Cervical cancer is an easily preventable disease. Cervical cancer is the only cancer which is caused by an infective agent – Human Papilloma Virus. There is almost a 100% association of cancer causing HPV with cervical cancer, which means that cervical cancer will not be caused in the absence of HPV infection. Of the various types of HPV, types 16, 18, 31, 33 and 45 commonly cause cervical cancer. This infection is acquired sexually but may not require the actual act of coitus to contract this infection – as it can be transmitted by hand to genital touch as well. Therefore, condoms are known to reduce but not eliminate the risk of cervical cancer.
HPV infection is very common and about 1 in 5 women will have HPV. However, most women manage to get rid of the HPV on their own. It is in those that HPV persists, changes in the cervical cells take place and may slowly over a period of 15 – 20 years convert into cancer.
HPV infection does not produce any symptoms. However, the development of cervical cancer follows a predictable pattern by passing through precancer -stage I, II, and III. This is also known as CINI, CIN II, CIN III (Cervical intraepithelial neoplasia).
There are at present 2 vaccines available in India – Gardasil and Cervarix. These are licensed for use in India from age of 9 to 45. The vaccines are best given around the age of 12 – 14. In countries like Australia where there is a high vaccination rate (licensed for use in males as well) there is a significant reduction in patients presenting with genital warts in the post vaccination era.
Vaccines are scheduled at 0, 1 and 6 months (Cervarix) and 0, 2, and 6 (gardasil). Protection is achieved at 7th month. If a woman becomes pregnant during vaccination, there is no need to abort the fetus and the vaccination can be completed after the pregnancy without restarting the schedule again. Mother can continue to breastfeed their babies even after vaccination.
Women, who are sexually active and has had vaccination should also have a PAP test, as the strains used in the vaccine are against Type 16 and 18 and prevents 70% of cervical cancers. Therefore PAP screening is necessary even in someone who has been vaccinated.
Sexually active women should undergo a PAP test to detect abnormal cells on the cervix. A small sample of cervical secretion is obtained from the cervix and carefully evaluated. A negative PAP test means that the test can be repeated in 3 years. It is painless and takes a few minutes. Sometimes a similar test is done to detect HPV DNA, and like the PAP test, if positive, requires further evaluation by a telescope called a Colposcope.
These tests help identify presence of precancerous lesions on the cervix – which when found can be treated immediately under Local Anaesthetic, without hospital stay. All these tests are simple and the treatment is very effective. The abnormal cells can be removed without sacrificing the uterus. A negative HPV DNA may be repeated after 5 to 7 years.
Women can reduce the risk of developing ovarian cancer in many ways; however, there is no prevention method for the disease. All women are at risk because ovarian cancer does not strike only one ethnic or age group. A healthcare professional can help a woman identify ways to reduce her risk as well as decide if consultation with a genetic counselor is appropriate.
The use of oral contraceptives decreases the risk of developing ovarian cancer, especially when used for several years. Women who use oral contraceptives for five or more years have about a 50 percent lower risk of developing ovarian cancer than women who have never used oral contraceptives.
Ovarian cancer has symptoms which are non – specific. The symptoms are
See your doctor, if you have these symptoms often during the course of one month and the symptoms are new or unusual for you.
Since there is no diagnostic tool for ovarian cancer, symptom awareness remains of key importance. Being cognizant of symptoms can help women get diagnosed sooner.