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In October of 2006, Liz Ellwood could tell that something was wrong, so she asked her doctor for an unscheduled pap test. A week later, she had an emergency appointment at the gyno-oncology clinic in Ottawa. “Clueless 24-year-old that I was, I managed to confuse the words oncology and obstetrics, so I figured the doctor was just a standard ob-gyn,” Ellwood recalls with a laugh. “When I got there and he said the word cancer, my heart dropped. That was also the day I learned what HPV was and that the first vaccine against it had been approved that year. It was, ‘You have HPV, it gave you cancer, and by the way, there’s a new vaccine that can prevent it.’”
A preventable health crisis
HPV is the most common STI in the world; about 75 percent of the adult population has been exposed to it. “HPV is a very common virus with multiple subtypes, some of which are oncogenic, or cancer-causing,” says family physician Dr. Vivien Brown, the Federation of Medical Women of Canada’s HPV Prevention Week Chair. “When people are exposed to HPV, the majority will clear the virus the way they clear a common cold, but some of us don’t, and it’s this persistent oncogenic HPV that leads to cancers.”
Three quarters of all adult Canadians are at risk, including both men and women. “HPV causes cervical, vaginal, and vulvar cancers in women, but also penile cancer in men, and anal and oropharyngeal (throat) cancers in both men and women,” says Dr. Angel Chu, an infectious disease specialist with Alberta Health Services. “Too often, health care providers, as well as the public, only focus on the HPV cervical cancer link, when in fact about one out of every three HPV-related cancers occurs in men.”
Facing mortality and infertility in your twenties
Biopsies of Ellwood’s tumour showed that it was larger than the doctors had initially thought, and they recommended surgery to remove her cervix. The surgery was a success and Ellwood recalls being on cloud nine – for about eight weeks. That’s when she got an email from the oncologist saying that her cancer had been identified as clear cell adenocarcinoma, and it was impossible to know if it had been fully eliminated. “I was already back at work pretending cancer had never happened,” Ellwood says. “Then I got this email saying, ‘You need chemotherapy, you need radiation, and you need it as soon as possible.’ I wish I could say I reacted more eloquently, but my only thought was to curse.”
After a life-and-death battle involving six chemo sessions and 35 radiation sessions, Ellwood was cancer-free, but also weakened and devastated. The treatment had left her unable to conceive and carry a child, which had been a lifelong dream of hers.
Fortunately, in 2011, Ellwood was able to realize this dream and her daughter was born through egg donation and surrogacy. She has since dedicated her life to helping other women do the same, first establishing a charity to cover the cost of fertility preservation for cancer patients and later co-founding an agency to help people find surrogates and egg donors. She’s also a committed advocate of universal HPV vaccination. “I’m just so happy now that there’s a vaccine out there,” Ellwood says. “I feel safe knowing that my daughter and my nieces will have access to that vaccine and that they’ll never have to go through what myself and countless other woman went through.”
Awareness and education are key to eliminating HPV-related cancers
Ellwood shares her story to help people understand that HPV immunization is about cancer prevention and, if we’re diligent, the elimination of HPV-related cancers as a public health issue. “Clinical studies have shown that three doses of HPV vaccine prior to exposure prevents 99 to 100 percent of all HPV infections from the strains included in the vaccine,” says Dr. Chu. “And, because humans are the only reservoirs for HPV, we could potentially eliminate the disease and its associated cancers through vaccination.”
Since 2017, the HPV vaccine has been freely available through the public school system to girls and boys in every province and territory across Canada. Unfortunately, access is more limited for the majority of Canadians who were beyond school age when the vaccine became available. This is critically important because the risk of HPV doesn’t decrease with age, and the vaccine can protect against cancers even in those who have already been exposed to the virus.
Increasing awareness about the lack of awareness and promoting education about HPV in general is the impetus behind Canada’s third annual HPV Prevention Week, running from October 1st to October 7th. The hope is that by promoting conversations about HPV between Canadians and their health care providers, these cancers can be sent the way of polio. “I think we’re doing a really good job, but we could be doing a better job,” says Dr. Brown. “There’s still a lot of room for more education and awareness, and that’s what HPV Prevention Week is all about. It’s for educating Canadians about what we can do in screening, what we can do with immunization, and what the options are.”
The Federation of Medical Women of Canada is committed to preventing the spread of HPV and the cancers it can cause. Please visit www.canadavshpv.ca to learn more about HPV prevention.
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Made possible through the support of Merck Canada Inc. The opinions expressed in this material are those of the experts featured and author and do not necessarily reflect the views of Merck Canada Inc.