Though it’s a life-threatening illness, cervical cancer is highly preventable. Following is what all women need to know to protect themselves and their daughters.
First the bad news: This year, nearly 500,000 women will be diagnosed with cervical (uterine cervix) cancer. It will kill more Thai women than any other cancer. The good news is, cervical cancer is more preventable than ever, thanks to advances in research and the introduction of the first-ever cancer vaccine.
CAUSES OF CERVICAL CANCER
Cervical cancer tends to strike women between the ages of 30 and 55. Among several factors that increase a woman’s cervical cancer risk, the critical factor is infection by the human papillomavirus (HPV) via sexual transmission. Nearly 80% of female adults will suffer at least one HPV infection during the course of their lifetime.
An HPV infection that persists and is left untreated can cause abnormal changes in cervical cells that can develop into cancer in five to 10 years. Without treatment, the cancer may then spread quickly beyond the cervix into adjacent parametrial tissue and then to other tissues or organs including the lymph nodes and the pelvic area, eventually resulting in failure of the kidneys, bladder, liver and lungs, and ultimately the death of the patient.
Besides HPV, other risk factors include: vaginal rupture during labor in multiple pregnancies, becoming sexually active at an early age, having multiple sexual partners, poor genital hygiene, untreated cervical lesion and inflammation, a weakened immune system, cigarette smoking, and alcohol consumption.
TREATING CERVICAL CANCER
As with all cancers, the progression of cervical cancer is measured by stages based on tumor size and whether and where the cancer has spread beyond the cervix. There are four stages: Stage I, the earliest stage, indicates the disease is contained within the cervix. Stage II indicates the cancer has also invaded the parametrial area. A Stage III classification means the cancer has spread to the pelvic wall or lower area of the vagina. Stage IV the most serious stage indicates the spread of cancer to areas beyond the pelvic area, such as the bladder, rectum or other organs and tissue.
Cervical cancer is usually treated with one or a combination of three methods, depending on the stage of disease, as follows:
Chemotherapy – Chemotherapy is the use of one or more drugs to kill cancer cells. It’s considered a primary treatment for cervical cancer patients and is often prescribed in combination with other treatments such as radiation therapy.
Radiation therapy – Radiation therapy has proven very effective in treating women with advanced cervical cancer that extends beyond the cervix (from stage II) or in patients whose conditions (such as those who are very obese or are allergic to general anesthetics) preclude surgical intervention.
Surgery – Surgery is generally recommended for treating early stage (I and II) cases where the cancer is confined to the cervix and vagina. During the procedure, the surgeon performs a radical hysterectomy to remove the cervix, the uterus and the upper part of the vagina adjacent to the cervix. In some cases, pelvic lymph nodes may also be removed.
SIMPLE STEPS TO PREVENTION
While cancer treatments are better than ever, they can still be difficult, unpleasant experiences with potential side effects and extended recovery times. The far better choice is to live a life free from cervical cancer it’s easier than you may think.
A cervical cancer prevention strategy includes simple but important measures like getting regular screening tests, receiving the HPV vaccine, and making changes to mitigate one’s individual risk factors.
PAP TESTS THE BEST SCREENING TOOL
Nearly 14 million Thai women over age 35 are considered at risk of HPV infection. But only about 800,000 Thai women have been screened for HPV. Thailand’s National Cancer Institute is forecasting that in 2008 the number of new cervical cancer cases will reach 8,000 - that’s more than 20 new cases diagnosed every day!
The Pap screening test is widely considered the best available tool for cervical cancer screening when conducted on a regular basis.
There are several types of Pap tests, including:
Pap Test (also called Pap smear) involves the collection of cells from the cervix. During the procedure, the doctor inserts a speculum into the vaginal area and collects a sample of cells from inside and around the cervix. The collected sample is examined for abnormalities indicating the presence of pre-cancerous cells. If abnormalities are found, the doctor will usually recommend follow-up testing using more powerful and precise methods such as a colposcopy (a visual inspection using a lighted high-power microscope) or a cervical biopsy (a small sample of cervical tissue is removed for further testing).
ThinPrep is another cytological screening test for cervical cancer, but with about 65% more sensitivity than a Pap test. Doctors may favor Thin Prep because of its higher diagnostic accuracy compared to a conventional Pap smear.
ThinPrep Plus HPV Test is a high-powered combination of Pap and HPV tests. This combination procedure increases screening efficacy and correctly identifies 95% to 100% of early-stage cervical cancers. As the collected sample of cervical cells is screened for both HPV and pre-cancerous cells, many women appreciate the convenience and time savings of combining two tests in one procedure.
THE FIRST ANTI-CANCER VACCINE
2006 marked a watershed year in medical advances with the introduction of two vaccines to prevent HPV, the leading cause of cervical cancer. These are the first, and still only anti-cancer vaccines, and they are changing the face of cervical cancer protection for millions of women around the world.
The vaccines provide complete protection against the HPV strains that cause about 70% of all cervical cancers. Vaccination also protects against other HPV strains known to cause about 90% of all genital warts cases in women.
The vaccination regimen involves three doses administered over a six-month period. Research has shown the regimen to be 100% effective. The vaccine is recommended for girls and young women from ages nine to 26 years. The vaccine protects best when it is administered before a woman becomes sexually active or before she comes into contact with the HPV virus. Women who have been previously diagnosed with an HPV infection may still benefit from the vaccine.
The vaccine has been shown to provide protection for at least five years, and more research is being conducted to see whether a booster vaccine is needed after the five-year period.
Vaccination is not a “cure all.” Women still need to receive regular Pap tests and take other preventive steps, as the vaccine protects against some but not all strains of cervical cancer-causing HPV and genital warts. Even vaccinated women are still at risk of exposure to unprotected HPV strains and other risk factors.
The HPV vaccines have been proven to be safe as well as effective; the most common side effect of the vaccine is brief soreness around the injection area. Vaccination is not recommended for pregnant women or for women who are allergic to vaccine ingredients.
LOWERING YOUR PERSONAL RISK FACTORS
Practicing safer sex and good hygiene along with your partner are two important steps to lower two key risk factors for cervical cancer. Condoms provide some - but not complete - protection against HPV.
Women who become sexually active before the age of 18, and women who have many sexual partners or multiple pregnancies are at greater risk of HPV infection and are more likely to develop cervical cancer. Parents can help by warning their children of the dangers of sexual relations and multiple partners at a young age. Finally, quitting smoking can significantly reduce a woman’s risk of developing cervical cancer.
The saying “prevention is better than cure” certainly applies to cervical cancer. Reduce your risk factors (and your daughters’ too), and see your doctor for vaccination and regular screening tests. Protecting against cervical cancer will be worth the bit of extra effort.
Know the Warning Signs
Protect Yourself and Your Daughters from Cervical Cancer
- Bleeding during or after sexual intercourse;
- Abnormal vaginal bleeding between menstrual periods;
- Sporadic or breakthrough bleeding;
- Prolonged menstrual bleeding that lasts from several days to a full month;
- Heavier-than-usual vaginal bleeding during menstruation;
- Leucorrhea (a heavy, thick and sticky vaginal discharge that is white, yellow or green in color with a fishy odor);
- Pain in the lower abdomen, sometimes in conjunction with abnormal vaginal discharge (leucorrhea);
- Loss of appetite, paleness, weak or tired feeling with unexplained weight loss.
- Cervical cancer kills seven women in Thailand every day;
- Nearly 275,000 deaths and 500,000 new cases of cervical cancer were reported worldwide in 2002, the last year for which data is available;In the early 1980s, German cancer researcher Harald zur Hausen discovered the link between cervical cancer and the human papillomavirus (HPV). Professor zur Hausen received the 2008 Nobel Prize for Medicine for his discovery;
- HPV is the most common sexually transmitted infection; 80% of women will contract the virus during their lifetimes. The highest infection rates are found in women between the ages of 18 and 28;
- Although most HPV infections clear by themselves, women infected by high risk strains can go on to develop cervical cancer;
- The newly-available cervical cancer vaccine has been shown to be safe and effective in preventing the transmission of strains of HPV that cause 70% of all cervical cancer cases.