Anti-cancer vaccine for Laos

 
Khonekham with health card with health card Khonekham holds her health card showing she has received her first dose of the HPV vaccine

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A programme to vaccinate girls against the virus that causes cervical cancer has begun in Laos, South East Asia.

It's one of nearly a dozen developing nations where the HPV vaccine is being introduced in the coming year as part of a scheme to enable poorer countries to benefit from the newest vaccines.

It is five years since the jab was first offered to girls in the UK.

The project is being organised with the support of the Global Alliance for Vaccines and Immunisation (Gavi).

Start Quote

The HPV vaccine represents a very significant commitment to women's health in the coming decades.”

End Quote Helen Evans GAVI Alliance

The vaccine protects against the sexually transmitted human papillomavirus - preventing the infections that cause 70% of cases of cervical cancer.

'Proud' to be immunised

Khonekham Sirivong, 13, stood patiently in the queue of girls waiting for the HPV vaccine.

This was a poignant moment for her and Somsouk, her aunt, one of the nurses, under the shelter of trees in the school grounds.

Somsouk's mother - Khonekham's grandmother - died from cervical cancer. The two helped nurse her through years of illness.

"I remember she was in a lot of pain," said Khonekham. "The family did everything it could, but she died. I am very proud to be immunised - and to have the HPV vaccine free of charge."

Vaccine 'crucial'

Cervical cancer is a far bigger cancer killer in developing countries because most lack a national screening programme, which can detect pre-cancerous changes in the cervix, enabling timely early treatment.

In Laos, most cases are discovered too late. Cancer treatment in the world's poorest nations is also limited. Laos has no radiotherapy. Patients who can afford it are sent to Thailand.

"Approximately 275,000 women die every year from cervical cancer and over 85% of those deaths are in the developing world," said Helen Evans, Gavi deputy chief executive.

"The number of deaths is projected to rise dramatically, so that's why it is absolutely crucial that this vaccine is introduced.

"The HPV vaccine represents a very significant commitment to women's health in the coming decades."

survivor of cervical cancer "I feel lucky to be alive," said Sommay Khamkeomany

I have visited a lot of hospitals, in many of the world's poorest countries - from Sierra Leone to Malawi and Bangladesh. But they have rarely been as crowded at Setthathirath hospital in Vientiane.

A senior oncologist, Dr Keokedthong Phongsavan, showed me round one of the wards, where the beds had spilled out into the corridor and were squeezed next to each other to accommodate more patients.

Sent home to die

However, it was not the overcrowding, but the limited treatment options that presented the biggest problem.

"I feel helpless," said Dr Phongsavan. "Patients are often diagnosed very late, and then there is often very little I can do to help them. I have to send them home to die."

The mortality rate for cervical cancer in Laos is six times that of the UK. But there are some success stories. Sommay Khamkeomany was diagnosed with cervical cancer last year when she was just 32.

She had surgery and has now been told she has a 95% chance that her cancer will not recur.

"I have two girls aged five and three," said Mrs Khamkeomany. "When they are old enough I will ensure they have the HPV vaccine - and fortunately I should still be here to see that happen. I feel lucky to be alive."

Milestone

The HPV jab is the most expensive of all childhood vaccines. A course of three injections can cost more than £200 privately in the UK and other wealthy countries. It was well beyond the reach of most developing nations until Gavi negotiated a price of less than £10.

Like other Gavi-supported countries, Laos has to make a token financial contribution, but also has to supply the nurses and organise distribution of the vaccine.

The two-year pilot project in Laos involves about 20,000 girls being immunised. If successful, it will lead to a national roll-out of the jab.

By 2020, Gavi hopes to have supported HPV immunisation of more 30 million girls in over 40 countries.

The benefits, in terms of lives saved, won't be felt for decades, but it represents a milestone in the promotion of women's health.

 
Fergus Walsh, Medical correspondent Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this
    0

    Comment number 60.

    59.
    vincent

    I saw one paper that concluded that spicy food, if anything, protects against ulcers. A GP is paid according to the number of patients whether they consult him/her or not. Antibiotics should not be freely available. They don't work for viral infections and they won't work for anything if we allow resistance to develop.

  • rate this
    0

    Comment number 59.

    58.
    HilaryJ

    the underlying problem is hot chillies which give you ulcers if you eat to much if your getting £4000 a week as a GP why would you tell your patients quick cures you want your customers to come back, antibiotics are freely available worldwide in the uk they are not, its the main reason people visit the doctor sore throat chest infections they gotta have there repeat patients.

  • rate this
    +1

    Comment number 58.

    55.vincent

    I'm glad it works for you but if you've had ulcers 6 times in 10 years it suggests that you're just clearing up the symptoms and not curing the underlying problem

  • Comment number 57.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +1

    Comment number 56.

    54.vincent
    'clinical trials for cabbage juice? its hardly a dangerous drug'

    Clinical trials are also to test efficacy. Natural products aren't always safe. Doctors are not keen on advising treatments that aren't fully tested but mine once handed me a drug company's leaflet with the words 'That's what'll cure you. The drug's useless but the exercises are first-rate'.

  • rate this
    -1

    Comment number 55.

    53.
    HilaryJ "Ulcer treatment has changed radically since then."

    No it has not 6 weeks of taking ranitdine or Prevacid (Lansoprazole), and 4 weeks of suffering, as a sufferer of ulcers i can confirm 110% the healing rate is 36hours for pain free & 3 to 5 days for healing it that is 3 cups of blended cabbage juice a day its worked 6 times in 10 years without fail, i am a hot chillie eater

  • rate this
    -1

    Comment number 54.

    53.
    HilaryJ
    "cabbage juice has not undergone proper clinical trials"

    clinical trials for cabbage juice? its hardly a dangerous drug, as a matter of fact 20% of doctors are well aware that cabbage juice is the best treatment for ulcers & some will recommend it to patients, but doctors by there proffession do not advise alternative treatments, even though penicillin is made from fungi.

  • rate this
    +1

    Comment number 53.

    '52.vincent '
    'cabbage juice can cure a stomach ulcer in 3 to 5 days everytime, what do they prescribe £50 medicines and 6 weeks of suffering'

    Probably because cabbage juice has not undergone proper clinical trials. Google brings up a few small scale studies from the 50's. Ulcer treatment has changed radically since then.

  • rate this
    0

    Comment number 52.

    HilaryJ
    Oncologists in the NHS don't make more money be prescribing more expensive treatments. "

    Funny i remember family GP's going on expensive holidays recieving gifts and perks all from drug companies in the last 20 years a practice that they cracked down on, cabbage juice can cure a stomach ulcer in 3 to 5 days everytime, what do they prescribe £50 medicines and 6 weeks of suffering.

  • rate this
    +1

    Comment number 51.

    "Dr. Diane Harper, lead researcher in the development of two human papillomavirus vaccines, Gardasil and Cervarix, said the controversial drugs will do little to reduce cervical cancer rates and, even though they’re being recommended for girls as young as nine, there have been no efficacy trials in children under the age of 15"

    hmmm.. I don't think I will be putting my child through that then

  • rate this
    +1

    Comment number 50.

    Oncologists in the NHS don't make more money be prescribing more expensive treatments. They are more likely to be under pressure to use the cheapest (or at least the most cost effective).

    According the fact sheets PDT is effective for early stage cancers and palliative in late stage. Many prostrate cancers don't even need treatment.

  • rate this
    0

    Comment number 49.

    From a Macmillan factsheet

    In cancers that are being treated at an early stage, the aim of PDT treatment is to try to cure the cancer. With more advanced cancers, the aim of PDT is to shrink the cancer and reduce symptoms.

    Your hospital doctor can advise you whether PDT is an appropriate treatment in your situation.

    There are also NICE guidelines

  • rate this
    -1

    Comment number 48.

    "I can't think why you think no doctor is needed"
    I round of chemo is something like £12,000 when parasites are making so much money to inflict the carnage of chemo on people photodynamic therapy will never be used, it is not surgery so you do not need a expensive surgeon & his waiting list & fee to match, it has a huge sucess rate for prostrate cancer but our quacks give us chemo, its all ££

  • rate this
    +2

    Comment number 47.

    #46 a duty nurse can do most things. The reason you need a doctor to administer therapy is to ensure the diagnosis is correct in the first place & to act if something unexpected happens.

    Plus you're working on a fallacy. If the drug companies want max. profits it doesn't suit them if you die. Plus even if they treat your cancer completely you'll get something else a few years later.

  • rate this
    -1

    Comment number 46.

    Photodynamic Therapy can cure so many cancers including esaoephagus, the huge problem is no one knows about it, hospitals do not tell anyone, reason is a duty nurse can give you it you do not need expensive consultants & there huge fee's there months long waiting list to see them, you will never cure cancer when there are so many people milking the cash cow of cancer.

  • rate this
    +4

    Comment number 45.

    #32 The whole point is to immunise them BEFORE they start having sex (and in some places 13 to 14 is a bit old) . There's no point immunising after they potentially acquire the infection. Early infection is the biggest risk factor for cervical cancer.

    Incidentally the vaccine will have been tested over 5 years but most carry virtual lifetime protection at least to some degree.

    #43. Exactly.

  • rate this
    +1

    Comment number 44.

    32. i am no subject
    it makes no sense to vaccinate anyone of age of 13 or 14 etc. - or do you expect girls of this age to have sex??
    ---
    You should expect what usually happens, certainly not what you want to happen. Additionally, what happened / didn't happen to you or to the people in your social circle is unimportant on the scale of national policy.

    http://news.bbc.co.uk/1/hi/4784939.stm

  • rate this
    +3

    Comment number 43.

    41.
    vincent

    'Photodynamic Therapy, is not some mexican alternative treatment....no Dr needed.'

    The link you posted described a therapy using drugs and light. I can't think why you think no doctor is needed. Who diagnoses? Who prescribes the drug? Who monitors the patient? The janitor can switch on the light box but I still want him overseen by qualified staff.

  • rate this
    +3

    Comment number 42.

    #91 What sort of skin cancer, what stage.

    With skin cancers by the time you get to needing chemo they've metastised everywhere and prognosis is pretty bleak. Catch them earlier and its a simple bit of surgery (I had an early stage basal cell carcinoma aged 32). Cut the tumour off takes ten mins & is nearly 100% successful if done quickly.

    P.S for melanoma ipilimumab (an antibody) is best.

  • rate this
    -1

    Comment number 41.

    23.
    "Bubonic, If I were you I'd be a little more cynical about the people pushing unregulated 'alternative' therapies as their livelihood."

    Photodynamic Therapy, is not some mexican alternative treatment its available in a handfull of nhs hospitals, it has a 90% or more sucess rate with curing skin cancer sure me chemo that has that rate? same with prostrate, big problem no Dr needed.

 

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