Result: HPV infects these cells, uses their machinery to produce its own proteins, i.e. the oncogenic proteins that will make these cells immortal. “The oncogenic proteins induce the cells to proliferate and inhibit apoptosis, i.e. the death of these cells. This is how cancerous cells appear that will then become invasive. This process takes about 7 to 10 years”. The scientists’ research and study of the literature available on this subject led them to the practises exercised before the discovery of HPV in uterine lesions in 1983. In the 1970s, a common practice to prevent cervical cancer was to use cauterisation or electrocoagulation to destroy part of the cervical cells. “This would take place, for instance, after giving birth and would reduce the risk of developing cervical cancer in the future by four to six times in patients undergoing this procedure, ”, Michaël Herfs adds. When comparing the benefits of such a practice with that of the vaccines currently available on the market, which only reduce the risk of cervical cancer by three or four, and only if they are administered to young virgin women who nonetheless have to be regularly screened by their gynaecologist... there is good reason to question why we no longer practice cauterisation / electrocoagulation. “When HPV was discovered, all research efforts became focused on developing HPV tests and the means to fight these viruses. The main one was to understand and explain the mechanisms linked to the development of cervical cancer. And so cauterisation and electrocoagulation procedures were abandoned”.

Cryotherapy, a simple and affordable preventive solution

Nowadays, if a patient has a precancerous lesion following cervical HPV infection, doctors will proceed with an ablation of the lesion or cervical cryotherapy.  “Cryotherapy consists of destroying the cervical cells using a compressed refrigerant gas such as liquid nitrogen. It’s a fast and easy method”, Michaël Herfs explains. “We would like to launch a clinical test in developing countries in order to validate cryotherapy as a solution to prevent hundreds of thousands of cases of cervical cancer every year in these countries”, the researcher continues. But a clinical study such as this is difficult to set up and may displease the pharmaceutical industry considering the low-cost alternative that cryotherapy could represent to fight this disease. If cryotherapy does indeed prove to be effective in reducing the risk of developing cervical cancer, it could be used as a prophylactic among women in countries where the disease is most devastating. This is what Michaël Herfs and Christopher Crum suggest in a study published in Nature Reviews Clinical Oncology (1). "We have all the tools to do it. It's risk-free and affordable. Preventive action simply has to become standard practice thanks to cryotherapy, rather than only using it to treat the disease once the precancerous lesion is already there”, the scientist stresses.  

To come back to vaccines as a solution on which the pharmaceutical world currently ‘relies’, besides having a limited spectrum of protection, being very expensive and not being applicable to young women who already have an active sex life, it only partly tackles the source of the problem. “HPV is transmitted by boys to girls and vice versa during sexual relations”, Michaël Herfs explains. “Therefore, one solution would be to vaccinate men as well or find a medical treatment that would eliminate the virus or prevent its spread at source”, the researcher specifies. Michael Herfs continues to be amazed that 30 years after the discovery of HPV, no preventive or therapeutic drug against HPV has yet been marketed. “This is clearly the next challenge in this domain that pharmaceutical firms should be focusing on...”.

(1) Michael Herfs & Christopher P. Crum. Cervical cancer: Squamocolumnar junction ablation—tying up loose ends? Nature Reviews Clinical Oncology 12, 378–380 (2015) doi:10.1038/nrclinonc.2015.104.