In cancer fight, thank Gardasil
An upgraded vaccine and its free administration will greatly benefit countless men and women
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.