Oncology (General Cancer)/HPV e6/E7

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QUESTION: I had my first abnormal pap ascus with detection of e6/e7.  Had colposcopy which showed only a tiny area size of 1/3 of a dime.  removed and came back cin 1 e6 detected not e7.  I haven't slept in days because I am petrified due to the oncogene that my prognosis is no matter what cancer is imminent and I am waiting to die.  Saw Oncologist who did another colposcopy shortly after last one and nothing showed up at all .  He didn't seem worried but asked me if I wanted for my peace of mind to test again in 3 months.  Wondering if I should just ask for a hysterectomy (I am 50) and if I do will that reduce my chances of cancer as I know it can still appear in vaginal cuff, vulva, oral and anal

ANSWER: While it's unfortunate that you have the infection, You should know that your problem is quite manageable, and simply requires periodic evaluation by your gynecologist.  The risk of getting cancer in the genital area is measured as between 3 and 6 times that of a "normal individual" over the course of your lifetime, (assuming the virus was detected in your twenties).  However, if lesions are discovered and removed when they appear, you probably won't get cancer, or if you do, it will be localized and treatable.  It's also possible that you won't have any more problems; there are numerous women who haven't had recurrences after the initial lesions have been removed.  Most gynecologists would re-examine you about every year, and remove anything that looked abnormal.  That's not fun, I agree, but it should be enough.  Follow your gyn's advice and don't have a hysterectomy to "reduce your chance".  And you won't get it in the oral or anal area.  The virus is transmitted by direct exposure.  Hope this helps.  

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QUESTION: One more question if you don't mind.  I went to the bathroom in my office a couple of times closing the door with my bare hand. I had all times spots where sebaceous cysts on my labia minora were lanced by dr so they were kind of open I guess.  I touched those areas could I have contracted hpv by that and if not could I have spread hpv to my labia so now I am waiting for VIN to spread there?

Answer
Oddly enough, the hpv virus does not easily get into cells.  They did some studies on gay sexually active men and found that those who used lubricant had less hpv than those who didn't, suggesting some degree of trauma was helpful in causing infection.  All in all,  I wouldn't worry other than to continue to have a good pelvic exam annually.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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