June 2014

Every 8 Minutes a Young Adult is Diagnosed with Cancer

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Stacey A

Over 70,000 young adults (YA) receive a world-altering diagnosis of cancer each year. I have. To put this into clearer perspective, that is one person, 15-39 years of age, diagnosed with the deadly disease, every 8 minutes.

I am one of them.

It is estimated that two out of three YA cancer patients will experience at least one major health complication as a result of their condition or life-saving treatment.

I am one of them.

Approximately, 1 out of 3 of them also undergoes further potentially-fatal complications due to their illness or therapy.

I am one of them.

They face a unique set of challenges (different from those of their younger child, and older adult, counterparts), ranging from increased risks for psychological and social issues, to distinct physical and financial concerns. I have. This is my 8 minutes, and how I became a statistic not just once, but twice. This is my cancer story.

Stage 3 Colon Cancer

I became a statistic when I was diagnosed with advanced, stage-3, colon cancer, in my twenties.  I should have been out enjoying the warm, sunny spring day with friends, but, instead, I was at a doctor’s visit, getting nearly the worst medical test results possible.  I should’ve been thinking about how to spend summer break, and looking forward to the season ahead, but, instead, I was feeling small, cold, and alone while stuck in an exam room.  I should have been anticipating my future, and planning for the next phase of my life, but, instead, I was frozen in time and place at the office check-out window…trying to figure out how to tell everyone the bad news.

Cancer and Infertility

I quickly became infertile from medically-induced early menopause as a result of radiation treatment, and underwent brain fog from chemotherapy, back then.  I am now undergoing recurrence of my primary tumor in my thirties, owing in no small part to being denied access to continued healthcare and regular follow-ups (after my original therapy), due to a preexisting condition (read my story of trying to get a diagnosis and treatment without insurance).  And, I currently expect to live with the disease and its side-effects as a chronic illness for the rest of my life, however long or short my time may ultimately turn out to be.  This means living with fatigue, low hemoglobin, iron-deficiency anemia, and sexual dysfunction, among other problems.  It also puts me at increased risk for infection, digestive trouble, bone and joint pain, surgery for colostomy bag or hysterectomy, cancerous spread to lymph nodes, and secondary malignancies of the lungs, GI tract, or female organs, plus other worries.

Cancer and Long Term Health

The long-term and permanent damage done to my immune and endocrine system has proved to hold further consequences for me, as well. I am still tens of thousands of dollars in debt from my original prognosis, and debts have only continued to mount, since I first began to show symptoms of my cancer returning (which took an unnecessarily long time to confirm because of the healthcare bureaucracy of the time).  It is a true challenge, trying to return to the workforce ~ not only because of my health status, but also because of my bi-weekly medical schedules; 3 – 5 days of labs, treatments, shots, other doctor appointments, and recovery periods in-between, every other week.  Likewise, it is very difficult to remain positive and hopeful, when you’re often depressed and anxiety-ridden about how to pay for rent, bills, and groceries, on extremely limited resources.  It’s equally tough to relax and try to relieve stress by enjoying even a short time out (although it may well be what you actually need the most), when you feel guilty about the extra expense.  You may already be leaving your loved ones with financial burdens that they won’t necessarily know how to handle any better, especially without you, after all.  And, it’s NEVER ever easy to be judged harshly by those who don’t understand the regular, ongoing pain, fear, loss, and uncertainty, which you go through and deal with on a daily basis.  That was my 8 minutes, and how I became a statistic not just once, but twice ~ and, this is why hormones and hormones research matter to me.

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Adventures in Natural Family Planning

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Samantha Wiessing

Ten years ago, I began researching fertility and natural alternatives to achieving and avoiding pregnancy. The more research I did, the more I realized that there was a decided lack of current, accurate information on the internet. After becoming pregnant with my first child, I focused my research to learn how to space my children without using birth control. Though my family has a long history of breastfeeding and childbirth, they did not provide me with any information that I could use. I didn’t want to use hormones while breastfeeding but neither did I want to get pregnant again immediately. While there has been significant research validating ecological breastfeeding, at the time it had not caught on. There was very little information on the internet about practically applying it in everyday life. Needless to say, using the information on the internet, I was soon pregnant with my second child and then my third child.  At that point, my forays into natural family planning were not working.

Natural Family Planning and Physicians

I was desperate to find a way to space my children without artificial hormones or invasive devices; I looked to my OB/GYN and the local health department. My OB and the health department could not provide me with any information about natural family planning, and in fact I was openly mocked by the doctors and nurses. The health department tried giving me Cycle Beads with very little instruction. I refused them, knowing that they would be completely ineffective as I was breastfeeding and didn’t yet have a menstrual cycle. It seemed that I knew more about managing my fertility than they did.

Do-it-yourself Natural Family Planning

Discouraged and outraged, I obtained as much information as I could and assembled my own version of natural family planning. It worked for two years until I found myself pregnant with child number four. When my family and I relocated to another state, I was soon able to find a natural family planning instructor. I learned the Billings Ovulation Method. I cannot stress enough how important an instructor is when using natural family planning. This system taught me what I had been doing wrong all these years (I will write more about this and other methods in subsequent posts). I was able to successfully navigate breastfeeding my fourth child without getting pregnant.

However, my hormones started acting up in very obvious ways shortly after giving birth. None of the doctors I spoke to about it could give me an answer. I was experiencing what is known as “tail-end brown bleeding” from the end of my menstrual cycle on up to and including the day of ovulation. I went to two OB/GYNs and a hematology specialist. The answers I received ranged from “it is normal” to “there is nothing wrong.” Not one of them could explain this very obviously abnormal symptom. They all seemed unconcerned even though I knew that something was up.

I continued my research of the female reproductive system, as I realized that neither the Billings Ovulation method nor the Sympto/Thermal Method did anything to help the women who had health problems such as PCOS, endometriosis, infertility, or in my case abnormal bleeding.

Natural Family Planning With Irregular Cycles

My continued search for answers led me to another method of natural family planning called the Creighton Model FertilityCare System.  The Creighton Model is considered the gold standard of the natural family planning world. Creighton has been able to research and document in a woman’s chart hormonal irregularities and how they relate to her overall fertility and health. Finally, I had a method of not only diagnosing but also treating the abnormality I experienced. With the use of the Creighton Model and NaPro Technology it is possible to work cooperatively with a woman’s cycle to help seek treatment for health problems like my abnormal bleeding pattern.

I fell in love with this method and went through the extensive training course to become a presenter and promoter for the Creighton Model. I originally set out to become a practitioner for this method so that I could help other women get the education they needed. I soon learned about the politics that surround natural family planning.  We’ve all heard the jokes. “You know what you call a woman who uses natural family planning?……….. Pregnant.”  Well, that pretty much sums up what most people think of natural family planning. Teachers are abundantly available for those interested in learning any method of natural family planning; but there is much more work to be done to change our culture’s current paradigm surrounding natural family planning

Luckily, we have come pretty far over the last decade. There is ever more press and discussion these days about the side effects of hormonal birth control (I will add a few links here). More and more women are deciding against hormonal birth control. Though, there is still much work to be done,natural family planning is becoming a viable alternative to the pill and other devices.

A New Approach: Fertility Awareness

Fertility Awareness is catching on as the new bias free catch phrase for a concept that has been around since the beginning of the birth control explosion. I have dedicated my life to spreading and sharing the wonder that is natural “organic birth control.” What we women really need is more voices who advocate for, and promote today’s modern Fertility Awareness Methods (FAM).

Over the coming weeks, I will be writing articles about the various methods of Fertility Awareness; the pros, the cons and my personal experiences with each. If you’d like learn how to navigate pregnancy naturally or if you have been diagnosed with a women’s health problem that you are currently treating with birth control, follow me on Hormones Matter. If you’d like to share your own experiences with natural family planning and fertility awareness, click Write for Us and send us a note.

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Before She was Born: Seeds of Postpartum Depression

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Margaret Aranda, MD

She was insy tinsy, curled up in a comfy ball. When she was happy, she did summersaults in the amniotic fluid, with plenty of room to spare. She had no idea, but first she went to the left, and then she swooned to the right, floating with pure bliss. There was no yesterday, and no tomorrow. There was only “now.”

Sometimes, she could hear a bigger voice, sometimes calm and sometimes yelling and screaming. With the screaming came a faster heart rate, pounding her ears and making her own heart beat pound!-pound!-pound! … beating faster and faster itself.

Then there were the nights. She didn’t know they were ‘nights’ per se, but she knew that when things got dark, the sound of the lady crying would start again and again. Over and over she would hear the crying, feel a hand over the wall covering her, making her shake and shake and shake all over again. Every night. The sobs scared her, making her crawl up in a ball as tight as she could get. She just wanted to disappear, to be invisible, to be nonexistent because she was made to feel so unwanted. Her mother never sang to her, never put Mozart music on her belly, never gave her a backrub from her buttocks to her head. So she never knew what she missed. She was just cold. She knew coldness.

On the other side of the wall, her mother was crying again, mascara blobs leaving black eyes as if she was in a bar-room fight. Her hair was dirty; she hadn’t bathed in a week. Her belly was big and she was running out of clothes to wear, down to the last pair of sweatpants. She couldn’t go to sleep and instead, she was tossing and turning from side to side, dragging the baby in the abdomen with her with a plop! to each side. And she woke up all night, on and off. Early morning awakening was all too common, with the mother up long before the sun rose. Her eyes burned from sleeplessness, tearing without crying. Crying without tearing. She felt that she was in a brain fog; she was boiled down to pure misery. How is she supposed to live like this?

She walked out to the apartment balcony, five stories up, and she toyed with the idea. She toyed with the idea of climbing up the balcony and jumping off, just to end it all. She wasn’t capable of caring for herself, let alone a baby. She would take the baby with her as she jumped, to spare her any more harm in this harsh world. She toyed with the idea, and then she slumped her shoulders, failure that she was, because she failed at everything and today would just be another day of failure. She turned around and walked away, towards the bed. Then she shut the sliding glass door on the way back in, locking it as if for safekeeping. She forced herself to eat, for the baby’s sake.

Weeks went by. Eventually, alone and in the darkness, she passed the mucous plug. Then the amniotic fluid broke, leaving a huge pile of wetness on the sheets and floor as she dragged herself to call 911 on the speakerphone.

Fluid still running down her leg, she just lay there crying real tears this time, wondering what she was supposed to do with a new baby girl. She was afraid she would throw her out the balcony. She was afraid she would sleep on top of her and crush her. She knew she wasn’t in her normal state, but she didn’t know what to do, whom to ask for help, what would happen, or what was wrong with her.

She didn’t know whom to call.

Her uterus contracted hard now that they were in an operating room, pushing the baby’s head down toward the cervical os and therefore, the outside world. In the meantime, the little baby’s head pressed flat on its way out of the vagina as she reluctantly made her way out to the outside world. She heard many voices, and the Cling! Clang! of metal instruments being thrown here and there. It hurt her ears! It shocked her!

It was cold, harsh, and they scrubbed all the wonderful, warm amniotic fluid solution off her with a cold, wet towel. She frowned at them with distaste. Then they laid her on a cold, hard scale, they pricked her foot for blood, and she screamed. It was just the beginning. She screamed and screamed and screamed.

After a few days, it was time for Mom to take the baby home. Everyone else was happier for Mom than she was for herself. The baby cried for her breast milk, and Mom whipped out a boob every two hours. Tired, sleepless, undernourished, Mom was wheeled out of the hospital with no balloons and no flowers. Her friend drove her home after ensuring the baby car seat was intact.

Mom’s sleeplessness continued. Her thoughts of throwing the baby out of the window resurfaced, her guilt and panic ensued when the baby cried, and this went on for months. No one knew. She didn’t have any friends. She wanted to jump off the ledge with the baby.

Disheveled, she went grocery shopping.  She had no glow on her face at being a new Mom, and you were the first to notice. So you struck up a conversation with her, pushing yourself into her life, almost against her will. But not really. Because secretly, she wanted you there, and inwardly, she yearned to have you there. You offered to babysit one night, exchanged phone numbers, and you called her the next day to ask her if she needed anything from the drug store. Any shampoo? Baby lotion?

And the more you talked to her, the more you discovered a probable diagnosis. So you gave her an ‘800’ number to call, and she did it. And she was one of the few women who got the diagnosis made, received treatment, intervention, and after about one year, she was cured. What was her diagnosis?

Diagnosis: Postpartum depression. Also known as maternal mental illness, it is more varied and common than previously thought, perhaps occurring in one of five pregnant women (Gaynes, 2005). During pregnancy, the etiology is due to hormonal complexity involving stress, hormones, and genes, wherein some endocrine hormones can go up greater than a hundredfold (Sichel, 2003). After childbirth, hormone levels fall to the ground, resulting in another hormonal insult swinging in the opposite direction. Sounds like a roller coaster to me, or the giant tick-tock of a ginormous grandfather clock, with a huge pendulum swinging two different ways. Either way, one could easily see it makes one prone to get sick.

So, maternal mental illness does not just occur in the postpartum period of up to one year (Belluck, 2014). It can occur during pregnancy. It is often accompanied with social isolation and/or it overlaps with common symptoms of pregnancy itself, confounding the diagnosis even more. There are a paucity of studies that include the screening, multi-ethnic, diverse socioeconomic status, pre- and post-partum depression assessment (e.g., “mild” vs. “severe” depression), the institution of an intervention, and the follow-up of the effectiveness of the intervention. Nevertheless, there are a variety of Resources and Help Sites available to turn to for use (Belluck, 2014).

The following states have actually passed laws for screening, education, and treatment of maternal mental illness, in an attempt to prevent baby drownings and maternal suicides: Texas, New Jersey, Illinois, and Virginia. New York is considering such legislation. Patient awareness and standardized physician questionnaires are needed to assess risk, not only of depression.

In this author’s view, every pregnant woman needs and deserves the assessment of the risks of: being battered, suffering emotional abuse, forming diagnostic criteria for diagnosing mental illness including maternal mental illness and/or psychosis, infanticide due to maternal mental illness, nutritional status, obesity, diabetes, and hypertension. Improved medical education should also ensue. For the women that are seeking prenatal care, the gynecologist is poised to be the “Gatekeeper”. Psychiatry should be front-runners in grading maternal mental illness through the DSM-V, and should take “front and center” in leading this riveting cause for women and their babies.

About the Author: Dr. Margaret Aranda is a USC medical school graduate, as well as an anesthesiology resident and critical care Fellow graduate of Stanford. After a tragic car accident in 2006, she unfolded her passion of writing to advance the cause of health and wellness for girls and women. You can read more of her work on her personal blog, Dr. Margaret Aranda, her Pinterest page, a page on Postpartum Depression, her author’s page at Tate Publishing or follow Dr. Aranda on twitter @DrM_ArandaMD.

References

  1. Belluck, P. ‘Thinking of Ways to Harm Her’. New findings on timing and range of maternal mental illness. Postpartum Depression. Mother’s Mind: First of Two Articles. The New York Times. http://www.nytimes.com/2014/06/16/health/thinking-of-ways-to-harm-her.html?_r=0. June 15, 2014 (Accessed June16, 2014).
  2. Belluck, P. ‘Thinking of Ways to Harm Her’. New findings on timing and range of maternal mental illness. Postpartum Depression. Mother’s Mind: First of Two Articles. Resources: Where to turn for help with maternal mental illness. The New York Times. June 15, 2014 (Accessed June 16, 2014).
  3. Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, Brody S, Miller WC. Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes. Evidence Report/Technology Assessment No. 119. (Prepared by the RTI-University of North Carolina; Evidence-based Practice Center, under Contract No. 290-02-0016.) AHRQ Publication No. 05-E006-2. Rockville, MD: Agency for Healthcare Research and Quality. February 2005.2 (Accessed June 16, 2014).
  4. Sichel, DA. Neurohormonal aspects of postpartum depression and psychosis, in Infanticide: Psychosocial and Legal Perspectives on Mothers who Kill. Edited by Spinelli MG. Washington, D.C., American Psychiatric Publishing, 2003, pp 61-80.

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Pain After Endometriosis Excision Surgery

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Philippa Bridge-Cook

When an endometriosis patient takes the step of having laparoscopic excision surgery to treat their endometriosis, they have often already been through a long journey with many failed treatments. This journey often includes treatments such as multiple rounds of different types of birth control pills, stronger hormonal medications designed to suppress menstrual cycles (such as Lupron or other GnRH agonsists), multiple cauterization or ablation laparoscopic surgeries, and various different complementary alternative medicine approaches.

Most patients who undertake excision surgery after trying many or most of the above, do so on the basis of their own research, since many gynecologists are misinformed about endometriosis treatment, and are not trained to do excision surgery. A recent worldwide consensus paper on the management of endometriosis states that “there is unanimous consensus over the recommendation to excise lesions where possible, especially deep endometriotic lesions, which is felt by most surgeons to give a more thorough removal of disease.”  Sadly, there are fewer than 100 surgeons in North America currently practicing expert excision of endometriosis.

Patients come to excision surgery with hope that this treatment will finally bring them relief. And when pain persists or recurs after excision surgery, patients may feel disappointed, hopeless, and confused.  However, there are many causes of pelvic pain that are not endometriosis, which can continue to cause pain even after expert excision surgery, and once these other causes are treated, excellent pain relief and relief of other symptoms may be achieved. Although it may be natural after previous surgeries have failed, to assume that endometriosis is still the cause of the pain, if surgery was performed by an expert, it is prudent to rule out other potential causes of pain before assuming that endometriosis continues to be the culprit.

Adhesions After Surgery

Adhesions are a very common occurrence after laparoscopic excision surgery. Adhesions occur in 70 to 90 percent of patients undergoing gynecological surgery. In some cases, adhesions may be present but not cause pain, but adhesions can also cause chronic abdominal or pelvic pain, small bowel obstruction (where the intestines are kinked or twisted, and are partially or completely blocked), female infertility, and more. Adhesions are the primary cause of bowel obstructions and are a common cause of hospital admission for people with a history of abdominal or pelvic surgeries.

Pelvic Floor Dysfunction

Pelvic floor dysfunction is also a common consequence both of endometriosis itself, and of the surgeries used to treat it. The pelvic floor is a group of muscles and other tissues that form a sling from the front to the back of the pelvis. When the muscles are too tight, too relaxed, or a combination of both, it can result in problems with urination or bowel movements, pain with sex, pelvic pain, genital pain, back pain, and/or rectal pain.

Adenomyosis

Adenomyosis is a disease of the uterus, where the inner lining of the uterus (the endometrium) is found within the muscle wall of the uterus. There is no clear association between adenomyosis and endometriosis, but it is possible to have both conditions. Adenomyosis may be underdiagnosed because it is difficult to see using imaging techniques such as ultrasound, and the symptoms overlap with many of other conditions causing pelvic pain.

Interstitial Cystitis

Interstitial cystitis is a disease of the bladder that can cause pelvic pain, bladder pain, urethral and/or vaginal pain, painful sex, urinary frequency and urgency. Some doctors have found a very high association between endometriosis and interstitial cystitis, where many patients have both conditions. This has led to the two diseases being nicknamed “the evil twins.”

Vulvodynia and Pudendal Neuralgia

Endometriosis patients may also be more susceptible to pain syndromes involving nerves in the pelvic area, such as vulvodynia, a condition associated with pain in the opening of the vagina, and pudendal neuralgia, a condition involving pain, burning, and/or numbness in the genital area and rectum. The potential cause and effect relationship between endometriosis and these other conditions is not clear; however, some doctors theorize that chronic inflammation, immune system dysfunction, and neural pathway sensitization may play a role in the development of multiple pelvic pain syndromes.

Not All Pelvic Pain is Endometriosis

Unfortunately, although endometriosis is a painful and often debilitating condition all on its own, in many patients other conditions also contribute to pain and other symptoms. For doctors and patients alike, it can be tempting, once a diagnosis of endometriosis is made, to blame every symptom arising in the pelvic area on endometriosis. However, pain after careful excision surgery can often be caused by one or more of these other pelvic pain conditions, and a correct diagnosis of the underlying cause of the pain is crucial to successful treatment.

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Undiagnosed Abdominal Pain

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Bette Burt

I have often read you have to be your own advocate. It is true and it’s also exhausting. In 2012, I had a pain in my lower left side. It became a chronic pain, so I went to my doctor and described the location as just fingertips beyond my hip bone and achy. Tests would ensue. There’s an old urologists joke that goes: When Mr. Ford died and went to meet his Maker, Mr. Ford said, “I am in awe of all that you have created, but as for the female body…you made a slight miscalculation. From a design point – you made the intake much too close to the exhaust!”.  With this pain, I understood that joke all too well.

In my case – the pain could come from a variety of female issues or bladder/kidney, or intestinal issues or muscles. All of which I knew without a medical license. My goal was to have a professional discern and fix the problem. Unlike an automobile, however, we cannot be hooked up to a single diagnostic machine and have it spew out the answer. And so it began: blood workup, pelvic ultrasound, pelvic ultrasound and a transvaginal probe (which is as uncomfortable as it sounds). Hmmm, doesn’t seem to be a “female” issue.

So let’s try a colonoscopy. Hmmm, there is some pouching in the large intestine – very usual for someone my age – must be diverticulosis causing the ache. Even though the pain area is a little lower, I was told that sometimes the source of the pain is not where we perceive the pain.

Since I have acid reflux and was undergoing all these other tests, I asked for an esophageal exam. The exam showed a polyp in the small intestine, almost completely covering the opening to the pancreas. There were no symptoms and left untreated – would have been fatal within the year. It’s a good thing I thought to add this test.

I had the surgery (another story for another time) and after recovering, went back to my regular doctor for a checkup. The pain in my side was still there and still chronic – which isn’t quite the symptom of diverticulosis; so we had one more pelvic and transvaginal imaging done. Nope, nothing showing to cause the pain…must be that pesky colon pouch.

It is now halfway through 2014, I’ve had multiple tests and major surgery and I still have my ache. I have regular checkups and blood work done, including the tests for cancer markers. There have been no new tests suggested, and honestly, I get tired just thinking of going another round. No one seems to know what is causing the pain.

There are days when I would like to demand they just remove that pouch and all those female parts and maybe find the problem but most days I use my “thorn” in my side, to appreciate how lucky I am to still be alive. Had this pain not emerged when it did, the pancreatic blockage would not have been found and I would be a lot worse off, perhaps even dead. So in that regard I am lucky.  I do wish they would figure this out though.

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HPV Vaccines are not Effective, Safe or Necessary

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Judy Wilymen

I was recently invited to present my research on the HPV vaccine at the Euroscicon Controlling Cancer Summit held in London on 12 May 2014. The theme of the presentations was Advances in Cancer Screening and Prevention Research and the paper I presented was titled: HPV vaccines have not been demonstrated to be safe and effective in the prevention of cervical cancer.

HPV Infections Mostly Harmless

In my presentation I provided evidence that HPV infections are harmless and asymptomatic unless specific environmental co-factors are also present. This is why HPV infections should not be feared by the public and why the medical literature states that cancer is a rare outcome from any type of HPV infection. The fact that cervical cancer is a higher risk in developing countries than in developed countries is explained by the presence of environmental co-factors that are necessary for an HPV infection to progress to cancer. These co-factors (risk factors) are more prevalent in the developing countries. The fact that HPV infections are mostly harmless on their own means that vaccinating all women in developed countries (e.g. Australia, US and the UK) results in the majority of women (99%) being on a drug for a disease that they are not at risk of getting. This is not cost-effective and it is also not necessary because the vaccine has not been proven to be safer or more effective than Pap screening combined with surgery.

If the HPV vaccines are proven to have value in years to come it could be offered to women in the high-risk category. That is, women who are exposed to the environmental co-factors that are necessary for an HPV infection to progress to cervical cancer. However, as yet the vaccine has not been proven to be safe or effective in preventing cervical cancer. Currently governments are claiming that because the HPV vaccine targets 2 of the 15+ strains of HPV associated with causing most cervical cancer, it will prevent some cervical cancer, but they have not determined how much can be prevented. This argument is flawed if the majority of women on the drug are not at risk of cervical cancer and if there is already an effective method of preventing cervical cancer in place. In this case, Pap screening combined with surgery is an effective method of prevention (9 out of 10 cancers) and it is risk free and will still be required by vaccinated women.

The Global Harm Associated with HPV Vaccines

Currently there is much global debate about the harm that is being associated with HPV vaccination programs. As of June 2014 Japan has stopped recommending this vaccine until further safety studies have been conducted. India and Utah have also stopped recommending this vaccine and France is considering similar action. In France the use of HPV vaccine was debated in an open scientific forum on 22 May 2014. This forum allowed all stakeholders to present their case to the French parliament. This is the debate that governments and health professionals are not having in many other countries, for example, Australia.  In fact, the Australian government is recommending this vaccine free to all adolescent girls and boys in school programs without a debate about its safety and efficacy in preventing cervical cancer (a non-infectious disease).

HPV Vaccine Adjuvants

The HPV vaccine has two ingredients that are linked to causing infertility. These are sodium borate and polysorbate 80 and the Australian government has not explained why these ingredients are in a vaccine that is being recommended free to adolescents. This vaccine also has three times as much aluminium hydroxyphosphate sulphate (an adjuvant that is linked to autoimmune diseases and hypersensitivity) as any other vaccine and three times as many adverse events have been reported to this vaccine. The most common adverse events are neurological conditions and autoimmune diseases.

Adverse Events Associated with HPV Vaccines

Since the introduction of HPV vaccines 34,700 adverse events have been voluntarily reported to the US CDC, including 157 deaths and 6,977 permanent disabilities and chronic illness. This is possible because the Merck (vaccine manufacturer) funded Phase 3 clinical trials for Gardasil vaccine did not use an ‘inert’ (non-active) placebo in the unvaccinated control group. They used aluminium adjuvant in the comparison group and they did not collect long-term adverse events. The clinical trials only followed the health outcomes of all vaccinated girls actively for 15 days after vaccination. After this time the reporting of AE’s was voluntary which does not allow scientists to make causal relationships to the vaccine.

Here is a link to a video of the serious adverse events that some girls have experienced after using this vaccine. These have included seizures, paralysis, convulsions, tics, encephalopathy, chronic fatigue syndrome and death. The parents of injured children and those that have died after vaccination urge you to research this vaccine before you trust the government’s recommendation of this vaccine.

Report from the French Parliament on the Safety of Aluminium Adjuvant in HPV Vaccines (22 May 2014) 

The public hearing held in Paris on the safety of aluminium adjuvants in vaccines was attended by the French Health Minister and reported on by the European parliament. The hearing was open to the press and titled ‘Vaccine Adjuvants: A Controversial Question’. The most recent science on aluminium adjuvants in vaccines demonstrates that many individuals have a pre-disposition (genetic condition) to experiencing a serious reaction from aluminium adjuvants in vaccines. These serious reactions include neurological damage and autoimmune diseases – multiple sclerosis, arthritis, lupus, etc – and are caused by the artificial stimulation of the immune system with vaccines. Here is a link to the report on the public hearing http://sanevax.org/french-vaccine-debates-immediate-measures-required/

This indicates the significance of fully informing parents about the vaccines that are recommended in government vaccination programs and the importance of vaccines being administered by general practitioners with an assessment of the family history of the patient. Vaccines are a medical intervention and they should not be administered in school programs because family history is a contraindication to vaccination.

Conclusion

Cervical cancer is curable with early detection by Pap screening (9 out of 10 cancers) and all vaccinated women will still need Pap screening. This is because the vaccine (costing $Au450 per person) does not target ~30% of cervical cancer (13+ strains of high-risk HPV are not covered in the vaccine) – even if it is proven to be of some value in years to come. It is also a fact that HPV infections are harmless unless specific environmental co-factors are also present and this is why vaccinating all women in developed countries results in the majority of women (99%) being on a drug for a disease they are not at risk of getting.

Reference

Wilyman J, 2013, HPV vaccination programs have not been shown to be cost-effective in countries with comprehensive Pap screening and surgery. Infectious Agents and Cancer. 8:21 (June): pp1-8.

About the Author: Judy Wilyman MSc, is a PhD Candidate studying Population Health Policy at the University of Wollongong (UOW) School of Social Sciences, Wollongong, Australia. She is the founder of Vaccination Decisions, a website that she has set up to present her research.

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Morcellation: Could There Be a More Foolhardy Technique?

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morcellation and hysterectomy

Uterine morcellation, the surgical technique that involves using a morcellator device to mechanically chew up larger pieces of uterine tissue, tumors and fibroids into much smaller, more easily removable pieces of tissue, has been a mainstay of laparoscopic gynecological surgeries, especially hysterectomy, since the mid nineties. It was only recently, when a high profile physician was herself injured by morcellation, did the dangers of morcellation come to the attention of the media and the broader medical community. One has to wonder, who the heck thought grinding up potentially diseased tissue and spreading those diseased cells, however inadvertently, within peritoneal cavity was a good idea in the first place?  Really, how in the world did these devices get approved and so readily adopted into medical practice?

FDA Clearance of Morcellators: No Safety Data

The first electromechanical tissue morcellators were cleared for sale in 1995 FDA’s 510k process. The 510k process is used for devices that are considered substantially equivalent to medical devices or tests already on the market. The 510k clearance is not approval per se, but a quick step around the approval process. It allows the manufacturer to go straight to market with the product, after a 90 day waiting period. No clinical trials are required, no safety data are required. According to the Project on Government Oversight blog:

“…the 510(k) process doesn’t evaluate anything about a device except whether it is substantially equivalent to previous devices. Thus it can’t really ensure the safety and effectiveness of these devices.”

Morcellators were cleared for sale via this process of suggesting that they were no more dangerous than the laparoscope itself. Since 1995 the FDA has cleared about two dozen electro-mechanical morcellators, all via the 510k process. In essence, these devices came to market without safety data. Indeed, there were no published studies evaluating the safety or efficacy of these devices for almost the first 10 years of their use, although case studies began emerging in 2002. How was that possible?

Adoption of Morcellation in Gynecological Surgery: The Business Case

Over half a million women in the US have hysterectomies annually. In fact, every 10 minutes, 12 American women lose their reproductive organs, every day of every year. Worldwide, the numbers are equally staggering. By the age of 60, one third of all women will have had a hysterectomy. Between 70-90% of hysterectomies are deemed medically unnecessary. Worse yet, an estimated 73% of hysterectomies include the removal of the ovaries, a procedure akin to male castration with all of the concomitant side-effects one might expect when critical, hormone-producing, organs are removed. Unnecessary hysterectomies are big business for hospitals and surgeons. It is within this landscape that morcellators found their market.

Morcellation is a no-brainer within the ever-expanding business landscape of hysterectomy. Considering up to 90% of hysterectomies are medically unnecessary in the first place, it is not difficult to see how decisions about surgical techniques and instruments might be more skewed toward efficiency than safety. And of course, from a purely mechanical perspective, grinding large matter into smaller pieces makes quick work of tissue removal from the ever decreasing size of excisions. Morcellation with laparoscopic or robotic hysterectomy is more efficient. No doubt, that is how these devices were marketed.

From a biological perspective however, morcellation makes absolutely no sense whatsoever. How did so many physicians, so easily disregard core concepts of human biology – that spreading cells means spreading disease – in favor of the latest gadgetry?  The potential risks of mechanical tissue morcellation could not be clearer. According to one of the first studies (2012) to address uterine morecellation:

“In order to remove these bulky lesions from the abdominal cavity through laparoscopic ports the tumors must be morcellated. This technique involves fragmenting the lesion such that it can pass through a small incision (i.e. the laparoscope port itself). Originally performed by hand with the assistance of a laparoscopic scalpel, newer methods involve the use of power morcellators, devices designed to draw the lesions into a whirling blade, which then generates small (approximately 1 cm diameter) cores of the lesion, capable of being removed through the port incision. The velocity with which these blades spin has been associated with dispersal of microscopic tumor fragments, thus potentially seeding the peritoneum with small pieces of both neoplastic and non-neoplastic material. This phenomenon is compounded with the fact that some morcellated tumors are not benign.”  

Indeed, the research shows the risk of metastatic cancer post morcellation is up to 9 times higher than when non-mechanical surgical techniques are used. Case reports show the possibility of spreading endometrial implants and parasitic myomas post morecellation.

Rate of Morcellation and Risks

Data are scant on the percentage of hysterectomies using morcellation and even more sparse on the adverse events associated with these devices. Some estimates suggest 11% of ~600,000 hysterectomies annually use morecellators – about 66,000 women per year. The risk of morcellation of an occult tumor is believed to between one in 400 and one in 1000 women. The risk for dispersal non-cancerous, but diseased tissue such as endometriosis or parasitic myomas is unknown. However, with such spotty reporting on these devices and this technique, it is difficult to calculate the real risk or even the real use patterns. The number of women potentially harmed by morcellation could be much larger.

The Morcellation Debacle

In essence, mechanical morcellation seeds cells in the abdominal cavity. If those cells are diseased or cancerous, the results can be deadly. And yet, this device was cleared by the FDA and adopted by surgeons with nary a question of its obvious risks – risks that could be presupposed based upon basic principles of biology. Of course, mechanical, high speed tissue morcellation would spread microscope cells. Of course it would. How could this not be recognized up front? How did it take until 2014, 19 years on the market, before the medical societies and the FDA recognized the dangers? More so, even though there were case reports beginning in 2002, evidence that the manufacturer was warned of its dangers in 2006, a large study in 2012, it wasn’t until a prominent physician was injured herself, and her husband, also a prominent physician, exposed the dangers publicly that the respective medical societies and the FDA recognized these dangers and felt compelled to issue statements of risk. To say this is an egregious lack of oversight does not begin to capture the across-the-board levels of ignorance and incompetence associated with the adoption of this procedure.

Sign a Petition to Stop Morcellation

Hormones MatterTM is conducting research about hysterectomy. If you have had hysterectomy, please take a few minutes to complete this important survey. Then share the survey link with all of your friends. These data could save the life of another women. The Hysterectomy Survey.

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