Jean Wisgirda, MD Commonwealth Ob/Gyn Specialists |
For many women, the
following is a familiar scenario: you saw your doctor for a routine gynecologic
exam, and were notified that your Pap smear showed the presence of high-risk
HPV (Human Papillomavirus). Otherwise,
your Pap smear did not show any abnormal cells, and you were advised to come
back in a year for another Pap smear. Or
maybe there were abnormal cells, and a procedure called colposcopy was
recommended, done, and the cellular changes seen were minor. No treatment was recommended, but careful
follow-up with another Pap smear was planned. You and your doctor are waiting for this viral
infection to run its course and, hopefully, to disappear.
So, what can you do to help
your body heal from the infection?
HPV is not new. Papillomavirus
causes our cells to make warts, and warts have been around for as long as we
can imagine. There are over 100 different HPV strains, with about 40 infecting
the genital tract. Some are external and
look like warts, others are flat and are not visible unless the slight skin
thickening they cause is brought out by application of acetic acid and/or
inspection with magnification. Some cause benign changes and are called “low
risk,” and others are “high risk,” meaning that their presence has been found
in cervical cancers.
The connection between HPV
and cervical cancer was not recognized until the mid-1980’s. Today, we know
that HPV is actually the inciting factor that underlies essentially all
cervical cancers, and up to 80% of American women will have been infected with
HPV by the age of 50. The majority of high risk HPV infections never lead to
cancer and 80% to 90% of new HPV infections will clear on testing over 2 years because our
immune system works to immobilize the virus and heal the cellular changes that
HPV creates.
The time course from HPV infection to cervical cancer typically is 10-20
years, and is most likely to happen in women whose bodies do not clear the
virus, rather, chronically carrying it.
This means that when changes are very early and mild, there is time to
introduce steps to assist the immune system in doing its job to clear the
infection. These steps all revolve
around maintaining a healthy lifestyle.
Quit smoking now. The biggest lifestyle risk associated with progression
of HPV infection to cervical cancer is cigarette smoking. It is estimated that
cigarette smokers have 3 ½ times the cervical cancer risk of nonsmokers. HPV infection is the inciting factor for
cervical cancer, but the toxins in cigarettes are promoters of cervical
cancer. Quitting smoking is the
healthiest step you can take to help heal yourself from HPV.
Eat plenty of colorful vegetables and fruits. Several studies have shown
that women who have good levels of beta carotenes and folate in their blood
also have less chance of developing precancerous changes. However, these women
did not use supplements. They got these healthy levels of antioxidants by
eating plenty of foods that are naturally high in them. Studies using beta carotene and folic acid SUPPLEMENTS
did NOT show any advantage. It seems that other substances exist in the foods
themselves that are beneficial, alone or in concert with the antioxidants, for
fighting off the HPV virus and reversing early abnormal cellular changes. Other
studies have shown some preliminary evidence that the antioxidants EGCG (epigallocatechin-3-gallate), glucosinolates, and indole-3-carbinol show
activity against HPV infected cells, though more clinical studies need to
confirm a definite beneficial link. Foods containing other antioxidants (Vitamins
C and E, flavonoids, and polyphenols, for example) may also help boost immunity
and have been found to help decrease risk of some other cancers. Lastly, a very recent study looking at the effect of a shiitake mushroom
extract on HPV infected mouse cells showed antiviral effect, both on the cells
in the lab and in infected mice. Studies are presently being done to see if the
benefits translate clinically to women as well.
Adopt lifestyle behaviors that strengthen your immune system. Chronic
stress and negative emotions have been shown to decrease the ability of the
immune system to fight off disease. In
contrast, positive emotions will strengthen immunity. Learning to manage stress
through exercise, meditation, hobbies, and nurturing supportive and caring
relationships with friends and family will also contribute to improved immune
function. This includes getting regular
and adequate sleep. It is also advisable
to avoid excessive amounts of sugar (pervasive in highly processed foods) and
alcohol, which can both adversely affect immune function.
One final thing to consider is that post-diagnosis is not a good time to
become involved in a new sexual relationship, since this opens up the
possibility of a new infection with a different HPV strain. If you are 26 years
old or younger, you may be eligible for the Gardasil immunization. While not
conferring benefit for the HPV infection you already have, it would help
protect you from any of the four most virulent strains to which you have not
been exposed. It should especially be noted that more significant, precancerous
changes in the cells do need to be treated directly by your doctor, but you can
use the same lifestyle and diet strategies to assist your body in healing from
the underlying condition.
The approach to healing HPV infection with either normal cells or mild
cellular changes on Pap test is essentially watchful waiting and careful
follow-up over months to several years with your practitioner. This can be done safely, and healing can be
optimized by adopting healthy habits and eating a nutritious, plant-abundant
diet.
For further inquiries about Integrative Medicine, HPV Infection, or general gynecological concerns, contact Jean Wisgirda, MD, of Commonwealth Ob/Gyn Specialists, at 804.285.8806.