TMC PULSE

t m c » p u l s e | m a r c h 2 0 1 6 8 W hen 33-year-old Kara Million visited her doctor for her annual well-woman exam in 2004, she thought it was going to be a routine checkup, just like all the previous years. She had been going annually, but this was the first time her doctor offered a human papillomavirus test. understand why people aren't running out the door just to get it now," Million said, adding that her children will receive the HPV vaccine when they're at the proper age. "If I could go back 30 years, I would get the HPV vaccine for sure. I don't want anybody to ever go through what I'm going through," she said. Million's experience is a cautionary tale for the four out of 10 unvaccinated girls and six out of 10 unvaccinated boys across the U.S., but a new collabo- ration between all 69 National Cancer Institute-designated cancer centers seeks to improve those odds. Earlier this year, The University of Texas MD Anderson Cancer Center, Baylor College of Medicine and others united to publish a joint statement that endorsed HPV vaccination for nation- wide cancer prevention. It was a groundbreaking move that Ernest Hawk, M.D., vice president and head of the Division of Cancer Prevention and Population Sciences at MD Anderson, called "the beginning of a new age for cancer control actions." "It doesn't benefit them at all, but it is directly aligned with their mission of service," Hawk said. "That's what's novel here: it's the fact that they chose to come together and agree upon the language, which was terribly difficult, related to HPV vaccination. They're not going to get paid for this. They're not going to get more grant money for it, but everyone knows it's the right thing to do." The idea to come together in concerted action was inspired by NCI grants that funded 18 environmental scans in January 2015 to study HPV vaccination barriers across 18 cancer centers' communities, looking closely at what factors prevent people from receiving the vaccines. The results of the scan and key informant interviews identified a variety of reasons people cited as barriers, including inconsistent If I could go back 30 years, I would get the HPV vaccine for sure. I don't want anybody to ever go through what I'm going through. — KARA MILLION Cervical Cancer Survivor A United Front to End Cancer The country's 69 NCI-designated cancer centers recently united in a joint effort to promote HPV vaccination and eradicate cervical cancer B y S h a n l e y C h i e n "I wasn't really worried about anything," she said. "I was married and didn't have any symptoms of anything." But when her HPV test came back positive, Million was instructed to see her doctor every six months in order for them to keep a close eye on her condition. She continued seeing her doctor on a regular basis and led an overall normal life, giving birth to her son in 2006 and daughter in 2008. "Everything was still okay. I guess being a mom of two very new kids, I let that six-month time relapse," she said. It wasn't until 15 months after her last doctor's visit that Million went back for her checkup and, by that time, her condition had worsened. She was diag- nosed with stage IIIA cervical cancer. After six weeks of radiation and chemotherapy and a year of remission, Million and her doctors were hope- ful about her outcome. There was no evidence of the cancer returning, but in October 2010, Million was back in the hospital. Her cancer had recurred and, this time, she would need to undergo a radical surgical procedure, called total pelvic exenteration. "I couldn't even talk about the sur- gery without crying. I mean, I had two babies at home. The thought of leaving them motherless was breaking my heart," she said. The surgery consists of removing the uterus, cervix, ovaries, fallopian tubes, vagina and other surrounding organs. "They removed my bladder. They removed part of my colon, part of my intestines and part of my rectum," Million said. After a 13-hour surgery that produced a scar from her right breast all the way down and around, she was left with two ostomies: one for urine and the other for stool. "This is my new normal," she said. Since her procedure, she and another cervical cancer survivor formed a support group for women undergoing total pelvic exenteration surgeries, comforting 15 to 20 different women over the past four years. Although many of those in her support group have survived, there are some who weren't as fortunate. "It's a high mortality rate. If the HPV vaccination can prevent that, I don't

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