There can’t be many gynecological crusaders in the world, but Lois Ramondetta of Pearland is surely one of them, and sometimes she gets angry. A parent of two daughters, she is committed to protecting them against the HPV virus, as well as cervical cancer, which is almost always caused by the virus. But she is also the chief of gynecologic oncology at LBJ Hospital and a professor at MD Anderson, which puts her into contact with parents not similarly committed, parents who refuse to have their daughters vaccinated. This, she will tell you frankly, is lunacy.
“My kids, for better or worse, have to hear about gynecological stuff all the time,” says Ramondetta, whose children are 17 and 7. “And the minute one of [my teenager’s] friends steps foot in my house or car,” she adds between sips of Tecate at West Alabama Ice House on a gorgeous Sunday afternoon, “I ask them, have you gotten the vaccine?” The doctor doesn’t mean to imply anything about the teens’ morals, of course. But the equation of the two, she is quick to acknowledge, is a major reason why only about half of eligible girls and a quarter of eligible boys—the vaccine is now recommended for both sexes—are inoculated once. Fewer still complete the three injections necessary to ensure immunity to the HPV subtypes most likely to cause cancer.
The problem, of course, is that HPV is transmitted sexually, and as such, “there’s a stigma associated with it,” says Ramondetta. “But there shouldn’t be. Eighty percent of the world has been exposed to HPV at some point.” Some never know it’s there; some get a strain that causes warts. In most cases, the body clears it, she explains, “but in some unlucky people—and we don’t understand why—the virus sticks around.”
And the longer the virus sticks around, the greater the chance that its host will develop a deadly disease, although even cervical cancer is highly treatable when detected early via pap smear. Nevertheless, Ramondetta sees advanced cases of it at LBJ, which is why she’s taken to calling it “the WTF cancer,” something she knows might bug her colleagues. “But I do,” she says. “It is.”
Ramondetta is a straightforward, blunt, but also compelling woman. To sit with her at a picnic table is to hear about the various cancers linked to HPV—vulvar, vaginal, anal, penile, and throat—and not give a damn what the next table must be thinking. These are painful, often fatal cancers, and they would be far less prevalent if parents routinely had their kids vaccinated at ages 11 or 12 (the younger the recipient, the more effective the vaccine).
“My kids aren’t gonna get it; my kids aren’t having sex,” says Ramondetta, repeating the most common excuses she hears. “The other one is, my kid’s not like other kids.”
Still, she concedes, the HPV vaccine has an image problem. “I feel like we went about advertising it in the wrong way. It was pushed toward OB-GYNs doing it when it should have been the pediatricians. It should have been about cancer, not STDs.” Ramondetta admires the example being set in Australia, where pediatricians and school nurses are on the front lines of the battle. There, the vaccine is administered in schools, and 70 percent of all girls complete the three-dose course. Not surprisingly, Australia’s HPV infection rate has dropped significantly (in February of 2013, the country extended the program to include males).
But on this side of the world, the crusade goes on. The day before meeting us Ramondetta was in Humble, where she’d volunteered to give a presentation at a middle school. There, she was approached by a woman proudly announcing that her daughter had been vaccinated. “What about your boys?” the doctor countered, in lieu of congratulating her. She smiles. “I think that after yesterday the Humble vaccination rate is going to go up.”
With that, we stand up, throw away our beer cans, shake hands, and turn to go.
“Wait, one more thing,” says Ramondetta, stopping us. “When was your last pap?”