Cancer survivor advocates for HPV vaccination to save lives
Penny Perry discovered a lump on her neck two years ago that turned out to be cancerous.
It marked the start of a terrifying health journey that she decided to share as a way of inspiring everyone under the age of 45 to get vaccinated against HPV, a common viral infection that is harmless for most people but can cause warts or serious illness in some instances.
Ms Perry underwent five weeks of chemotherapy and 35 rounds of radiation after doctors identified human papillomavirus as the underlying cause.
“In November of 2022, a lump came up on my neck. I went right away to my GP. I had ultrasounds, I had a biopsy [at King Edward VII Memorial Hospital] in January and the results came back in February. All the results came back negative; there was nothing to worry about.”
In June 2023, she was at the dentist for a regular cleaning when he noticed a one-centimetre lesion on her tonsils.
As a result of heart palpitations that she attributed to her “stressful” job in reinsurance, Ms Perry was due to fly to Boston the following month for specialist care. Her dentist insisted that was too long a wait.
“He referred me to a dental surgeon because we had no ear, nose and throat doctor on the island, and we still do not, I believe, have a proper one.”
A biopsy came back negative and a CT scan with contrast dye was inconclusive.
Concerned because her lymph nodes were swollen, Ms Perry’s doctor referred her to Eleni Rettig, a head and neck surgeon at Brigham and Women’s Hospital in Massachusetts.
“Within 30 minutes of being in her little examination room, with her putting a scope and everything down my throat, I was told that not only did I have tonsillar cancer, but it was caused by the HPV virus.”
The illness was “85 per cent to 90 per cent curable” Dr Rettig said, but the treatment “was going to be very aggressive”.
A pathology test confirmed the diagnosis. “Fortunately”, the cancer was limited to the right side of Ms Perry’s neck.
“They wanted me to stay in Boston. Because this is a relatively new cancer in the last 15 years, they wanted me to do my treatment there for exploratory purposes for them.”
Ms Perry had been in Boston for nearly two weeks, and the thought of undergoing treatment in a place where she didn’t have any family wasn’t appealing.
“I had been away for 12 days. I have all my family here in Bermuda. I don't have anybody away. I didn't have anywhere I could stay. I would have had to stay in a hospital.”
She proposed that she undergo her treatment at home, with Bermuda Cancer and Health Centre, and was happy the idea was supported.
“They said, ‘We trained everybody there. They're amazing. We have 100 per cent confidence in them.’ I just couldn't be out here for seven weeks of treatment without my husband and my family. So I chose to come back.”
Both her radiation and her chemotherapy treatments started in the middle of August, on the same day. The radiation ran a seven-week course, Monday through Friday.
The chemotherapy was initially too strong; her kidneys “took a dive” but responded well to the second prescription.
“I went through my treatment. I got very sick. I lost 51lb.”
Ms Perry is grateful for the support she got from her “absolutely amazing” Pals nurse, Merlyn Burgess, her husband, Alan Perry, her sister, Roxanne Knights, and the “most amazing team” of medical professionals at both Brigham and Women’s and Bermuda Cancer and Health.
Kevin Ard would love to see more people vaccinated against human papillomavirus. Below, Dr Ard explains about the stigma attached to HPV and why the vaccine is needed.
Q: How rare it is for HPV to cause cancer?
A: Most HPV infections resolve on their own; only a small proportion ultimately cause cancer.
Q: Is there a stigma attached and why?
A: I think there is, unfortunately, stigma about HPV. I suspect this stems from the fact that some HPV infections arise from sexual contact, and there is societal stigma about sex.
Q: What is the uptake generally on children and vaccines?
A: In the US, approximately three-quarters of children have received at least one dose of the HPV vaccine. A substantial proportion have not received it, which is unfortunate, since the HPV vaccine prevents cancer.
Q: What should people past vaccination age do?
A: People who are not eligible for the vaccine can still take steps to protect themselves from HPV. Condoms can reduce the likelihood of HPV transmission or acquisition, although they are not 100 per cent effective. It is crucial that people have cervical cancer screening if they are eligible; this screening can detect treatable precancerous lesions.
Q: Penny Perry described hers as “a relatively new cancer”, can you expand on that?
A: HPV-associated oropharyngeal cancers have been increasing in incidence lately, while HPV-associated cervical cancer has declined.
• Kevin Ard is medical director of the National LGBTQ+ Health Education Centre at The Fenway Institute and director of the Sexual Health Clinic in Massachusetts
By the end of September, she had finished her treatment. In February she returned to Boston for PET scans as Bermuda doesn’t have the specialised equipment needed to create three-dimensional images from inside the body.
“I had two PET scans — one from my head to my neck and another from my neck to my knees. My head to my neck showed no cancer and my neck to my knees showed no spread of cancer. So I am cancer-free, thank God, but it has been a journey.”
Ms Perry remains under the care of Patrick Murray, a consultant clinical oncologist at Bermuda Cancer and Health as she “still [has] issues with [her] throat” but so far, her check-ups have been clear.
Her hope is to prevent others from experiencing what she went through, but she believes that the association of some HPV infections with sexual contact creates a barrier to open discussion.
“There’s a stigma attached to it [with] maybe the older population — they don’t even know what it is. I didn't even know what it was until two years ago, until it happened to me. I see the commercials coming on TV urging parents to get their children — boys and girls — vaccinated after age 11 or 12. But what they don't say is that people who are older that didn't get the vaccination can have it up to age 45,” she said.
“There's a chance that I could help save somebody else from going through what I've been through for two years. I just really feel that I wasn't in my body when I was going through all this. It was like I was outside looking in, like I was this person that knew I had a mission I had to do and it didn't matter if I was on my knees throwing my guts every morning, or whether I was constipated to the end of the earth, or I couldn't eat for five weeks because of my throat. I just felt like it was a mission I had to do.”
She believes that her first bout of Covid-19, in October 2022, made her susceptible.
“It was too coincidental that I had Covid in October for the very first time, and the following month I had a lump on my neck and the HPV is a virus as well,” she said.
“I've spoken to a lot of medical people about this, and nobody will commit and the reason is because there's just not enough known about Covid. Covid attacks things in the body that nobody can prove. It attacks if you've got a weak immune system, if you've got a weak heart, it just attacks different things. But nobody can say that this is what triggered the HPV virus for me.”
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