After several years of "some obvious, some not" annual exam, pap smear him indicates that the situation is getting worse. The results showed high-grade Dysplasia, which means there is a significant change in the cells of the cervix, put him in great danger for developing cervical cancer. Once again, the Saxon physician assured him that everything will be fine, but it was a closer look is needed.
A series of exams and invasive biopsy followed over the next year. All of them have disappoint if not frightening results. If the problem continues, Saxon will need what is called a cold knife cone biopsy, a surgical procedure to remove the cervical lesion.
"My husband and I are making plans to start a family," recalls the Saxons. "As if the threat of cancer is not scary enough, how about my fertility? I want to know everything about why this is happening and is there anything I can do to get it to stop. "
That's when he started doing his own research. Will change her diet help? How about sport? If the problem is that he's not against viruses, could he jump-start his immune system somehow? In the course of digging, he discovered an online forum which says he should quit the hormonal birth control pills, which she has taken on a regular basis since the age of 17. Later, he dug deeper and found many mentions of the site such as the National Cancer Institute and the Guttmacher Institute birth control pill-linked to cervical cancer. He mentioned his findings during the next appointment, but doctors could not say whether that might be the reason he does not clean up the infection.
"He said there was no evidence that stopping the pill will help," said Saxon. "He suggested I stop Googling things because I just freaking myself out."
So far, what we know for sure is that any complications associated with pills--including effects on the immune system-this is exacerbated during pregnancy. And we know that the majority of women infected with HPV will clear itself.
Dr. Curry Braaten, an obstetrician and gynecologist at Brigham and women's Hospital in Boston.
Can a pill really depresses the immune system?
If you do a quick Google search for the above questions, you will get more than 400,000 results, many of which come from the sourced (read: not reliable) requested the Board such as ChaCha or Yahoo! Answers. Perhaps worse – oddly enough – you will find information vaguely shocking about the possibility, however, the effect of the pill on cervical cancer and the immune response on trusted sites, such as the Saxons did.
Women wonder about this, but there doesn't seem to be direct advice about what to do-even when they ask their doctors about it. "And when that happens, often because there's just no clear answer yet," said Dr. Curry Braaten, an obstetrician and gynecologist at Brigham and women's Hospital in Boston.
"No one will say that the pills by itself make you more likely to contract HPV; nor does it make you more susceptible to other infections such as colds or the flu, "said Dr. Jen Gunter, an ob-gyn's San Francisco Bay Area. And even though there is evidence linking oral contraceptives for a slight increased risk for cervical cancer, experts disagree on what is behind it. "It's controversial," said Gunter "people are very divided about what actually happened." This can be a risky sexual behavior problems. For example, a study found that women's 2012 taking birth control pills are less likely to use condoms, which are known to reduce exposure to HPV.
Contrary to what the doctor told her to Saxon, however, there is at least some evidence that long-term use of the pill or virus persistence in repeating the latent virus reactivation, according to Dr. Xavier Castellsagué, Director of the WHO/ICO (the Catalan Institute of Oncology) central information about HPV and cervical cancer in Barcelona, Spain. In 2002, the International Agency for research on cancer published a review that found a strong presence of cervical cancer and cancer of the pre-season in HPV-positive among women who used the pill consistently over the past five years or more, and research since then has supported that. There is no increase for women who use the pill for four years or less.
"It was clear it was a co-factors," said Castellsagué, even if there is no certainty about the mechanism.
It is important, though, to emphasize that the case and others like it are rare. Saxon is the right doctor to consider every step of the Saxon will clean it myself.
"Even his own biopsy can stimulate a positive immune response in the cervix and helps to clear it up," said Gunter.
HPV is the most common sexually transmitted infection in the United States. More than half of sexually active people will get one or more strands of the virus and clear it in their lives, and at any given time, about 43 percent of the women who become infected with HPV, according to the National Cancer Institute. "Most women test positive for it at the age of 23," said Gunter.
Almost all cervical cancer begins as HPV, but scientists are still studying why some women become infected with HPV develop cancer while most have no effect at all. Ninety 90 percent of those infected with the virus are clear that within two years, said Castellsagué.
It's impossible to say why the Saxons came to an end in the remaining 10 percent who develop persistent infections and cervical lesions that, if left untreated, can turn into cancer. He's still young and otherwise completely healthy. And that's the real problem: still no way of knowing, at the level of the individual, which will remove the virus and who will need further treatment.
The development of cervical cancer, as with other forms of cancer, is a complicated dance of genetics, environment and other factors contributed. High risk or "onkogenik" strain of the virus is more likely to lead to cervical cancer. (Two of them, types 16 and 18, are responsible for almost all cancers linked to HPV and existing vaccines.) But there are many other factors that are known, apart from the possibility of the link pills.
While it is true that your personal genetics play a role in whether you can remove the virus, "the immune system is the key here," said Castellsagué. Thinking is that the immune system is suppressed is what allows the virus to survive and cause problems, which is why women with HIV or those taking immunosuppressive drugs for autoimmune disease are at greater risk for cervical abnormalities. Similarly, smokers are twice as likely to have problems with tenacity because the effects of smoking on the immune system.
The Bottom Line
Medical advice is weighing the benefits and risks of certain tactics based on what are the most common or most likely to occur.
"I never recommend that patients stop her just because she is KB not clear HPV," Braaten said "so far, what we know for sure is that any complications associated with the pill. Including the effect on your immune system – exacerbated during pregnancy. And we know that the majority of women infected with HPV will clear itself "meaning:. In many cases, the pregnancy is both larger and more likely to be a threat.
If you're on the pill now, don't panic. Oral contraceptives remain among the safest, most effective medications on the market. As long as you get a clean bill of health during your annual examination and pap smear regularly, there is no reason to worry. Your best bet to prevent problems down the road is to talk with your doctor about HPV vaccine-do not stop the pill, no matter how long you have been on it. And remember, the pill does nothing to protect you against sexually transmitted infections, so don't skip the condom!
For women struggling with a lingering problem, the cause of the virus, the official bottom line is that there is not enough evidence to say that the go pills will definitely help you clean up the infection. But also no harm, as long as you use other contraceptive methods are reliable.
Saxon eventually opted to switch to condoms after clear he would need surgery. "It was just so frustrated," he said. "Each time, [the doctor] said it would be clear, but things only got worse. I feel like even if there is only a small likelihood of stopping the pill can help the immune system fight off infection better I would be useless. "
Although there is no way to demonstrate exactly what difference the switch is made, the Saxons can count at least one expert in his corner: "the situation is very rare, but it does happen," said Castellsagué "in my opinion, once you have some cervical. disorders for over a year and it's not going away, it is a good idea to switch to another contraceptive method. "
The Saxons may be an anomaly, but the fact is he was one of those people who, for whatever reason, have trouble getting the virus under control. If there is a smidgen of chance pills may play a role in combating what can become cancer, why am I even taking that chance? He asked.
Finally, in October 2012, after six years, a long series of invasive tests and surgery to remove a 1-inch section of the cervix, the Saxons had the peace of mind of pap smears are obvious.
"And so far," he said, "I'm still in the clear."