| Subject: Re: VIN1 |
Author:
Myra
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Date Posted: Sunday, April 01, 07:09:20pm
Author Host/IP: 208.54.94.33
In reply to:
Lynne
's message, "VIN1" on Sunday, April 01, 02:26:02pm
Lynne, Aldara is an adequate treatment for VIN 1, 2 3
.
http://www.jreprodmed.com/Features/2002/2002May.htm
Most women don't really know much about VIN. Statistics do tell us it is on the rise. April is Vulva Awareness Month....maybe soon more information will reach the general population.
With VIN 1...I would not be too concerned with bladder involvement. Is your VIN on the urethra? Have you had a hysterectomy? Have you been battling Cervical HPV?
There is really no standard screening in place for the Vulva many times it is a woman who brings the changes of the vulva i.e. color, itching, bumps to the attention of their doctors.
If you have engaged in anal sex it is imperative you talk with a anal specialist regarding doing the HPV test in the anal canal. Again there is no standard screening...HPV in the anal area is probably does occur with anal sex. Knowledge is power.
I will hope that the Aldara takes care of the VIN and no laser surgery is necessary.
Imiquimod Cream Effective for Vulvar Intraepithelial Neoplasia
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NEW YORK (Reuters Health) Mar 07 - Imiquimod cream is well tolerated and results in histologic regression of high-grade vulvar intraepithelial neoplasia (VIN) lesions, according to researchers in Canada.
"VIN lesions are increasingly being diagnosed in younger women," Dr. Tien Le and colleagues from the University of Ottawa, Ontario, write in the February issue of the American Journal of Obstetrics and Gynecology. "This is classified as a premalignant condition," they note. "High-grade lesions (grade 2/3) are often treated even if asymptomatic because of increased risks of malignant transformation."
The researchers examined the tolerability and efficacy of 5% imiquimod cream for the primary treatment of VIN 2/3 in patients recruited from regional colonoscopy units. Twenty-three patients with a mean age of 55.2 years were included in the study. Twenty patients (87%) had VIN grade 3 and nine (39%) had multifocal disease distribution.
The women were instructed to apply imiquimod cream over the abnormal area using an escalating dose regimen. Total treatment duration was 16 weeks.
The team assessed response at the end of the study with repeat colonoscopy and biopsy of the target lesion. They defined complete response as a complete disappearance of all visible VIN lesions and a histologic confirmation of VIN 1 or less. Partial response was defined as a decrease in the target lesion of at least 50% from baseline measurements with no new observed lesions.
The therapy was generally well tolerated, and the most common side effect was irritation at the application site. Seventeen patients were evaluable for response. Of these, nine patients (53%) were classified as complete responders and five (29%) as partial responders, for a total response rate of 82%.
Partial responders had a median percentage reduction of target lesions of 56%. The median time to response was 7 weeks.
"A comparative study between laser ablation/surgical excision and imiquimod treatment in VIN grade 2/3 patients will be needed to establish the role of local immunostimulant in the management of this morbid condition," Dr. Le's team suggests.
"The use of imiquimod as maintenance therapy after standard treatment to prevent recurrences should be explored," they add.
Am J Obstet Gynecol 2006;194:377-380.
Women with CIN at Higher Risk for Anal Cancer
and Other Cancers
According to an early online publication in Lancet Oncology, women
diagnosed with cervical intraepithelial neoplasia (CIN) grade 3 are
at an increased risk of developing vaginal, vulvar, and anal cancers.
Further research into the impact of the human papillomaviruses on
these risks is underway.
Cervical intraepithelial neoplasia refers to pre-cancerous or
abnormal cells on the surface of the cervix cell layer. The different
grades of CIN refer to the severity of the cells' abnormality as
viewed by a microscope as well as the depth of the abnormal cell
layer. CIN3 refers to the highest grade of cellular abnormality,
which is often treated in order to avoid progression to cervical
cancer.
Because the human papillomavirus (HPV) is thought to play an
extensive role in the development of CIN3, researchers continue to
evaluate HPV's link to CIN along with the potential preventive
effects of the vaccine now available against HPV.
Researchers from Sweden recently conducted a clinical study to
evaluate potential associations between CIN3 and increased risks of
other cancers potentially caused by HPV. This study included women
from Sweden between the ages of 18 and 50 years. Participants were
evaluated between 1968 and 2004.
• Compared with women who had not been diagnosed with CIN3,
women with a history of CIN3 had nearly a sevenfold increased risk of
developing cancer of the vagina, more than a 4.5-fold increased risk
of developing cancer of the anus, and a greater than twofold
increased risk of developing cancer of the vulva.
• There was no increased risk for rectal cancer among women
diagnosed with CIN3.
The researchers concluded that women diagnosed with CIN 3 have a
significantly increased risk of developing cancers of the vagina,
vulva, and anus compared with the general population. The authors
state, "Further studies are needed to clarify the type of HPV
associated with this increase in risk to determine the clinical
applicability of the new HPV vaccines."
Women diagnosed with CIN3 may wish to speak with their physician
regarding their individual risks and benefits of screening for
cancers of the vagina, vulva, and anus.
Reference: Edgren G, Sparen P. Risk of anogential cancer after
diagnosis of cervical intraepithelial neoplasia: a prospective
population-based study. Lancet Oncology [early online publication].
February 27, 2007. DOI:10.1016/S1470-2045(07)70043-8.
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