Beating cervical cancer.
Cancer isn't ordinarily thought of as a transmissible disease - something that can be passed from one person to another, and which can be prevented by an inoculation. But Merck & Co. has tested a vaccine that has proven effective in preventing cervical cancer, which kills 290,000 women a year worldwide.
This welcome development highlights the hydra-headed nature of cancer: It is not one disease but many, requiring an array of treatments and preventive measures. Some of the most effective weapons against cancer are already in the arsenal - all that's needed is the will to deploy them.
Nearly all cervical cancers are caused by human papillomaviruses, an extremely common group of 30 viruses carried by half of American adults and spread through sexual contact. Two of these cause 70 percent of cervical cancers; the vaccine protects women against both and may block others as well. Tests showed that the vaccine is also effective against two other papillomaviruses that cause 90 percent of cases of genital warts. Further testing will be needed to show whether the vaccine is effective in men; if it is it will prevent most cases of genital warts and slow the transmission of the virus.
This is a significant breakthrough, promising a steep reduction in the 10,400 cases of cervical cancer reported each year in the United States. About a third of those cases prove fatal. The benefits will be even greater in poor countries, where fewer women obtain routine Pap tests that detect precancerous growths early enough to allow effective treatment. As with many other drugs, the challenge will be to find ways to distribute the vaccine widely at an affordable price.
An anti-cancer shot is the stuff of dreams. But while the vaccine promises to win an important battle against cancer, it won't win the war. Most cases of cancer, the No. 2 cause of death in the United States after heart disease, aren't caused by a virus and won't be prevented by inoculation.
No scientific breakthroughs would be required to achieve a far steeper reduction in the cancer death rate than will result from the papillomavirus vaccine. The leading cause of cancer in the United States is smoking, which causes cancer in the lungs and elsewhere. Programs to stop young people from becoming addicted to tobacco, and to help cigarette smokers quit the habit, are effective cancer-fighting strategies. Oregon, to its shame, has shortchanged anti-tobacco programs that once were among the nation's best.
Other known causes of cancer include exposure to sunlight, exposure to carcinogens such as asbestos, excessive alcohol use and dietary imbalances. All of these risks can be reduced through individual or collective action. Still other causes are genetic, biochemical or unknown, and await the discovery of preventive strategies.
The vaccine, which is expected to be on the market next year, represents a significant advance, and shows the contribution that medical technology can make in the fight against cancer. Other advances can be made outside the laboratory - in legislatures, in workplaces and in homes.
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|Title Annotation:||Editorials; Vaccine shows it's a war on many fronts|
|Publication:||The Register-Guard (Eugene, OR)|
|Date:||Oct 10, 2005|
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