Written by Wei Yan Yeo, Wei Sheng Cheah, Pharmacists
What is Cervical Cancer
Cervical cancer is the fourth most common cancer of women in the world, with the name originating from the cervix, which is the lower, narrow end of the uterus. The cervix connects the vagina (the birth canal) to the upper part of the uterus (or womb) where a baby grows when a woman is pregnant.
According to the World Health Organization(WHO), an estimation of 570,000 new cases and 311,000 deaths was reported in 2018. Many women diagnosed early can be cured with a significantly longer life expectancy following completion of treatment and is among the easiest gynecologic cancer to prevent with regular screening tests and follow-up.
In this article, we will explore the facts and myths surrounding cervical cancer.
Who gets Cervical Cancer?
All women are at risk for cervical cancer. It occurs most often in women over age 30. The risk for cervical cancer often correlates with early onset of sexual activity, multiple sexual partners, immunosuppression (e.g., HIV infection, transplant recipients), cigarette smoking, low socioeconomic status, poor nutrition, and prolonged oral contraceptive use. The main is often associated with human papillomavirus (HPV).
Although what causes cervical cancer in its entirety is unclear, HPV is the main cause of cervical cancer. HPV is a common virus that is passed from one person to another during sex. Most sexually active people will have HPV at some point in their lives, but few women will get cervical cancer.
What are the Symptoms?
Early on, cervical cancer may not cause signs and symptoms. However, if you notice any bleeding or discharge from the vagina that is not normal for you, such as bleeding after sex or painful sexual intercourse, it is advisable to see your doctor. The symptoms may be caused by something other than cancer, but the only way to know for sure is to see your doctor.
When and How do I get tested?
HPV testing can be started as early as 21 years old or within 3 years of the onset of sexual activity. You may choose to have a Pap test, or an HPV test, or both. However, if your tests are normal, you do not need to repeat both the tests for another 3 years.
Pap Smear / Pap Test
The Pap test is one of the most reliable and effective screening tests for Cervical cancer available. It involves using a small brush to gently remove cells from the cervix to be checked under a microscope for cell changes that may lead to cervical cancer. A Pap smear may also help find other conditions, such as infections or inflammation.
HPV Test
A HPV Test is done similarly to a Pap Smear, where a swab is used to collect cells from the cervix. The main difference being HPV Test checks for the presence of HPV Virus instead of cancerous changes in the cervical cells.
How do I prevent cervical cancer?
Due to the nature of cancer cells, which can be attributed to spontaneous changes in the cell, we cannot fully prevent cervical cancer. However, many methods are available to us for early detection and risk reduction. One of it being vaccination against HPV virus.
Vaccination against HPV virus strengthens the immune system by imitating an infection, so it can fight the disease quickly and effectively if the need for it arise. However, HPV vaccination can only provide protection against the most common types of HPV that cause cervical cancer. It does not protect against all types of HPV, hence the need for regular Pap Smear and HPV tests.
HPV is spread by skin-to-skin sexual contact; therefore, practicing safe sex and using effective barrier contraception may play a role in primary prevention. It is also important to note that HPV infection can occur in both male and female genital areas, even when protected by a latex condom. The effect of how a condom prevents HPV infection is not well understood, however the lower incidence of cervical cancer with condom use has been observed by health organisations. There are currently no approved tests for HPV in men, so vaccines can be used in men to achieve the same level of protection albeit awareness for HPV vaccination in men is weak.
Limiting the number of sexual partners, getting regular checks for and treating any underlying sexually transmitted diseases (STD), and giving up smoking has also been noted to reduce the risk of cervical cancer.
My doctor told me I have cervical cancer, what can I do?
When your doctor tells you that you have cervical cancer, it is best to get a referral to a gynecologic oncologist, who is trained to work out a suitable treatment plan that is best suited for you. While there are many natural supplements that are marketed to help with cancer such as antioxidants, it is important not to substitute any medications prescribed by the doctor with supplements.
Do not let shyness or economic status overcome the need to get tested or treated. If you require help, many local organisations such as the National Cancer Society Malaysia may be able to help. Reach out.
References:
- Duska, L. R.; Overview of approach to cervical cancer survivors. Up-to-Date. 2019
- Cervical Cancer. Inside Knowledge About Gynecological Cancer. 2019, 99-9123.
- BMJ Best Practice. Cervical Cancer. BMJ Publishing Group Ltd 2019. 4. Cervical Cancer. Mayo Clinic. [Online] 2019. Available from: https://www.mayoclinic.org/diseases-conditions/cervical-cancer/symptoms-causes/syc-20352501
- Cervical Cancer Screening. The American College of Obstetricians and Gynecologist. [Online] 2017. Available from:https://www.acog.org/-/media/For-Patients/faq085.pdf?dmc=1&ts=20200105T0939199187
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