HPV: a vaccine to prevent cancer

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By Jennifer Arnhold, M.D., GYN, Embrace Women’s Health Clinic


If you could get a vaccine that prevented cancer, would you? Well, you can, and it’s available right now.

Human papillomavirus (HPV) is a common virus that has the potential to cause multiple cancers and other conditions, such as genital warts and cervical dysplasia.

HPV is spread through sexual transmission and can infect most males and females in their lifetimes. In fact, 1 in 4 people in the United States is infected with HPV, according to the Centers for Disease Control and Prevention (CDC). Each year, about 14 million people become infected, including teens. In most cases, people don’t suffer symptoms, and the virus clears on its own.Child receiving HPV vaccine at shoulder

However, if the virus worsens, the consequences could be severe. Along with genital warts or cervical dysplasia, it can cause mouth, throat, cervical, vaginal, vulvar, penile and anal cancer. Alarmingly, 2 in 3 people will get genital warts after any kind of genital contact with an infected individual, and regarding cervical cancer, 30 women are diagnosed and 11 women die from it each day.

The good news is that HPV can be prevented. A vaccine exists that is extremely effective at reducing the prevalence of HPV, therefore reducing the risk of these conditions and cancers.

The CDC recommends that children should get the vaccine starting at age 11, and it can be given through the age of 21 in males and 26 in females. It’s not a yearly vaccine. Rather, it’s given in an effective series of three.

The reason for vaccinating so young is we want to vaccinate before sexual activity begins because it’s more effective if you’ve never been exposed to HPV. Plus, it will help the child develop a sufficient immune system.


What prevents you from being vaccinated?

One of the reasons why parents might choose not to vaccinate their children is a general thought that, overall, vaccines are unsafe. However, many years of extensive research have shown these claims to be unfounded.

Diverse group of teenage friends hang out outside together at a local park or school campus.Because sexual transmission is how HPV is spread, it can be hard for many parents of young children to wrap their head around having to discuss this subject.

It may be uncomfortable, but regardless how the virus is spread, the fact is that the vaccine is a reliable method of prevention. Think about this: Of the more than 30,000 annual cases of HPV-caused cancer in the U.S., the vaccine can prevent about 28,000 cases.

I think this is one of the greatest arguments for getting the HPV vaccine. Not only that, but it decreases the need for anxiety-provoking procedures such as pap smears or colposcopies. In my mind, it’s an absolute win-win. And for parents, it can be a huge benefit your kids later in their lives. A little bit of prevention now can make a big impact later.

Ask your provider if your child is ready for the vaccine.

photo of doctor Jennifer Arnhold


About the Author: Jennifer Arnhold, M.D., enjoys spoiling her son, Ty, and poodle, Andy. Her hobbies include cooking, yoga and reading. She graduated from medical school in 2000 and performs gynecology and gynecological surgery at Tri-County Health Care in Wadena. You can also see her for outpatient appointments at Embrace Women’s Health Clinic in Baxter.

Ann’s breast cancer journey: early detection is key

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By Jessica Sly, Communications Specialist


One year. That’s how long Ann Immonen has been on her breast cancer journey. It taught her much about her own strength and the strength of family and friends. It also taught her that early detection is key to breast cancer survival.

A picture of Ann with her Coworkers

Ann and her TCHC co-workers.

Late in October 2016, Ann went in for her annual mammogram, utilizing the new 3-D technology at TCHC. Just a year earlier, she had been cleared with a normal mammogram. This one, however, revealed concerning lumps that doctors determined needed further investigation.

Following a diagnostic ultrasound on Oct. 31 and needle-guided biopsy on Nov. 9, the diagnosis came back positive. She had breast cancer.

“Maybe because of my health care background, I really never cried about my diagnosis,” she said. “I was just thankful for the early detection because they have come a long way with breast cancer treatment.”

Then came a choice: to undergo a mastectomy or not. The knowledge of her medical history helped her decide. When Ann’s mother was diagnosed with breast cancer, she chose a single mastectomy but experienced recurrence in her other breast. So Ann opted for a bilateral mastectomy.

Chemotherapy began the first week of January. Because of debilitating side effects – nausea, fatigue, hair loss – Ann was unable to work, but she is grateful for the amazing cancer care program at TCHC, which allowed her to receive chemo right in her hometown of Wadena.

Though wigs were an option, she chose instead to sport a fantastic array of hats and made sure to be open with her family about the changes.

“I was never uncomfortable not having hair. I loved hats and I wore them well, but I felt I needed to tell my grandchildren,” she said. “One of my grandsons told his mom, ‘Grandma took some medicine, and her hair popped out!’

Breast Cancer - Ann Ringing Bell

Ann ringing the bell after treatment.

“That’s what you do this for at this age,” she added. “You do it for your children and your grandchildren. They were amazing.”

Radiation started in May and continued through June, again causing more side effects. Finally, two weeks after the 25-day radiation treatment, Ann returned to work.

“It was amazing to be back around people again,” she said. “And I have gotten stronger and stronger and stronger.”

She will continue chemotherapy every three weeks through December, but the aggressive part of the medication is over, meaning her energy and her hair have returned.

Ann credits the support of her family, friends, church members and coworkers with keeping her spirits high.

“Faith, family and friends with a positive attitude can get you through anything,” Ann said. “That’s my motto.”

As she reflects on the past year and looks forward to the end of treatment, Ann’s message to other women is that screenings matter.

“The biggest thing is early detection,” she said. “It’s amazing how when you sit at a table with maybe six ladies, three have had biopsies and two of us were positive. It happens to people every day, but the biggest thing I can say is early detection.”


Ann with her Family at the Relay for Life.

About Ann: Ann Immonen and her husband, Eldon, live in Wadena and have two daughters and two grandchildren. She began working at Tri-County Hospital 39 years ago as an LPN. Over the years, she has worn different hats within Tri-County. Following a Type 1 diabetes diagnosis about five years ago, she transitioned to a part-time float nurse position in the Wadena Clinic.

Sun, summer and what you can do to prevent skin cancer

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By Tammy Nevala, TCHC RN, Ambulatory Care Supervisor


As we reach the pinnacle of summer, days become warmer and the sun becomes brighter. It’s the perfect time to get out and enjoy the Minnesota lake country.

It’s also a great time to make sure you’re practicing proper sun safety in order to prevent skin cancer. Caused by damage to skin cells, this cancer is often preventable and can be cured if caught early enough. But in order to prevent it, you need to know what causes skin cancer in the first place.

sunblock applicationSunlight is the number one culprit. It gives off harmful radiation called ultraviolet (UV) rays, and they come in two types. UV-A are steady all year long and increase aging and the development of wrinkles, while UV-B are more powerful, more common in the summertime and more likely to cause sunburn. The longer you’re in the sun, the more radiation you get.

Tanning beds also play a part in skin cancer growth. Many believe the lights in tanning beds are harmless, but in reality, they give off the same UV rays as the sun to give you a quick tan. Early exposure to tanning beds can significantly increase your risk of getting skin cancer, even if it’s just an occasional use.

Knowing some of the causes of skin cancer will better equip you to prevent it. Here are some practical ways to apply this knowledge:

Say no to tanning beds. Because tanning beds give off such concentrated doses of UV rays in a short amount of time, your chance of skin cancer is augmented. It’s best to avoid them altogether. If you still want to achieve a tanned look, use a sunless tanning lotion instead.

Cover up exposed skin. Use sunglasses, hats, long-sleeved shirts and long pants whenever feasible to protect your skin from direct sunlight. Dark colors and tightly woven fabrics are best.

Take shelter in the shade. Don’t linger in direct sunlight for too long. UV rays can even reach you on cloudy days, so it’s best to stay in shady areas as much as possible. You should also limit time spent around sand, water or snow, as they reflect sunlight and increase UV radiation.

Slather on the sunscreen. The higher the sun protection factor, or SPF, the better. Only broad-spectrum sunscreens with an SPF of at least 15 can help protect you from skin cancer. Broad spectrum simply means it protects against both UV-A and UV-B rays. Use waterproof or sweatproof sunscreen and reapply it often if you’re planning a long day of outdoor activities.Dermatologist examines a mole of male patient

Keep an eye on the kiddos. Since kids tend to spend more time in the sun when playing or exploring, parents should take the proper precautions to protect them from sun exposure and set a positive example by using good habits themselves. Keep babies younger than 6 months out of direct sunlight.

Watch for changes on your skin. You know each mark and bump on your body better than anyone. By routinely checking your skin for anything out of the ordinary, you’re more likely to spot and report a strange mole or growth before it can turn into skin cancer.


About the Author: Tammy Nevala is a registered nurse and the ambulatory care supervisor at Tri-County Health Care. The role of ambulatory care is outpatient medicine, which includes chemotherapy, blood transfusions, IV antibiotics, IV fluids and more.