, vul­var, throat and anal can­cers in women, and anal and throat can­cers in men.

It’s Aus­tralian Trans­la­tional Re­search In­sti­tute re­search di­rec­tor Ian Frazer and his re­search part­ner Jian Zhou who we have to thank for the vac­cine. The pair de­vel­oped and patented the tech­nol­ogy be­hind it at the Univer­sity of Queens­land in 1991.

Work was then done in con­junc­tion with the Na­tional Cancer In­sti­tute, Ge­orge­town Univer­sity and the Univer­sity of Rochester be­fore Gar­dasil was ap­proved by the US Food and Drug Ad­min­is­tra­tion and our own Ther­a­peu­tic Goods Ad­min­is­tra­tion in 2006. At the urg­ing of prime min­is­ter John Howard, health min­is­ter Tony Ab­bott struck an agree­ment to roll out Gar­dasil free to Aus­tralian school­girls from April 2007.

While my treat­ment last week was un­pleas­ant, any on­go­ing com­pli­ca­tions are highly un­likely and my only pain dur­ing the 10 minute loop elec­tro­sur­gi­cal ex­ci­sion pro­ce­dure was caused by a cou­ple of jabs from the nee­dle that ad­min­is­tered the lo­cal anaes­thetic.

A cou­ple of much less ex­pen­sive (and less in­va­sive) jabs will spare the next gen­er­a­tion of Aus­tralian women from find­ing them­selves on the gy­nae­col­o­gist’s op­er­at­ing ta­ble, let alone be­com- ing one of 250 who die of cer­vi­cal cancer each year. The Aus­tralian cost of an in­di­vid­ual course of Gar­dasil 9 has not yet been made public but the US price and the price of its pre­de­ces­sor in­di­cate the two jabs will cost the tax­payer about $300. You can’t put a price on a life but even in my case Gar­dasil 9 would al­ready have paid for it­self. I’ve spent about $1500 on di­ag­no­sis and surgery, al­most $500 of which was cov­ered by Medi­care, with ex­tra pathol­ogy costs and a bill for a check-up to come. No­tably it was the new gen­er­a­tion ThinPrep pap test that de­tected the low-grade le­sions on my cervix. A rou­tine pap smear two years ear­lier had failed to de­tect the ab­nor­mal­i­ties that left un­treated would likely have pro­gressed to cancer dur­ing the next decade or so.

Con­tro­ver­sially, we’re now in a tran­si­tion pe­riod be­tween the old­style pap test and a new screening regime that will see the ThinPrep test and an HPV screening cov­ered un­der Medi­care from De­cem­ber 1. The move is ex­pected to re­sult in a 30 per cent in­crease in the de­tec­tion of pre­can­cer­ous or can­cer­ous cells.

Since May, women have been able to claim the old test or the ThinPrep test un­der Medi­care, but not both, and not the HPV screening.

I paid $36 for my ThinPrep test, and I’m glad I did. I’m also glad other women won’t have to pay for it after De­cem­ber 1.

Women, get your­selves tested, and par­ents, get your chil­dren vac­ci­nated. Thank good­ness we live in a time and place where preven­tion is pos­si­ble.

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