Question

Fifteen-year-old Dolores was embarrassed to talk with her mother about the pain she felt in her “private parts,” but she was worried she might have gotten a disease, despite Nick’s assurance that she was his “first.” Her mother insisted that Dolores see a doctor, who discovered cervical lesions caused by a virus associated with cancer.

• What sexually transmitted virus is involved?
• How should the physician treat the lesions?
• How could Dolores have protected herself?

Answer 1

Q1: What sexually transmitted virus is involved?

Answer 1: The sexually transmitted virus involved in this particular case is HUMAN PAPILLOMA VIRUS. It is a viral infection that causes skin or mucous membrane growth or warts. There are more than 100 types of HPV, some type’s causes genital warts and some cause cancers. The types of cancers caused are, cervical (symptom is cervical lesions), anal, oropharyngeal

Q2: How should the physician treat the lesions?

Answer 2:

At present there is no medical treatment for HPV infection as there is no cure for virus, however warts, lesions, in cervix can be treated, and the treatment is more focused on treating the symptoms.

Following are the ways in which the physician can treat the lesions.

1. Monitoring abnormal cell change of cervix.

• Close monitoring of the changes of the cell is done before actual treatment to observe changes such as cervical dysplasia, precancerous changes in cell; normally they will heal without any treatment due to body’s immune response.
• Conisation: it is treatment in which abnormal cell lining are removed.
• Cryotherapy: it is treatment in which liquid nitrogen is used to freeze off abnormal cell lining of the lesions.
• Laser therapy : it is treatment in which light beams is used to remove off abnormal cell lining of the lesions
• LEEP: it is treatment in which electric current is used to remove abnormal cell lining of the lesions.

.

Q3: How could Dolores have protected herself?

Answer 3: Dolores could have protected her from HPV-related genital lesions by:

• Using a latex condom, which can minimize risk of HPV transmission
• Being in a mutually monogamous sexual relationship ( trusted partner)
• She could have taken commercially available HPV vaccines (Gardasill) between 9 to 13 years of age. ( or her parents should have insisted her for vaccination )
• She could have undergone PAP test or visited her physician for screening on first instance of pain or any other symptoms.