hpv-kling2ALAN KLING, M.D

Dr. Alan Kling is recognized as one of the foremost specialists in the field of HPV infections. Throughout his years as an HPV specialist, Dr. Kling has contributed to research and lectured at various medical schools, including Columbia, Cornell, Mount Sinai, NYU, and Yale as well as having been a part of a number of national panels on HPV and HPV prevention. His extensive research has allowed him to keep up with the latest HPV treatment protocols and to educate others in the field as well. While HPV is an important field of dermatological study for many physicians, Dr. Kling has clearly separated himself from the pack, making him the top HPV treatment specialist in NYC today.

Dr. Kling's private practice offices are located at his Park Avenue practice on the Upper East Side and in Park Slope, Brooklyn.

Q: What is the connection between HPV and cervical cancer?
A: HPV infections are the cause of cancer in the cervix 99% of cases.

Q: How long does it take for cancer of the cervix to develop?
A: There is usually a 20 year period of time between the time that a person was first infected with HPV and the time when an invasive cancer of the cervix is detected.

Q: When did the woman who gets cervical cancer acquire the actual infection that caused the cancer?
A: Most cases of HPV infection which eventually progress into cancer of the cervix were first contracted when the woman was a teenager or young adult.

Q: How could a women minimize the chances of her getting an HPV infection and possibly cervical cancer?
A: A woman who wants to minimize her chances of getting an HPV infection and cervical cancer would need to decrease the risk factors for acquiring an infection, which include minimizing the number of sexual partners, using condoms, not smoking, and avoiding passive smoke exposure.

Q: What is the long term prognosis for a women diagnosed to have cervical cancer?
A: The prognosis depends on the stage at which the diagnosis of cervical cancer is made. The stage refers to how far along the infection has progressed. The earlier the stage the better the survival rate.

Q: What are the survival rates for cervical cancer?
A: The five year survival rate of cervical cancer in the early stages of the disease is 96%-99%. The five year survival rate for the late stages of the disease is 15%-20%.

Q: How serious is the prognosis if a woman gets diagnosed with cervical cancer at a late stage?
A: The prognosis is always more favorable for any cancer when it is diagnosed at an early stage, so that the appropriate therapeutic interventions can be initiated as the soonest possible time. Diagnostic screening tests and effective treatments for HPV infections, precancers and cancers are available to those women who are screened appropriately and regularly on their health care providers.

Q: Can an HPV infection progress rapidly and in a short period of time from an infection to a more advanced cancer?
A: Most cases of cervical cancer are detected at an early stage when a woman gets cervical cancer screening on a regular basis. An infection that evolves and progresses from an early infection to an invasive cancer despite screenings at regular intervals would be extremely rare.

Q: Is cervical cancer preventable?
A: Cervical cancer is preventable in the vast majority of cases. Most cases of cervical cancer can be detected at an early stage of development in women who are properly screened at regular intervals. Cervical cancer usually occurs in instances where the women did not get her screening tests at the appropriate regularly prescribed intervals.

Q: If a woman is diagnosed with an HPV infection, does that mean that she may get cancer of the cervix?
A: The fact that a women has an HPV infection does not automatically mean that she is going to get cancer of the cervix. The vast majority of women who have an HPV infection have the low risk (benign) strains that have zero potential to progress into any type of cancer. Only high risk strains of HPV have the potential to progress into cancer of the cervix, and only a small percentage of the high risk strains evolve into cervical cancer.

Q: What percentage of people infected with HPV have high risk strains?
A: 10% of the people infected with HPV have the high risk strains. Only a small percentage of high risk strains will progress and evolve into cancer of the cervix.

Q: Will a woman get cervical cancer if she has high risk strains?
A: A women will not necessarily get cervical cancer if high risk strains of HPV are identified. Nonetheless, she needs to be closely monitored by her doctor because she will have a higher risk for developing an abnormal Pap smear (cervical dysplasia) or a cervical cancer.

Q: How common is cervical cancer in the United States?
A: Over 11,000 women in the United States develop cervical cancer each year.

Q: How many women die each year in the United States from cervical cancer?
A: 4,000 women/year die from cervical cancer in the United States.

Q: Why are so women dying from cervical cancer if there are so many screening tests available to detect cervical precancers and cancers?
A: Most of the deaths from cervical cancer are preventable if the women had gone to their physicians or health care providers and gotten checkups. Many of the people who develop cervical cancer fell between the cracks of the health care system. Cervical cancer is a preventable disease in developed countries – and hopefully one day also in developing countries – and does not need to happen.

Q: Isn’t 4000 deaths/year from cervical cancer a lot of people dying?
A: Although 4,000 deaths per year from cervical cancer is a far greater number than is acceptable, it remains a relatively small number considered in the context of the fact that the United States has a population of over 300 million people.

Q: How common is cervical cancer on a worldwide basis?
A: Cervical cancer is the third most common cancer in women worldwide. An estimated 533,000 women worldwide were diagnosed with cervical cancer in 2008, according to Cancer Research UK. The developing countries have the largest burden of cervical cancer and account for 86% of all cases diagnosed worldwide in 2008.

Q: How does the incidence of cervical cancer in Latin America and the Caribbean compare to the incidence in the United States?
A: The mortality rate from cervical cancer is 5x higher in Latin American and the Caribbean compared to North America. The main reason is lack of resources in the developing world to do adequate screening and to deliver quality health care.

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