A few addendums to previous blogs
- I've had differing reactions to my blog on peanut bans, one of which was that young allergic children cannot be charged with keeping themselves safe. I totally agree and I did not want to give that impression. Risk management must have responsible adults oversee it. Adults ensure safe processes are followed. It means that teachers or cafeteria staff must enforce the rules that everyone sits in place and eats their food, with no food sharing. It means that the adult asks who has an allergenic food that day, and that kids are separated in a way that no one feels bad, or singled out or isolated. It means the adult oversees the safe and effective clean up - "Johnny, you missed that spot there, wipe it up again." or " Dylan, don't throw that wash cloth, walk over to the sink and rinse it out." Without a process that all agree to, responsible adults to monitor the process and consequences if the process is not followed, the allergic child is left to fend for his or her self and risk management is equally unsafe as peanut bans or no plan at all.
- An interesting article on HPV vaccination appeared in the Nov 5 New England Journal of Medicine. Instead of using the vaccine to prevent infection with HPV -- as it is being used now -- Dutch doctors created a variant of the HPV-16 vaccine and gave it to 19 women with early precancerous lesions of the vulva. Typically these women would have had to undergone an invasive course of repeated ablations with a carbon dioxide laser ( burning) or wide excision via surgery ( cutting) of their vulva to remove these lesions to stop them progressing to cancer. Recurrence is almost universal. So instead the Dutch doctors gave the vaccine to prime the women's immune systems to fight the HPV strain themselves. Of the 19, 15 had a marked improvement of symptoms and 9 women completely cleared the lesion and remained lesion free 2 years later. The use of immune modulating to fight early cancer is a fascinating and hugely important area of medicine. The HPV vaccine and the Hepatitis B vaccine are both proving that some future cancers can be prevented by immunization. Now new evidence is emerging that early cancer may one day be widely treated by the same means. I believe the viral role in cancer will be an area of explosive research in the decade ahead. Some are suggesting that viral causes of prostate cancer and some forms of breast cancer may also be revealed.
Anne
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