Let's talk about HPV


Shieva Ghofrany: [00:00:00] Good morning. You know what I haven't talked about in a while? Hpv. Let's talk about hpv. HPV V, human papilloma virus. It's the virus that you probably have all heard. 90% of us in our lifetime will be exposed to it. So it's the virus that when someone has had sex, even if they have used a condom, a hundred percent of the time, they can get exposed because the virus lives all over the skin, the skin outside the penis, the skin right around the penis, the vulva inside the vagina, the areas that are not covered by the condom. 

So the minute you've had sex with someone who may have had sex with someone, You can get exposed to it even if you use a condom. I'm gonna keep repeating now. Is that scary? As I say to patients all the time, it's not scary. It's a fact. It's something that is so pervasive and so common that I want you guys to understand why we care about it. 

HPV is the virus that can cause genital [00:01:00] warts, and it can potentially rarely cause cervical cancer. Also, they're finding head and neck cancers and rectal cancer. Is it? To have the cancer? Absolutely not. Yesterday alone, I called four patients. I would say maybe five. Um, and I have several more today that are constantly in my list of people to call to talk about their pap smear test. 

The pap smear test is the test for women that we use to see if the HPV virus has gotten into the cervix and affected the cervix by changing the cells. Okay? So if you get a call from your doctor saying, Hey, your pap smear was abnormal. Do not freak out because all it means is, hey, we see a little change. 

We need to look further with a test called a microscope test, a coloscopy. And we need to just make sure that the changes are mild because your body has a strong immune system, typically, and it can reverse the changes back to normal. So the number of us who have been exposed [00:02:00] to HPV in our lifetime, they believe close to 90%, if not over 90. 

Many people don't know they've had hpv. They have no symptoms because there are no symptoms unless you have warts. They have never had an abnormal pap smear either because they're a man, they don't get pap smears or because their pap smear has never shown any abnormality, because even though 90% of us can get it, it does not affect our cervix for the vast majority of us. 

And of those people who get the abnormal pap smear, which is still a pretty decent percentage, the vast, vast, vast, vast, vast majority of those. We'll, never have cervical cancer. Never have cervical cancer. Now, that doesn't mean blow it off. That means we don't get cervical cancer from HPV because in America we follow the algorithm in a strict protocol of you get your pap smear. 

If your pap smear is abnormal, the doctor looks with the microscope, they take some samples. If those samples are more abnormal, those are removed before they turn into cancer. So again, in my 21 years [00:03:00] of practicing, I've. cervical cancer, but I could actually count if I needed to. How many times. That's how unlikely it is in populations where we screen. 

Okay. I don't wanna talk about the screening guidelines here because they're detailed and they kind of vary depending on how you practice. Um, but suffice to say, you don't need to have a pap smear until you are 21. Okay. Regardless of whether or not you've had sex, that changed from back when I was growing up. 

What I also would like to point out is that there are two broad strains of the HPV virus that. Poorly named, in my opinion. So there is the, or I should qualify, sorry. There are two large subtypes. Within those subtypes. There are multiple strains. Okay. So HPV is the virus. One subtype is called a low risk subtype, and that includes the ones that might affect warts. 

Okay. Then there's the high risk subtype, poorly named in my opinion, because that seems very inflammatory and just increases angst, and it just means [00:04:00] that those subtypes are the ones who can get into your cervix and may cause cancer. Again, it's not, it will cause cancer. It is, if you have abnormal pap smear, you need a colonoscopy. 

If the changes on the colonoscopy are. Goodbye. Done. Your body will regress them back to normal, most likely, but we'll surveil to make sure if the changes are more aggressive, then we probably won't wait. We will remove them so that we don't take the chance. So again, it is not that, oh my God, I have hpv. 

HPV leads to cervical cancer. I'm gonna get cervical cancer. It's, oh, turns out I have hpv, like 90% of us, I'm gonna do my surveillance. Like my doctor has told me I'm gonna keep my immune system as strong as I can. Things like do not. Make sure that you're keeping your immune system robust by eating a lot of vegetables. 

Taking vitamin D is good for our immune. Those are the things you can do that are concrete and fairly simple. There's actually some emerging data about a mushroom, which I love when we have some natural things, but in the western data [00:05:00] there is emerging information about a specific mushroom. Actually several mushrooms, but a lot of the data seems to be on one. 

Um, and that might have some good promise in the western world melding with the integrative eastern world. Um, and short of that, you have to just remain calm because the fact is there is a very, very small chance that you will ever have cervical. . Okay. All right. I hope that helped. I'm gonna go to the Office Peace Act.