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Should Florida law require school kids to get the HPV vaccine?

By Justine Griffin for the Tampa Bay Times 

During a spring legislative session dominated by school safety concerns, lawmakers left another pressing health issue on the back burner. And, like the Parkland shootings that commanded their attention, it involves life, death and young people.

A bill called the “Women’s Cancer Prevention Act” would have required children entering Florida public schools to receive the vaccine that protects against cervical and other cancers caused by human papillomavirus (HPV) infections.

While it didn’t get much traction in the Capitol this time around, the bill is likely to pop up again next year as other states begin to pass and consider similar legislation. It also enjoys overwhelming support from the medical community.

Still, the continuing controversy over the HPV vaccine threatens to stand in the way.

“The introduction of any new vaccine is controversial. But as a country, we seem to forget the benefit of vaccination. The message that we need to get out is that we can prevent multiple cancers in men and women with this vaccine,” said Dr. Anna Giuliano, founding director of the Center for Infection Research in Cancer at Tampa’s Moffitt Cancer Center.

Nearly all sexually active adults carry some of HPV’s 170 active strains. Most are harmless, but a few are known to cause cancer. Reproductive cancers of the cervix, vagina, vulva and anus are most common, but HPV is also the cause of 72 percent of oropharyngeal cancers, which can impact the base of the tongue, tonsils and walls of the pharynx.

Because of this, the sexual stigma attached to the vaccine makes it difficult for physicians to talk to worried parents about it. Sometimes, it’s hard to convince them to give the shot to their 10- or 11-year-old child, said Dr. Ellen Daley, a professor studying women’s health at the University of South Florida.

In addition, according to physicians and researchers, anti-vaccination groups have spread fear and misinformation about the vaccination online, with stories of health problems including deaths.

“No, it’s not causing autism and no, it’s not causing your kid to walk backwards,” Daley said. “It’s a very, very researched vaccine, but I think when people are not ready to trust something, there’s nothing you can say to make them change their mind. It’s a tough group to break into.”

Read more here.

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The future of the flu: Will we ever be able to beat it?

Much of the funding and research on the flu is focused on developing a universal vaccine that would target parts of the virus that can't mutate. But real progress on that front is up to 10 years away, doctors and researchers say. [Associated Press (2015)]

By Justine Griffin for the Tampa Bay Times 

This year’s particularly nasty flu season has doctors and researchers worried about what’s ahead.

Though the number of outbreaks in Florida has declined in recent days, the first six weeks of 2018 saw soaring numbers of flu patients in emergency rooms, urgent care clinics and doctors’ offices — and at rates that far exceeded the last three years. More people than expected died from influenza and pneumonia, including six children. And this year’s shot was only 36 percent effective against the two main flu strains, compared to 40 to 60 percent in past seasons.

Does this mean it’s going to keep getting worse? Will we ever be able to stop it? What is the future of the flu?

The answers are a decade away at best, some researchers say.

“The one thing about flu that you can count on, is that it will be unpredictable,” said Dr. Nicole Marie Iovine, a physician and professor at the University of Florida who specializes in infectious diseases. Iovine said UF Health in Gainesville saw twice as many positive cases of the flu this year than the last busy season in 2014-15.

“The reason that the flu vaccine doesn’t protect us more right now is because the virus is like a moving target,” she said. “It’s mutating constantly, to the point that the common strains we see at the beginning of the season will be different from the ones we see at the end of the season. If you caught the flu last year, you could catch the same strain again this year, because at the molecular level, it’s not really the same virus at all.”

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Tampa Bay Times: Chronic pain sufferers plead for a nuanced approach to opioids (w/video)

By Justine Griffin

 


Will Michele Jacobovitz get out of bed today?

That depends on how many painkillers she has left in her monthly prescription, which sometimes she’s forced to ration. Some mornings are harder than others.

Jacobovitz, 56, has suffered from chronic pain since a 1987 car accident. The Pasco County resident has had 73 surgeries since, from her neck to her ankles, and she has the scars to prove it. In December, she was diagnosed with breast cancer.

She says it’s impossible to function without popping a highly addictive painkiller with Acetaminophen and Oxycodone components, in the morning. Without it, she says, there are days she can’t get up at all. Or get to the bathroom in time. It can be humiliating.

Jacobovitz says she’s not addicted to painkillers, just absolutely dependent on them.

“It comes down to quality of life,” she said. “I’m not using these drugs to get high. I’m using them so I can have some kind of life. So I can get out of bed. They don’t take my pain away. But they mask it so I can function.”

She is one of many Floridians who suffer from chronic pain and are worried about a government crackdown that would make it even harder to get the prescription drugs they need every day.

Gov. Rick Scott has proposed legislation that aims to put a dent in the opioid epidemic by prohibiting doctors from prescribing more than three days’ worth of opioids — or seven days if doctors can explain why that’s medically necessary.

Under the measure, Florida would share a database of opioid prescriptions with other states and require doctors to routinely check it. Doctors also would be trained on proper prescribing techniques.

“When people think of opioids, they think of addicts and criminals,” Jacobovitz said. “That’s not us.”

Read more here.

 

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Tampa Bay Times: At Moffitt, a push to ease cancer’s toll in the workplace

By Justine Griffin

Cathy Bishop, a retired teacher and assistant principal in Hillsborough County, is in remission after treating stage IV colon cancer at Moffitt Cancer Center in Tampa. The disease affected key decisions about her career and retirement. [Photo courtesy of Moffitt Cancer Center]

Cathy Bishop worked as a teacher and assistant principal at Hillsborough County schools for nearly 35 years when she found out she had colon cancer.

Diagnosed after a routine colonoscopy, she had to make a tough decision about how she was going to let the disease impact her career. She would rely on the health insurance offered to her through the school district to pay for medical bills that stacked up because of chemotherapy and surgery. But ultimately, Bishop chose to work through her diagnosis and treatment plan instead of taking medical leave.

“My retirement is a teacher’s pension, which is half a salary. Basically, not much,” Bishop said. “I have two sons, and one of them was in law school at the time. I had to make a decision that was best for my family.”

Bishop told her story Monday to a room full of professionals from some of the Tampa Bay region’s largest employers. Tech Data, Port Tampa Bay, the YMCA and the city of Orlando government were just a few of the organizations in the audience at the Moffitt Cancer Center in Tampa. Moffitt hosted its first ever “Employer Forum,” where doctors and administrators shed light on the cost of cancer and its huge impact on the workforce. They also proposed a new way of collaborating with insurers to make treatments more affordable for patients like Bishop.

“It’s a topic that’s hardly ever mentioned in the workplace, but the employer plays a big role in terms of support for the patient and their family,” said Dr. Louis Harrison, chief partnership officer at Moffitt and one of several physicians who shared stories about how difficult it can be for patients to balance work and cancer.

“Just recently I was treating a patient with neck and head cancer who was worried a test was going to take too long,” he said. “He told me he had to get back to work or else they were going to be angry with him. What a predicament.”

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Tampa Bay Times: Yes it’s awkward, but more dentists should talk to patients about oral cancers and sex

By Justine Griffin

Dentists and dental hygienists see nearly 85 percent of children and their parents in the U.S., making them an important group of health care providers who could address HPV prevention and detection -- even if the conversation can be awkward, says Ellen Daley, a professor studying women's health at the University of South Florida. [DOUGLAS R. CLIFFORD | Times]

Dentists may soon be prying deeper in their patients’ sex lives.

The human papillomavirus, or HPV, is now the most common sexually transmitted disease, and one local researcher is urging dentists to get on board to warn patients about it.

But talking about HPV — and how it can be spread through oral sex — can be awkward.

“This is an emerging topic for dentists and not really one they ever expected to have to talk about,” said Ellen Daley, the lead investigator of a recent study on this topic published in the Journal of the American Dental Association this month. “It’s controversial and uncomfortable. No one wants to talk about these sensitive topics.”

HPV is the cause of 72 percent of oropharyngeal cancers, which can impact the base of the tongue, tonsils and walls of the pharynx, said Daley, who is also a professor studying women’s health at the University of South Florida.

Younger patients, usually pre-teens and teens, are the most at risk for HPV. But the virus can also be dormant for years, which could impact older patients who won’t necessarily experience symptoms for many years.

It’s transmitted during vaginal, anal or oral sex with someone who has the virus.

Nearly 80 million people — or about one in four — are currently infected with HPV in the U.S., according to the Centers for Disease Control and Prevention. About 14 million people become infected each year, and 30,700 of those cases cause cancer in men and women.

The HPV vaccine can prevent most of those cancers, or 28,000 of them. An estimated 50,000 cases of oral type cancers will be diagnosed this year, according to the American Cancer Society.

The Florida Legislature is currently considering companion bills in the House and Senate that could add the HPV vaccine to the child immunization requirements for school.

Read more here.