Fighting Cervical Cancer: Physician Pursues HPV Research

I saw something on television, one patient tells her. I came across it in a magazine, another mentions.

"With a high cervical cancer rate, South Carolina is an important place to study the HPV virus." – Dr. Lisa Spiryda

The topic is HPV. While an increasing number of Dr. Lisa Spiryda's patients have heard of HPV (human papillomavirus), they don't always realize that it's a very common virus that affects most women at some time in their lives. So the assistant professor of obstetrics and gynecology explains how the virus, which is spread through intimate contact, is fought off by most women and never causes any problems. She makes sure they understand how in some women it can remain in the cervical cells for months or years before becoming active. If the virus is not detected and treated, these abnormal cells can develop into cervical cancer. 

That's why Dr. Spiryda and other obstetricians/gynecologists are recommending a two-fold approach to cervical cancer prevention. The first step is a vaccine (known under the brand names of Gardasil and Cevarix), which protects against the two most common types of HPV, which are responsible for 70 percent of cervical cancers. It's advised for females ages nine through 26. "It only works when an individual has not been exposed to the HPV types in the vaccine. Ideally they have not engaged in sexual activity and have therefore not been exposed. We're seeing girls as young as 12 who have had intercourse," Dr. Spiryda said. She'd like to see the vaccine become a standard vaccination at age nine before young girls even contemplate sex.

The second tool is HPV testing for women age 30 and older. This is done in conjunction with Pap testing that women are already accustomed to during gynecological check-ups. "Women under 30 don't need to be tested. Most of them will have been exposed to the virus, but the vast majority of them will have fought off the infection," Dr. Spiryda explained about the virus, which doesn't usually stay active long in younger women.

In addition to her work as a clinician, Dr. Spiryda (who also holds a Ph.D. in biomedical sciences) began HPV research when she came to the School of Medicine last fall. "My life work is to study why some individuals can fight the HPV virus, and why the virus causes severe dysplasia (abnormal cells on the surface of the cervix) in other women that needs to be treated," she said. 

In the lab Dr. Spiryda is looking at HPV from a molecular basis and trying to understand how the virus can transform cells into dysplasia and then into cervical cancer.  She plans to continue research she started as a graduate student in which she identified a protein that made the cells less cancerous and studied the relationship of this protein to HPV.

The clinical portion of her research is delving into a database of 15,000 women who have been treated by the Department of Obstetrics and Gynecology, concentrating on women with severe dysplasia. She's looking at other medical conditions these women have, which strains of HPV affect them, and how their bodies respond differently to the virus. Her ultimate goal is to eliminate the need for a surgical procedure removing a part of the cervix, which can cause pre-term labor and pre-term delivery in women later on. Her hope is that the research could lead to a non-surgical treatment for this pre-cancerous condition as well as better screening protocols. "If we knew that women with certain medical conditions were more likely to develop dysplasia, then we could do something earlier," she said.

Reprinted from Connections newsletter, August 2008

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