Women Physicians
GYN Medical Group
Care of Women by Women

Newsletter Index -- January 1. 2007

Barb Dehn is a TV star!

Free Talk on Hormones -- From Adolescence to Menopause

The New HPV Vaccine

Join Us in the Fight Against Cancer

New Guidelines for Pap Smears

 

Happy New Year!


 

Barbara Dehn, Nurse Practitioner at Women Physicians,

a TV star on NBC and Bravo!

Our very own nurse practitioner, Barbara Dehn, has been selected to be a regular guest expert on women’s health for NBC’s newest daytime show, iVillageLive.  Tune in to her next appearance on Monday, January 8th.  The show is seen nationwide from 12 – 1 pm on NBC, Bravo and on-line via the website: ivillagelive.com.  Since so many women have busy schedules, the show can also be seen on-line for 24 hours after it’s filmed.  

Barb was on during the show’s first week in early December when she helped to diagnose the sex of a pregnant woman’s baby.  “This is an amazing opportunity to connect with more women,” said an enthusiastic Dehn. “Being on the show means I can highlight issues that affect women and hopefully make a positive difference in their lives.”

“I’m lucky to have such amazing patients at Women Physicians. I love the idea of being able to care for my patients and also be able to return to Orlando regularly to film the show.”

Barb’s friendly, engaging personality helps her put patients at ease here at Women Physicians and has helped her connect with a larger audience on TV.  She will be posting articles on the iVillageLive website and monitoring on-line chats on the day of filming. We hope you’ll tune in or go on-line to watch on Monday, January 8th, from 12 -1 pm on NBC or Bravo.  For more information see:  www.barbdehn.com


We hope you will join us at our office for a free talk by Dr. Sutherland on 1/22/07 at 6:30 PM 

Your Hormones — From Adolescence to Menopause

All of the doctors will be available for questions.  Light refreshments will be served. 

Friends and family are welcome.  RSVP to Lisa at 650-988-7557.  


The New HPV Vaccine

Many of you may have noticed the recent TV ads discussing the link between HPV (Human Papilloma Virus) and cervical cancer.  You may have also heard that the U.S. Food and Drug Administration (FDA) recently approved a new vaccine against HPV.  We think these are important topics and wanted to make sure you have all the facts.

HPV is transmitted primarily through genital contact.  In fact, it is the most common sexually transmitted infection. There are an estimated 6.2 million new cases of HPV infection each year.  Among all sexually active women and men, it is estimated that 50% will become infected with HPV at some point in their lives.  However, the good news about HPV is that the majority of infections clear spontaneously.

What is the Link Between HPV and Cervical Cancer?

When HPV infection doesn’t clear, it may lead to precancerous changes of the cells on the cervix.  PAP smears screen for these changes.  In many cases, these precancerous changes can be successfully treated.  If untreated, these changes may progress to cervical cancer.  We are very fortunate in this country that most women are able to get regular PAP smears.  As a result, cervical cancer is fairly rare here, with about 10,000 new cases a year and about 3,700 deaths per year from cervical cancer.  (This compares with approximately 80,000 new cases and 73,000 deaths per year from lung cancer, the leading cause of cancer deaths in U. S. women.)

In contrast, the worldwide statistics on cervical cancer are quite different. There are an estimated 493,000 new cases per year and about 274,000 deaths per year, making cervical cancer the second leading cause of cancer deaths in women.  Eighty percent of these cases are in countries with very limited health resources, where routine pap smears are rare or non-existent. 

There are actually more than 100 subtypes (called genotypes) of HPV.  Fifteen of these have been linked to cervical cancer. 

A number of other HPV subtypes are associated with genital warts, which, while benign (non-cancerous), can cause a great deal of concern for a patient.  Warts can be successfully treated, although the treatment can cause temporary discomfort.

Who should get the HPV Vaccine?

The HPV vaccine (called Gardasil) protects against infection from four specific subtypes:  16, 18 (associated with about 70% of cervical cancers) and 6, 11 (associated with about 90% of genital warts).

Gardasil has been approved for use in females between the ages of 11 and 26.  It is given as a three shot series with an initial vaccination followed by injections 2 and then 6 months later.  Ideally, it should be given before potential exposure to HPV, i.e. before the onset of sexual activity, but it may be given after that time.  Studies to date have shown that the vaccine provides protection for at least 5 years.  It is not yet known if booster shots would be needed after that time.

Studies are now being done regarding the HPV vaccine in women over age 26 and in men, but at this time, the vaccine has not been recommended for these groups. 

What about PAP smears?

It is most important to remember that the recommendation for when and how often to get PAP smears has not changed for women under thirty and would not change depending on whether or not one has been vaccinated.  Remember that the vaccine does not protect against all the HPV subtypes that have been linked with cervical cancer.  Therefore, it is still critical that women follow their doctor’s recommendations regarding frequency of PAP smears.  See the final article in this newsletter for current pap smear guidelines for all ages. 

Is the vaccine available at Women Physicians OB/GYN?

Yes, we have had the vaccine since it was approved last summer.  We have been busy vaccinating the young women in our practice.  We are able to vaccinate any young woman who needs to start or complete their vaccination series.  Please call for an appointment if you have questions or are interested in getting the vaccine.  We would be happy to talk with you about it.


Join Us In The Fight Against Cancer

Do you have a loved one who has suffered with cancer?  Are you a cancer survivor yourself?  Have you been newly diagnosed with cancer?  Do you fear the very thought of cancer?  Cancer touches us all.  Join us at Women Physicians Ob-Gyn in taking a small step forward to do something about it.  

This year Women Physicians Ob-Gyn is pleased to announce that we are going to be a Team Captain in the American Cancer Society Relay for Life on June 2, 2007.  And we need your help.  Each team is asked to have a representative on the track at all times during the event. Relay is an overnight event, up to 24 hours in length.  At Relay For Life, teams commit to keeping at least one member walking the track at all times—because cancer never sleeps. If necessary, the doctors will walk all day and all night, but we hope you will be willing to help us in the fight against cancer.  Call Lisa at 988-7557 if you are interested in participating. 

We invite all cancer survivors in our community to attend the opening ceremonies of the American Cancer Society Relay For Life and walk with Dr. Sutherland, an 11 year breast cancer survivor. We encourage you to enjoy the day, make new friends, and celebrate the progress we have made in the fight against cancer!

http://www.cancer.org/docroot/PAR/Content/PAR_1_Relay_For_Life.asp


New Guidelines for Pap Smears

Your doctors at Women Physicians Ob-Gyn Medical Group may have spoken to you recently about some changes in the guidelines for pap smears.  Doctors have been recommending annual pap smears for all women to diagnose cervical cancer and pre-cancer for more than 50 years.  That advice has been ingrained into your brains.  Now that we have more understanding about what causes abnormal pap smears and cervical cancer (e.g. the Human Papilloma Virus), our recommendations are changing.

In March 2003, the FDA approved HPV testing, in conjunction with Pap smear screening, for primary screening of women over age 30.  Both the American Cancer Society and the American College of Obstetrics and Gynecology have endorsed combined screening in women over age 30, under the conditions that among women who test negative for both tests, screening should not be repeated for 3 years.  The absence of HPV infection in conjunction with a normal Pap smear is very accurate at identifying women at extremely low risk for cervical abnormalities. Screening intervals in these women can be safely extended to 3 years.  HPV screening is not recommended for women under age 30 because HPV infections, while common is this group, tend to clear up without any treatments.

Pap Smear Screening Guidelines by the American Cancer Society

Age to begin screening

Age 21, or three years after onset of sexual activity

 

When to discontinue screening

 

Age 70, if they have had three or more normal Pap tests and no abnormal Paps in the last 10 years.

 

Screening Intervals

Annually with conventional cytology or every two years with liquid-based cytology.

 

Screening Intervals for women over 30

 

Every 2-3 years at the discretion of the provider, after three consecutive normal cytology results (unless high risk or immuno-suppressed)

 

Screening Intervals for women with total

hysterectomy

 

May discontinue all screenings (cervical/vaginal) if hysterectomy was done for a benign condition.

 

Use of HPV Testing in conjunction with

screenings

 

Recommends the use of high-risk HPV typing following an atypical Pap. (+) HPV warrants colposcopic evaluation, while (-) results can resume annual screening protocol.

 

Recommendations support combo cervical screening/HPV test, for women over 30, no more frequently than every three years.

 

The annual exam includes much more than just the Pap smear.

We continue to recommend regular annual check-ups.

 

 
El Camino Women's Medical Group provides comprehensive Obstetric & Gynecologic care for patients throughout the Bay Area. Minimally invasive surgery, infertility, women's mental health, and the MonaLisa Touch are just a few of the specialized services we offer.
The MonaLisa Touch treatment is available at El Camino Women's Medical Group. Call the office (650-396-8110) or email Shar (Shar@ElCaminoWomen.com) for more information.
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