Dr. Donohue: Cervical cancer vaccine intended for younger women

Dear Dr. Donohue: Why isn’t the cervical cancer vaccine given to women in their 30s and 40s? Also, please discuss Pap smears and the new and better Pap smear. Why is it better? — Anon.

Answer: Gardasil, the new vaccine for prevention of papillomavirus infection — the cause of cervical cancer — is not as likely to be effective in preventing cervical cancer in women already infected with the papillomavirus. It works best before exposure to the virus. Therefore, the principal target is younger women, between the ages of 9 and 26, with girls of 11 and 12 being the ones chosen to be the concentrated focus of immunization.

More studies are needed to ascertain the vaccine’s effectiveness in older women and in men.

Doctor George Papanicolaou deserves the credit for saving the lives of an uncountable number of women through his work in devising the Pap smear for detection of cervical cancer. The standard Pap smear is still an excellent way to detect what was once a very common cancer. All women who have been sexually active for three years or who have turned 21 — whichever comes first — are strongly urged to begin having Pap smears.

The “new” Pap smear is a new technique in processing cells taken from the cervix. (The cervix is the necklike projection of the uterus; it juts into the vagina.) The technique is called liquid-based cytology, “cytology” being the microscopic study of cells. The sample cervical cells are suspended in liquid and then spun in a centrifuge. The cells collect at the bottom of the centrifuge tube and are more plentiful than cells put directly on a slide after obtaining them from the cervix. The sensitivity of this test — its ability to detect abnormal cervical cells — is increased over the standard test. That’s not to say that the standard test is not good or reliable.

The booklet on cervical cancer and Pap smears provides details on both subjects. Readers can obtain a copy by writing: Dr. Donohue — No. 1102W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

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Dear Donohue: My mom, 86, is fine in most respects, but she makes too much saliva. It drips out of her mouth when she eats. She’s a very fastidious woman, and this bothers her to no end. She has to use a napkin after every bite. Is there a medicine that can turn off the flow? — C.N.

Answer: First, find out if your mother is making too much saliva or if she’s having a swallowing problem. Swallowing problems require a different solution.

Medicines can dry the mouth. They often have such unpleasant side effects that people don’t like to use them. The scopolamine skin patch can dry the mouth. It’s a prescription medicine, and the doctor has to judge whether it’s safe for her.

In extreme cases of too much saliva, an ear, nose and throat doctor can tie off some or many of the ducts that lead from the salivary glands to the mouth.