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Seattle Children’s Research Institute adolescent medicine expert Dr. Rachel Katzenellenbogen.

Nearly all men and women in the United States are infected with human papillomavirus (HPV) during their lives, putting them at greater risk of developing life-threatening cervical, anal, vaginal, penile, throat and tongue cancers. But, what if it was possible to stop these cancers from developing?

The National Cancer Institute has awarded Seattle Children’s Research Institute adolescent medicine expert Dr. Rachel Katzenellenbogen more than $2 million to research that possibility. She is studying what happens in the body between the time of HPV infection and cancer development in search of opportunities to intervene and prevent malignant disease.

“There are generations of people who did not get the HPV vaccine or got vaccinated after they were already exposed to HPV,” Katzenellenbogen said. “Those people could still develop cancer. We need to understand their disease process if we are going to help them.”

Cervical cancer offers a unique opportunity for preventative research. While some cancers progress rapidly over months or weeks, cervical cancer develops over decades. Most people are infected with HPV shortly after they begin having sex, but the average cervical cancer patient is 48 years old. This lengthy time frame offers doctors more time to intervene and reverse the evolution of the disease.

“Once we understand the pathways that lead to cancer we can understand how to stop that process and develop treatments to prevent cancer,” Katzenellenbogen said.

While her study is focused on cervical cancer, Katzenellenbogen’s research applies to all HPV-related cancers and may help prevent other cancer types as well.

“Understanding the basic biology of cancer, the human cell, and a virus is exciting,” Katzenellenbogen said. “It tells a story about how the body works and how it is deregulated during disease.  I love delving deeply into the science behind cervical cancer with the ultimate clinical goal of healthier families in future generations.”

Not there yet

While the possibility of preventing cancer in the HPV-infected population is thrilling, Katzenellenbogen warns – we’re not there yet. Today, the best way to prevent cervical cancers and other HPV-related cancers is to get the HPV vaccine, but only a third of Washington teens have received all three recommended doses. Here are some tips from Katzenellenbogen for families about the vaccine:

All teens should get it – boys and girls

The CDC recommends the HPV vaccine for all girls and boys ages 9 to 26. While it is most widely-known to prevent cervical cancer, the vaccine can also prevent many types of cancer that can develop in boys and can prevent genital warts in both genders.

It may be most effective in younger kids

Because many people become infected with HPV shortly after they begin having sex (40 percent of 14- to 19-year-old girls), it is recommended that adolescents be vaccinated before they become sexually active. Additionally, studies have shown that children vaccinated between ages 9 and 11 develop greater immunity from the HPV vaccine than older adolescents. This is why the Centers for Disease Control and Prevention (CDC) recommends the series of HPV vaccines be given to children when they are 11 or 12.

Older teens and young adults should also be vaccinated

While the HPV vaccine is most effective if administered before the patient becomes sexually active, anyone under age 26 should be vaccinated, even after having sex.

“The chance of somebody being infected with all four HPV types that are included in the vaccine is less than 1 in 1000,” Katzenellenbogen said. “If you have one high-risk HPV type, that puts you at risk for cancer. If you have more than one, you are at greater risk. So, if you have been exposed to any, you have even more reason to protect yourself from others.”

The vaccine does not affect sexual activity

While parents have expressed concern that vaccinating their child for a sexually-transmitted infection will encourage sexual activity, research has shown that vaccinating adolescents does not affect their behavior.

“At some point, we all want to become grandparents,” Katzenellenbogen said. “We all hope for long-term relationships for our children. It’s best to protect kids before they are exposed to the virus.”

The vaccine is safe

Many studies have been conducted to determine the safety of the HPV vaccine and no serious safety concerns have been found. The most common side effect is temporary pain at the site of the shot. Fainting can be another side effect after shots, especially for pre-teens and teens. Sitting or lying down for 15 minutes after the HPV shot and other vaccines can help prevent injuries.

“The risk of an abnormal pap smear or genital warts is much greater than the risk of vaccination,” Katzenellenbogen said. “You should protect yourself from known diseases rather than worrying about a hypothetical, unproven risk.”

Additionally, the vaccine does not contain the DNA for HPV, which is what gets integrated into your cells and leads to cancer, so you cannot get cancer from the vaccine.

Your doctor may not mention it

Researchers at Seattle Children’s found many doctors do not suggest the HPV vaccine to adolescents during clinic visits. Because preteens and teens visit their doctor less often than infants, each opportunity to discuss the vaccine with a provider is crucial. Katzenellenbogen recommends parents advocate for their child and ask about the vaccine beginning at age 9.

Ask for the quadrivalent vaccine

There are two types of HPV vaccine – the quadrivalent and the bivalent. The quadrivalent protects against four HPV types, while the bivalent protects against two. The quadrivalent is the only vaccine available to boys, and the only type to protect against genital warts.

Katzenellenbogen recommends the quadrivalent vaccine to all of her patients.

Media who are interested in interviewing Dr. Katzenellenbogen should contact Seattle Children’s PR team at 206-987-4500 or at press@seattlechildrens.org 

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