With high local cancer death rates, Volusia promotes HPV vaccine

Linda Ryan knows the mental and physical toll cancer can take on people and their families. 

Ryan, 49, a four-time cancer survivor and three-time cervical cancer survivor, now dedicates her life to helping others battle cancer, funding cancer research and sharing her story so others know the consequences HPV-related cancers can have on a life. 

"I used to think I had checked cancer off my list, but that’s not the case," said Ryan, sitting in her DeLand home recently as a storm brewed outside. "There’s a very good chance my cancer could come back again."

Human papillomavirus, or HPV, is one of the most common viruses that can lead to cancer, with roughly 14 million people, including teenagers, becoming infected each year, the Centers for Disease Control and Prevention states. 

Most commonly spread through sexual contact, the virus usually goes away on its own and many people don't realize when they are infected. But when HPV doesn't go away, it can cause issues ranging from genital warts to more dire diagnoses, like cervical cancer in Ryan's case. In 2015, 24 people, a rate of four people per 100,000, died from HPV-related cancers in Volusia County. That's nearly twice the state rate of 2.1, according to a report released by the Florida Department of Health in Volusia County this month. 

Discouraged by the higher number of deaths and low number of teens getting vaccinated, health officials are trying to raise awareness among parents and encourage family physicians to recommend HPV vaccinations that could help to eventually eradicate the disease. In 2016, CDC estimates show 60-64 percent of teenage girls in Florida have started their HPV vaccination series and only 40-49 percent of boys have started. 

“We can protect our youth from this disease,” Patricia Boswell, the Volusia health department administrator, said in a statement. “By vaccinating them against HPV before they contract the HPV virus, we can keep them from developing this type of deadly cancer.”

Vaccination numbers since 2012 in Volusia show some promise. While the number of teens getting vaccinated is still low — 3,056 adolescents by the end of 2016 — that number grew by 50 percent in the county since 2012. CDC data show a recommendation from doctors is the main reason parents give for vaccinating their children.

Dr. John Hill of West Volusia Family and Sports Medicine said he always recommends the HPV vaccine for children. Beginning in 2006, female teens were encouraged to get the vaccine in a series of three shots. Since then, health officials now recommend males and females ages 11 and 12 should begin the series of two shots and finish before their 13th birthday.

Hill said a lengthy discussion occurs when he recommends the HPV vaccine to families, and he tries to be clear with parents that the vaccine is preventing certain types of cancer — not pregnancy or other sexually-transmitted diseases.

"I think it’s extremely important to do," Hill said. "We could prevent cervical cancer entirely from that virus if we got teens vaccinated."

Hill said patients, in general, tend to get their information about medicine from the Internet where there is no real standard for the knowledge being put forward. Hill suggests parents look to organizations, like the Centers for Disease Control and Prevention, the American College of Pediatricians and the American Academy of Family Medicine for information about the HPV vaccine.

"Vaccines have this underlying tone across the country that they cause autism and all these other things," Hill said. "There are always two sides to every situation, but you just have to educate a patient about what it’s (HPV vaccine) good for."

While some parents opt not to get their children the vaccine, the CDC states numerous research studies have shown HPV vaccines are both effective and safe. To date, the CDC has not observed the vaccinations cause death, neurologic conditions, autoimmune conditions, blood clots in the veins or infertility. Side effects of the vaccine include redness, swelling and some children faint after the shot is given. 

The HPV vaccine was not available when Ryan was a teen, but with two teenage sons of her own now, Ryan said both have been vaccinated. 

“Think about being that parent that did have the option and didn’t vaccinate your children against cancer," she said. "I didn’t want to be that parent, so my boys have both been vaccinated.”

The Volusia health department states HPV-related cancers can be prevented/caught early in older women with regular Pap tests. The agency offers a program, volusiahealth.com/mammo, that provides low- or no-cost preventive Pap tests for women who qualify.

Ryan first got cervical cancer in 2004 and underwent a hysterectomy to remove it. In 2011, right after running a marathon, Ryan learned the cervical cancer had returned. 

The survival rate for recurrent cervical cancer was only 15 percent, Ryan said. For treatment, she participated in a clinical trial with 54 women, flying to Houston every three weeks for treatment with her best friend Barbara Underhill by her side for many of those trips. 

Out of the 54 women on the trial, only one was able to completely eliminate the cancer — Ryan. The cervical cancer returned again last year, though, and Ryan had to undergo daily radiation treatments and weekly chemotherapy. 

A petite woman who enjoys running and staying in shape, Ryan said it was surprising and frightening to see what her body could stand through chemotherapy and other treatments.

But some good did come from her cancer, Ryan admits. To honor her struggle with cancer and promote physical fitness, Ryan and four of her closest friends now host one of the largest 5K race events in Volusia called "Me Strong." 

The race grew from about 900 participants in 2012 to nearly 3,000 this year. The nonprofit has given nearly a half million dollars to people fighting cancer in the area and money from the race also helps fund a research grant through the Foundation for Women's Cancer.

Because of cancer, Ryan had to miss things like Christmas and her children's school program. She described how she went from being a fully-involved mom to not being able to do anything for her sons.

"If I had that vaccination, my kids wouldn't have feared losing their mom," Ryan said. "They wouldn’t have lost their mom for several months. It wasn’t fun and it wasn’t easy. It was painful."

The Centers for Disease Control and Prevention states that with misinformation circulating online, it can be difficult for parents to get credible information about the HPV vaccine. The CDC said a child's doctor is the most trusted source for information about vaccines, but the following organizations also provide information online that parents can trust: 

• CDC: www.cdc.gov/hpv/parents/index.html

• Children’s Hospital of Philadelphia: chop.edu/centers-programs/vaccine-education-center/vaccine-details/human-papillomavirus

• American Academy of Pediatrics: healthychildren.org/english/safety-prevention/immunizations/pages/default.aspx

• National Foundation for Infectious Diseases: adolescentvaccination.org

HPV vaccine information