Newsgroups: sci.med
Subject: Re: Cervical Dysplasia Questions
From: RGINZBERG@eagle.wesleyan.edu (Ruth Ginzberg)
Date: 23 Jan 93 10:10:45 EDT
Distribution: world
Organization: Philosophy Dept., Wesleyan University
X-News-Reader: VMS NEWS 1.20In-Reply-To: guruman@ac.dal.ca's message of 22 Jan 93 19:36:03 -0400Lines: 80

In <1993Jan22.193603.10478@ac.dal.ca> guruman@ac.dal.ca writes:

> I have a few questions about cervical dysplasia, any help would be appreciated.

I would like to take a stab at answering these, but I hope if I have made any
errors that someone else will correct me. I am not a doctor.

> 1) Cervical dysplasia is a a)bacteria, b)virus c) a state of cells.

I believe it is a *description* of the appearance of cells under a microscope.

> 2) CD is a communicable disease ?

I believe it is a symptom, not a disease.  Some causes of this symptom are
communicable; some may not be.

> 3) Venereal Warts are a majour cause of CD ?

I don't know about this, but it sounds unlikely, given how CD is detected.  It
is usually detected via pap smear, which is usually performed on the cervix,
not on visible venereal warts.  However, if there *were* venereal warts on the
cervix & these areas happened to be the areas swabbed in the pap smear, it
wouldn't be at all surprising for the cytologist to find dysplastic cells, I
wouldn't think.

>       if yes, must HPV be present in infected person, or is exposure to HPV
>       enough?

Um, not quite sure of the focus of this question. but...

Infection by HPV (Human Papilloma Virus -- of which I think there are currently
23 identified strains, each distinct from one another) is the usual cause of a
cytological finding of cervical dysplasia. I should think that if a woman were
exposed to HPV but not infected by it, there would be no evidence of cell
changes caused by HPV infection (just like, if you're exposed to the flu but
don't 'catch', you have no symptoms of the flu). 

> 4) Cervical Dysplasia can be carried by men. ??

Again, cervical dysplasia is a symptom, not a disease.  Men cannot have this
symptom because they don't have a cervix on which to have the dysplasia. :-) 
However, HPV -- which causes cervical dysplasia -- is pretty well demonstrated
to be a sexually transmitted disease (STD), which means that a man can be a
carrier of HPV and transmit it to a female sexual partner.  Usually both
partners are treated for HPV simultaneously, so that they don't keep reinfecting
one another.

> 5) It is totally treatable, and any re-occurrence is a new infection. ??

Yes, with a hedge or 2.  Hedge #1:  If BOTH partners are not treated and CURED
of it at the same time, they can keep re-infecting each other over & over again
even though neither one is exposing him- or herself to it elsewhere.  Hedge #2:
SOME (I believe 2/23) HPV viruses have been implicated in the development of
cervical cancer, when left untreated.  This is why it is important to treat HPV
infections and cure them.  If left untreated for a very long time, to the point 
at which cancerous changes are occuring in the infected cervix, the notion of
"totally treatable" takes on a different tone.  Then you have to be concerned
about treating the cancer, not just the HPV.  While EARLY cervical cancer is
one of the MOST curable cancers (maybe second only to some skin cancers), it
does have a slightly lower cure rate than 100%, which is why you don't want to
let it develop in the first place.

> 6) If antibiotics are used to treat CD, then mustn't it be a bacteria?

I believe Flagyl is most commonly used, and it is not a bacterial antibiotic.

> Any help would alleviate a lot of confusion for me.
> Thanks very much in advance.

I think your questions are a VERY good indication of why a physician treating a
STD in a patient REALLY ought to make an effort to speak to BOTH partners about
the disease.  It requires knowledge & cooperation & commitment on the parts of
BOTH partners to clear up a STD, & it seems that this would best be facilitated
by having both partners meet together with the physician -- to educate & treat
them *as a couple* -- which is who really has the STD, not one of them alone.
Just MHO.  Hope this helps.

------------------------
Ruth Ginzberg <rginzberg@eagle.wesleyan.edu>
Philosophy Department;Wesleyan University;USA
Newsgroups: sci.med