Correcting Myths and Misconceptions About Cervical Cancer

HPV can lead to cervical cancer, and this infection is much more common than you might think. More than 70 percent of the sexually active adult population will be infected at least once in their lifetime, said Judith A. Smith, Pharm.D., a professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at McGovern Medical School at UTHealth Houston.

Another healthcare provider had an even higher estimate. At least 75 percent to 80 percent of sexually active adults will get HPV by the age of 50, said Amy Pilotte, MSN, ANP-BC, OCN, ACHPN, a senior oncology advanced practice provider with Iris by OncoHealth based in Newport, Rhode Island.

It's important to note that most of these HPV infections are transient, which means they are often cured by the person's immune system without treatment, Pilotte explained.

There can be a lot of shame and guilt associated with HPV because it is a sexually transmitted infection (STI).

"HPV is the most common STI and it is the primary cause of almost all cervical cancer," Smith said.

However, getting HPV doesn't mean you were sexually irresponsible.

"One of the misconceptions is that only women that have had multiple sexual partners will get [HPV which] can lead to the development of cervical cancer," Smith explained. "The truth [is], even one intimate encounter without barrier protection may expose you to HPV that may lead to persistent infection associated with [the] development of cervical cancer."

Another common misconception is that HPV is transmitted only by intercourse, when the virus actually can be passed by any direct, intimate skin-to-skin contact, Smith added.

"Condoms are important for reducing transmission of sexually transmitted infections, but it is important to know that condoms do not provide complete protection against infection with HPV as they do not cover all exposed skin in sexual encounters," Pilotte explained.

It's often believed HPV causes only cervical cancer. In reality, HPV is connected to anal, vaginal, vulvar and penile cancers, as well as head and neck cancers in both women and men, Smith said.

While HPV is common and easily transmitted, it can be safely and effectively prevented with the HPV vaccine. In addition to preventing human papillomavirus, the vaccine can protect against the HPV strains that cause genital warts, Pilotte explained.

HPV vaccination can also help prevent cervical cancer.

"The CDC recommends routine HPV vaccination at age 11 or 12 for both males and females, but [it] may be given as early as age 9," she said, referring to the Centers for Disease Control and Prevention. "The vaccine is most effective prior to the person's first sexual encounter. Vaccination should be recommended to everyone up to age 26 if they were not vaccinated when they were younger, and it is approved up to age 45 depending on individual circumstances."

Another common misconception regarding cervical cancer is that once there is a persistent HPV infection, nothing can be done to cure it. A study suggested the mushroom root extract AHCC might help fight off this infection.

A double-blind, placebo-controlled phase II study led by Smith at UTHealth indicated that when women with a history of persistent HPV infections lasting more than two years took 3,000 milligrams of AHCC once a day for six months, the immune systems in 58.8 percent of the women were able to eliminate the infection, compared with 10 percent in women who received the placebo.

Unlike some cancers, cervical cancer is not genetic.

"While there might be some extremely rare cases of an increased genetic risk for cervical cancer, that connection is more likely related to a genetic mutation that weakens immune function and the ability to clear HPV infections," Smith explained.

Ninety-nine percent of cervical cancer cases are caused by persistent HPV infections that lead to cell damage (dysplasia), which can lead to cancer if there is no intervention, such as surgery.

This is why it's important for women to have regular Pap smear screenings, especially if they have a history of HPV, Smith added.

Pap smear screenings are the best way to detect cervical cancer because the disease itself usually doesn't present with any symptoms.

"A lesion or abnormality on the cervix may be visible during a pelvic examination. Your medical team will advise you on an appropriate schedule for [a] Pap smear depending on your history," Pilotte said.

"For patients that do have symptoms, they may notice irregular or heavy vaginal bleeding, bleeding after sex and/or abnormal vaginal discharge, though many of these symptoms can be seen with other disorders. Therefore, it's important to discuss with your team and be examined," Pilotte added.

You can have sex after treatment for cervical cancer, but when and how may depend on your unique circumstances.

"Many will be able to have penetrative sex after treatment for cervical cancer, but some will have challenges that require attention," Pilotte explained. "In rare circumstances, a patient may not be able to have penetrative sex after treatment. Typically, a patient will be advised to avoid penetration for six weeks after surgery, as well as during and for four to six weeks after radiation therapy."

While you can have penetrative sex after cervical cancer treatment, you should be aware sex might not be exactly how it was before your treatment.

"There are post-treatment symptoms that can impact sex in survivorship from cervical cancer, but there are modifications that can help," Pilotte said. "Depending on the treatment, women may experience vaginal dryness, narrowing or shortening of the vagina [stenosis], tissue damage to the genital area, painful sex, dysfunction of orgasm and/or arousal changes."