Ask Your Doctor: CANCER OF THE CERVIX
Cancer of the cervix (womb) is one of the leading cancers affecting women in Anguilla. Almost all of us know of a mother, grandmother, aunt or sister who is affected by this cancer. Recent medical advances, screening programmes and the development of a vaccine will fortunately result in fewer women getting this deadly cancer.
What is cancer of the cervix?
Cervical cancer is a type of cancer that occurs in the cells of the cervix. The cervix is the lower part of the uterus (womb). Most cervical cancer is caused by some strains of a virus called human papillomavirus, or HPV. When exposed to HPV, a woman’s immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years, contributing to the process that causes some cells on the surface of the cervix to become cancer cells.
You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.
Risk factors for cancer of the cervix
Any woman can get cancer of the cervix, but there are certain factors that increase a woman chances of getting HPV (the main cause of cancer of the cervix) and cancer of the cervix. These factors include:
• Many sexual partners. The greater the number of sexual partners — and the greater your partner’s number of sexual partners — the greater the chance of acquiring HPV.
• Early sexual activity. Having sex at an early age increases your risk of HPV.
• Other sexually transmitted infections (STIs). Having other STIs — such as chlamydia, gonorrhea, syphilis and HIV/AIDS — increases the risk of getting HPV
• A weak immune system. You may be more likely to develop cervical cancer if your immune system is weakened by another health condition and you have HPV.
• Smoking. Smoking is associated with squamous cell cervical cancer.
How do you know if you have cancer of the cervix?
In the vast majority of individuals in the early stages of the disease there are no signs or symptoms. In the late stages of the cancer some signs and symptoms include the following:
• Vaginal bleeding after intercourse, between periods or after menopause
• Watery, bloody vaginal discharge that may be heavy and have a foul odour
• Pelvic pain or pain during intercourse
Having regular medical check-ups, and having appropriate screening tests, can allow for prevention and early detection of this cancer. In young girls, getting the HPV vaccine has been shown to also prevent the development of this cancer.
Screening tests of cancer of the cervix
Cancer of the cervix screening includes two types of screening tests: cytology-based screening, known as the Pap test or Pap smear, and HPV testing. The main purpose of screening with the Pap test is to detect abnormal cells that may develop into cancer if left untreated. The Pap test, also referred to a cervical test, can be taken in the doctor’s office and is a relatively simple and painless test. It is often done during a pelvic examination.
HPV testing is used to look for the presence of high-risk HPV types in cervical cells. These tests can detect HPV infections that cause cell abnormalities, sometimes even before cell abnormalities are evident.
Women should talk with their doctor about when to start screening and how often to be screened. Most guidelines suggest that women begin screening for cervical cancer and precancerous changes at age 21 or before if sexually active.
If the screening test are abnormal the woman should be referred to a gynaecologists. A woman will usually have follow-up testing with colposcopy. Colposcopy is the use of an instrument much like a microscope (called a colposcope) to examine the vagina and the cervix. A biopsy might also be done so that a diagnosis can be confirmed.
Once a biopsy is done and the diagnosis confirmed, your gynaecologist will arrange further tests to determine the extent (stage) of the cancer. Your cancer’s stage is a key factor in deciding on your treatment.
The earlier cancer of the cervix is detected the better the chances of cure from treatment. Treatment for cervical cancer depends on several factors such as the stage of the cancer and other health problems. Surgery, radiation, chemotherapy or a combination of the three may be used to treat cancer of the cervix. Once treatment is completed, the doctor will recommend regular checkups.
Cancer of the cervix, found in its early stages can be successfully treated.
Supportive care from family members and friends is often vital in the management of cancer of the cervix.
Cancer of the cervix is a leading cancer affecting women in Anguilla. Countries that have an effective screening programme or cervical cancer screening have seen a rapid fall in the number of cases of cancer of the cervix. All women are encouraged to have regular screening tests for cervical cancer and regular medical check-ups.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).