HPV for the uninitiated

You know that phone call you just hope you won’t get for a long, long time. That one from the clinic or the hospital, saying “We just got your lab test back, and there’s something abnormal going on with some of your cells. We need you to come in for further testing.”

That call sounds vaguely like mortality, like the name and hour of your death. And it doesn’t help that it’s so vague; that they don’t actually know anything yet. So you rush off to the one place that has all the answers: the internet. The internet should be able to give you some clues as to what it is you might be facing. Only, of course, it doesn’t really help, because it holds such a gamut of possibility from the people who have gotten similar calls, everything from “this turned out to be nothing” to “and then I had cancer, wouldn’t you know it, and had to have my organs taken out.”

So, in my case, I tried to slow-breathe my way to what turned out to be a mini-biopsy of five different sites. The doctor threw out terms I’d never heard of before: squamous cells, glandular cells. Both of mine had some form of abnormality. That’s pretty common, though, the doctor told me. You know, you have HPV; this is common in women with HPV, and the immune system often just clears these things up, but we’ll wait for these biopsy results and see what they say.

I like to think I’m reasonably well-informed, but as it turns out, I knew little about HPV, and for that reason, I didn’t get regular Pap smears. I’d had a grand total of one ever previous to this. Apparently (who knew?) a typical STD panel does not check for HPV, and a typical Pap smear doesn’t check for it either. Also, long-term celibacy does not guarantee that you won’t develop an HPV infection, because the virus lives invisibly, often for many years. Even if you’re a virgin, you can contract HPV through, shall we say, messing around with someone, as this study mentions. Truth be told, transmission possibilities are still somewhat a mystery, and in looking for medical articles on the subject I stumbled across this Finnish study that looked at the rate children get it from their parents, for example. In any case, HPV rates among the general population are quite high; available data from the Center for Disease Control indicates that “at least 75 percent of the reproductive-age population has been exposed to the sexually transmitted HPV.” The moral of the story: even if you think you’re pretty low risk for “sexually transmitted” anything, as a woman, you should probably get checked out and talk to a medical professional about HPV and cervical cancer.

Because if you have high-risk HPV (which apparently I do), you can get what’s called dysplasia, where cells start turning shady. I say “shady,” because to classify them as “precancerous,” which they potentially are, sounds scarier than it actually is. Often, your immune system can take care of minor dysplasia. Once it gets past a certain point, though, they recommend getting the cells removed. In other words, having part of your cervix snipped out.

I have CIN II, moderate to marked dysplasia. So they recommend the surgery. I’m not terribly happy about this, to say the least, because with the surgery — an LEEP procedure, where they cut stuff out with an electrical wire — your risks of premature delivery during pregnancy are increased. Not necessarily substantially, as I was relieved to discover. But it doesn’t get rid of the HPV, just the infection. Theoretically, you could have reoccurring infections any time your immune system is having an off month, and by the time you get two LEEPs (or one larger surgery), things can get more dicey from a childbearing standpoint… and other standpoints, apparently.

So for nearly the last month, I’ve been thinking about this, pondering what to do next. I haven’t scheduled the LEEP. Instead, I started working on my immune system in various ways, primarily through improved nutrition and not getting stressed out. It’s a bit of an experiment, but from the research I’ve done thanks to temporary access to a medical database, my odds of improvement are much higher than my odds of actually developing cancer (about 40% versus about 5%) and the whole thing is pretty slow-moving. I’ve told myself that if I get too stressed out, I’ll go back in, and if I feel worse — honestly, I can feel the inflammation that sometimes accompanies HPV lesions; a dull cramp-like ache that first alerted me that maybe I should go get myself checked out — I’ll go back in, and either way, I’ll evaluate my progress soon. So far, I feel better, although that could be wishful thinking. And I suppose we shall just have to see what happens next.