Cervical Cancer: The Preventable Cancer
Cervical cancer is one of the most preventable cancers, yet remains the world’s second-leading cancer killer of women. Of the 490,000 cases diagnosed every year, more than 280,000 will die. As a survivor of cervical
cancer I would like to educate you on how to protect yourself from this cancer.
According to the National Cancer Institute infection of the cervix with human papillomavirus (HPV) is the most common cause of cervical cancer. HPV is a very common infection that can be spread from person to person through sexual contact. Past studies have shown that up to 75 percent of people will be infected at some point during their lifetime. In 2005, the Centers for Disease Control and Prevention (CDC) estimated that 20 million people in the United States had the virus. To date over 100 different types of HPV have been identified and some cause no known harm. Several types are known to infect the genital tract of both women and men and, like other sexually transmitted infections (STI”s); they are often present without signs or symptoms.
Unfortunately this means someone can pass the virus on to others and not know it. Risk factors for HPV infection include: previous genital cancer, HIV infection, multiple sex partners, or a weakened immune system. A few types of HPV cause genital warts which are easily treated and not linked with cancer.
Some types of HPV infection have been linked to invasive cancer of the cervix, vagina, vulva, and anus, with cervical cancer being the most prominent. HPV causes the cells on or around theses areas to become abnormal or precancerous. This process is called dysplasia. These precancerous changes may, but not always, progress to cancer. In fact, in many instances, the abnormal cells and HPV will go away without treatment over the course of months to years. The obvious concern is to catch the abnormal cells that won’t go away before they progress to a malignancy.
If the infection is not discovered and treated early then abnormal cells can develop in the lining of the cervix. The cervix is the part of the uterus that connects the upper part of the uterus (the womb) and the vagina. These abnormal cells can become precancerous and then possibly cancer. This process can take a number of years, but in rare cases it can happen within a year.
Precancerous changes and early cancers of the cervix generally do not cause pain or other symptoms. As the disease progresses, women may notice one or more of the following symptoms: abnormal bleeding, increased vaginal discharge, pelvic pain, and pain during sexual intercourse.
Currently, women get PAP tests on a regular basis to identify abnormal cells on the cervix. If a certain minimal level of abnormality is seen, their doctor may order an HPV test. This test checks for the high-risk types of HPV infection that have been linked to the development of cervical cancer, but not all types of HPV. If the PAP test shows more significant abnormalities a procedure called colposcopy, or biopsies, is performed. Treatment of the abnormal cells can usually be easily accomplished in the office or with an outpatient surgery.
If the cells are found to be cancer then there are several treatment options: Laser surgery using a laser beam to destroy the abnormal cells, Cryosurgery which destroys the cancerous and pre-cancerous cells by freezing them, the LEEP procedure which uses a then wire loop with an electrical current to cut away an area of abnormal cells from the cervix, Conization which surgically removes a cone-shaped piece of tissue from the cervix, radiation therapy using high energy beams to destroy cancer cells, and chemotherapy using medication to disrupt the growth of the cancer cells. Sometimes treatment will include a combination of these methods. The worst case scenario would be a Hysterectomy. There are two types of Hysterectomy’s: Simple is the removal of the cancer, cervix, and the uterus and Radical which involves the removal of the cervix, the uterus, part of the vagina and the lymph nodes in the area.
In the United States 10,000 women will develop cervical cancer this year, resulting in 3,000 deaths. Cervical cancer tends to occur in women in their 40s and 50s, when many are still raising children and contributing to their families’ livelihoods and security. Women in low income and minority communities are less likely to undergo recommended cervical cancer screening, which could account for the greater risk for cervical cancer among these groups. Maketheconnection.org notes that the highest incidence rates of cervical cancer are among African-American and Hispanic women. African-American women are twice as likely as Caucasian women to die from cervical cancer.
Although there is no cure for HPV, precautions can limit your exposure as you would with any other STI. In June 2006 the Food and Drug Administration approved a vaccine for HPV called Gardasil. Gardasil was developed to cause an immune response in the body to prevent HPV infection. It is important to note that this vaccine is only effective against four of the over 100 types of HPV infection. However these four types are responsible for up to 70% of cervical cancer, and up to 90% of genital warts. This vaccine will not treat HPV once a person has been infected and is meant to be used as a prevention for the disease. According to MERCK & CO., Inc the maker of the vaccine, it is administered as a series of three vaccinations over a six-month course. It is recommended for use in girls and women aged nine through 26 years of age. Currently it is not recommended in other age groups or males because they were not included in the original vaccine studies.
Hopefully the HPV vaccine is the key to prevention of all cervical cancer in the future. If you have any questions or concerns talk to your doctor for further information.
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Vollmer, Sabine, “Few pediatricians have first cancer vaccine: HPV – Cervical Cancer”, News & Observer, The, October 7, 2006.
“Cancer – Reducing Risk for Cervical Cancer”, www.cdc.gov/cancer/cervical/basic_info/reducing_risk.htm
“Cancer – Cervical Cancer Statistics”, www.cdc.gov.cancer/cervical/statistics/