Treating Cervical Pre-Cancer With Cream Not Knives

When a woman gets an early pre-cancer of the cervix, called mild dysplasia, or CIN I, she is likely to resolve her infection, or at least keep it in check so that it doesn't progress, and it's only likely to progress to overt invasive cancer in about 1/100 cases. Even if she has severe dysplasia, or CIN III, she only has a 1/10 chance of progressing to invasive cancer. The reason that so many women clear or control their disease is related to an innate immune response that some women can count on. The cervical pre-cancer is caused by the Human Papilloma Virus (HPV). Various types of HPV viruses cause other diseases rather than just cervical cancer, including genital warts. It has been shown that the warts too can be cleared by an immune response. To aid the ability of the body's immune response to clear the HPV Virus a novel wart treatment called imiquimod was developed and approved for use in 1997. In 1999 a small group of women (56 women) were given the opportunity to have treatment of their dysplasia either by medication with imiquimod or by a surgical treatment. The results were reported in the January 2012 issue of the American Journal of Obstetrics and Gynecology, the imiquimod treatment of the cervix was tolerated well and helped to clear HPV types, but it did not reliably clear the pre-cancer (dysplasia). So we cannot yet prescribe creams, but surgery, weather performed with knives, lasers, freezing or burning is still the treatment of choice when you do need to be treated.


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