Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, February 27, 2007

My Blood is Boiling

NBC Nightly News with Brian Williams is trumpeting the HPV epidemic with the statistic, "1 in 4 American women is infected with the virus that causes cervical cancer." And guess what: there's now something that can be done to prevent it. Gardasil to the rescue!

About that opening statistic of "1 in 4": technically, no. Although 1 in 4 women may have HPV, only about a dozen of over a hundred types have actually been assiciated with genital warts or cervical cancer, so the number of women infected with those high risk types is correspondingly lower. The Associated Press piece from which the story is reported quickly backs off, but I heard those exact words quoted above. Myself. On TV. Less than half an hour ago.

I also heard these words spoken by Nancy Snyderman, MD: "Almost four thousand women die of cervical cancer in this country every year." That's playing with the numbers a bit. The projected figure for 2006 was 3700 deaths. I know, because I looked it up for my first post on this subject. The Associated Press piece used by NBC quotes 3670 as a projection for 2007. Projections. I haven't seen any data on actual numbers yet. Even so, anyone notice that the projection for 2007 is for FEWER deaths than 2006? HPV vaccination will have nothing to do with that, as the first possible benefits from vaccination today won't be seen for at least a decade, given the natural history of the disease.

The Blog That Ate Manhattan put it best (paraphrased; sorry I deleted your email):
A huge part of Merck's marketing strategy in the wake of the Vioxx debacle consists of selling this expensive vaccine to frightened first world women and their daughters.
If all the money that's going to be spent on Gardasil and other HPV vaccines were instead used to enhance basic gynecological services (paps and HPV treatment) and outreach to women who currently either don't have access or to help overcome the barriers to screening, those cervical cancer death rates -- already ridiculously low; the lowest numbers for all GYN cancers -- can be slashed even further, and in far less than the 10-12 years it will take for Gardasil to "prevent" its very first case.

Thanks, Mr. Williams. Now I'm going to be fielding calls for weeks from adolescents and their mothers whom you have scared shitless. Nothing new here. Stick to the stock market crash. Please!

(Yes yes yes: I know all about the supposed reduction in abnormal paps and treatment for HPV induced dysplasias and all. But it still makes my blood boil.)


At Tue Feb 27, 08:27:00 PM, Blogger Cathy said...

Oh boy, you're probably going to be mad at me also. I just now posted using these new figures I heard on NBC nightly news.

But, I looked them up and NBC isn't the only ones saying it. I dont have a doubt that 25% of american women have HPV infection. Do you?

Why are you SO much against all this? So what if the actual numbers are 3700, 4,000, or 3650? One cancer death is one to many when it can be avoided.

At Tue Feb 27, 09:10:00 PM, Blogger #1 Dinosaur said...

But HPV vaccination is NOT the way to avoid it. That's my point.

At Tue Feb 27, 10:27:00 PM, Blogger The Angry Medic said...

This comment has been removed by the author.

At Tue Feb 27, 10:30:00 PM, Blogger The Angry Medic said...

It may not be, but alas, 'tis not a perfect world. Big Pharma's holding a lot of pursestrings, I'm afraid. And they'd rather fund cure than prevention, simply because it'll bloat their wallets more.

I can see how it makes your blood boil though.

On another note, I love your Laws! I read your Blogging Rules a long time ago and they've held me in good stead thus far.

I've added you to my blogroll. Hope you don't mind the heading I've given you :)

At Wed Feb 28, 08:47:00 AM, Anonymous Anonymous said...

I hate spin and outright lies as much as the next person. I also have zero fondness for Nancy Snyderman.

I still want Gardisil for my child (turning 5 soon) even though I never once had so much as a bad Pap result. I anticipate her being able to have all routine gyn care, but I would rather do what I can to prevent her from extra Paps, LEEPs, and any pregnancy issues related to cervical condition. She is already at risk of having polycystic ovarian syndrome just for being related to me, the PCOS poster child. HPV is so easily contagious and it's not as if there is any visible warning that a given boy will be transmitting it or even any test he can have to show that he isn't a carrier.

I'm sorry they over-played the cancer card, but LEEPs and colposcopies are wonderful things not to need.

As an aside, I wonder if there are any ob-gyns who resent what financial loss of HPV-related procedures they may face as a result of widespread Gardasil usage. I've read a lot about gynecologists who rant that interventional radiology as a treatment for fibroid tumors is cutting way into their hysterectomy profits.

At Fri Mar 02, 10:33:00 PM, Blogger Margaret Polaneczky, MD (aka TBTAM) said...

Celeste: If you think ob-gyn's are making profits doing hysterectomies, you haven't seen what managed care pays for a hysterectomy, or what the malpractice costs to be able to operate and do major surgery.

Gyn surgery is a money loser, and those who do it do it for the love of what they do and as a service to the women who still need these operations.

I don't think any of us care about losing colposcopies. It is absolutely no fun to operate on the cervix of a young woman. I cheer the day when all the paps I ordered come back normal, and I don't have to make any dreaded HPV phonecalls to frightened young women.

At Mon Mar 12, 07:54:00 AM, Blogger Narya said...

I'm happy to agree with you on criticizing the marketing strategies of BigPharma and their pursuit of BigDollars--and I'm also happy to agree with you on the complicity of BigMedia in that project.

I still wish I'd been able to avoid the HPV, and thus the cryosurgery, additional pap smears, multiple colposcopies (with more in my future), and general anxiety about being able to afford the care I do and might need, seeing as how the only health insurance I could get won't cover any HPV-related crap (it being a pre-existing condition and all).

In short, if a vaccine could have prevented the above, or could prevent a child of mine from having to go through it, yeah, I'd do it (and I'd vaccinate sons as well as daughters).

At Mon Mar 26, 11:44:00 AM, Blogger my2centsworth said...

Has Dr. Nancy Snyderman given up the personal ethics of Medicine in favor of profits and financial greed on the part of the network she represents?

Recent events may lead to that exact conclusion. Snyderman, Chief Medical Editor for NBC is now appearing in numerous roles on NBC Nightly News, and the NBC Today Show, in effect, as a representative of Merck & Co.,Inc., the large pharmaceutical company. Dr. Snyderman is being paid by NBC, in what appears to be a blatent attempt to legitimize and advertise drugs manufactured and distributed exclusively by Merck under guise of news, or important medical information. Recently, on three separate shows produced and aired by NBC, Dr. Nancy Snyderman has suggested that she supports the legislative mandates of states like Texas, to require vaccination against HPV. Obviously to the financial gain of Merck, and NBC as the recipient of advertising dollars. Fortunately the Texas State Legislature has now blocked the governors order in favor of Education, over Legislation!

Several days ago, she again supported the new Chicken Pox vaccine which is manufactured and exclusively sold by Merck. Snyderman then admitted that the vaccine actually gives no assurances against getting the Chicken Pox. This was done in a pseudo / tabloid like interview on the NBC Today Show relative to a story about Chicken Pox parties being hosted throughout the country.

As recently as March 23, 2007, Dr. Snyderman again suggests that drugs like Fosamax are appropriate in the treatment of Elizabeth Edwards cancer. All without the benefit of any examination, or consultation with her doctors. Fosamax is manufactured and sold by who else; Merck!

So, has Dr. Snyderman discredited herself? Is Snyderman guilty of Media Malpractice ? Many seem to think so, and as such, no longer deserves recognition as someone we should trust to provide us with unbiased medical advise! Her advise now appears to be tied to the fortunes of Merck, and NBC. This is truly another tragedy in ever expanding story of corporate greed in America, as we sacrifice our once trusted advisors on the Alter of Profits!

On February 28,2007, NBC Nightly News with Brian Williams reported that a study done by the CDC report 25 to 27% of the female population is currently infected with HPV. This is not so!

In fact, there is no study done by the CDC, and apparently they were referring to the data created by and distributed by Merck!

In the interest of full disclosure, Merck is also the manufacturer of the vaccine, and the one and only company who stands to profit from the grossly over stated and misrepresented data, other than NBC as a perpetuator of the intentional misinformation, and a benefactor of the advertising revenue!.

Following is a document distributed by the CDC which will dispel much on the hype, and over statement, and over reaction.

Some of what is stated therein is;

Communicability "HPV is presumably communicable during the acute infection and during persistent infection. This issue is difficult to study because of the inability to culture the virus." NOTE: "inability to culture the virus."

Laboratory Diagnosis "HPV has not been isolated in culture. Infection is identified by detection of HPV DNA from clinical samples. Assays for HPV detection differ considerably in their sensitivity and type specificity, and detection is also affected by the anatomic region sampled as well as the method of specimen collection."

And finally "The use of HPV vaccine does not eliminate the need for continued Pap test screening, since 30% of cervical cancers are caused by HPV types not included in the vaccine."

Dr. Nancy Snyderman is helping turn The Nightly News into just another Tabloid TV SHOW! News, should be factually reported, and in the opinion of many, without biased or prejudiced interviews from those who stand to profit from the report, that being NBC, and the manufacturer, Merck & Co.!


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