Cervical cancer is entirely preventable, yet millions die due to lack of awareness
By:?Rajiv Tewari ,?based on inputs from Dr. Shafiq Ahmed & Dr. Indu Bansal Aggarwal. Detailed introductions are shared towards the end of the article.
Cervical cancer affects millions of young women aged 15 years & above?
Cervical cancer is the 4th most commonly diagnosed cancer in women worldwide and 2nd most common cancer in Indian women. Globally, around 13.1/100,000 women are diagnosed with cervical cancer on a yearly basis. Though it is a preventable, easily detectable and treatable disease, yet millions of women in the age group of 15 years and above die due to lack of awareness. Unfortunately one life is lost every 2 minutes to this disease. But thankfully, with a comprehensive approach to educate, prevent, screen and treat, cervical cancer can be easily eliminated.
What is cervical cancer?
Cervical cancer occurs in the cervix (the entrance to the uterus through vagina). In 95% cases, it is caused by the human papillomavirus (HPV), a sexually transmitted disease. The human body’s immune systems tries to prevent the virus from harming the body but in many cases the virus survives and over the years causes cervical cells to become cancer cells. It begins as a mild dysplasia and can take over 10 years to develop into cervical cancer. This long gap makes the disease highly preventable through regular screening and HPV vaccination.
Symptoms of cervical cancer
Cervical cancer like many other types of cancer is a silent disease and may not produce any sign or symptom for a long time. Many times women shy away or are reluctant to disclose the symptoms which leads to delay in treatment. This is why early diagnosis and prevention are critical in all cases of cancer. In cases of advanced stages of cervical cancer, symptoms may manifest in the form of vaginal bleeding, watery discharge, foul smell, pelvic pain & pain or spotting during intercourse.
If the cancer spreads to other organs than the symptoms can be acute and the treatment can become very challenging. These symptoms include:
-?????????Difficulty in passing urine accompanied by pain & sometimes blood in the urine.
-?????????Loose motions, pain or bleeding from your rectum while passing stool.
-?????????Loss of weight, general feeling of weakness and illness.
-?????????Backache or swelling in the legs.
-?????????Pelvic or abdominal pain.
One should immediately consult a Gynecologist if any of the above symptoms manifest in the body however all these can easily be avoided through preventive steps during regular health checkups.
Causes & prevention?
One of the well-known factors is the human papillomavirus (HPV). However HPV is very commonly found in the human body and in several cases the virus may never develop into cancer. HPV is transmitted through sexual intercourse.Two human papillomavirus (HPV) types (16 and 18) are responsible for nearly 50% of high grade cervical pre-cancers. Other factors are related to lifestyle which includes the following risk factors:
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-??Early marriage or very young age at starting sexual intimacy.
-?Many sexual partners increase the chances of acquiring HPV. Other sexually transmitted infections too increase the risk of HPV.?Safe sex & avoiding multiple sex partners can prevent the chances of acquiring HPV to a great extent.
-??A weak immune system is prone to all kinds of diseases including cancer so maintaining a good fitness regime and eating right are necessary to keep the body’s immune system strong. Transplant recipients too are at increasing risk of cervical cancer due to lower immunity.
-??Patients with HIV are six times more likely to develop cervical cancer.
-?Smoking is a well-established and known cause of not only cervical but many other types of cancers. Stop it as early as possible. Take your doctor’s help in finding out the ways of getting rid of this habit.
-??In certain cases drugs may also cause cervical cancer so self-medication can be dangerous in many cases. It is important to take medicines only when these are prescribed by a reputed doctor.
-?Vaccination to prevent HPV infection can reduce your risk of cervical cancer & many other HPV-related cancers. HPV vaccines work best if administered prior to exposure to HPV. Therefore, to prevent cervical cancer WHO recommends vaccinating girls aged 9 to 14 years, when most have not started sexual activity. However, it is important to consult a good doctor to check out whether HPV Vaccine is appropriate for you or not? HPV vaccination does not replace cervical cancer screening so it’s important to continue cervical cancer screening as well in-spite of vaccination.
-??Routine Pap test screening is a very simple, easily available and non-invasive, out-patient test which can easily detect pre-cancerous cells of the cervix which helps in monitoring and taking preventive action. Pap tests should be carried out every year for consecutive 3 years after attaining the age of 25 years. If these are normal then Pap test can be conducted every 3 years or HPV/Pap co testing every 5 years till 65 years of age. Females who have undergone hysterectomy but have intact cervix should also get Pap smear done too.
India has developed its first HPV Vaccine in the price range of Rs. 200 to Rs. 400
The launch of an indigenous HPV Vaccine by the name of?CERVAVAC,?at an affordable price is a major step towards saving millions of lives. Over 90% cases of cervical cancer cases are attributed to HPV therefore such a cost effective vaccine can certainly go a long way in saving lives not only in India but also in several other parts of the world where India exports its medicines.
Earlier the foreign manufactured cancer vaccines were in the price range of Rs. 2000 to Rs 3500 creating a huge budgetary challenge for reducing the instances of cervical cancer. CERAVAC protects women from the risk of infection from four types of HPV (6, 11, 16, 18). It also lowers the risk of genital warts and a few other types of cancers. The vaccine will be given in a two-dose schedule for girls in the age group of 9 to 14 years and a three-dose schedule for girls and women in the age group of 15 to 26 years. Due to the cost benefit of this vaccine, it will be possible for the Government of India to include it in the National Immunization Program so that even the poorest of the poor can benefit and in the process lift the weel being of the country as a whole.?
Dr. Shafiq Ahmed is Director and Senior Consultant, Urology & Renal Transplant at the Narayana Super-speciality Hospital, Gurugram though he visits all the centers of the group hospitals across North India. He is an US credentialed robotic uro-oncologist and specializes in robotic radical prostatectomy, robotic radical cystectomy and robotic partial nephrectomy for treatment of patients suffering from prostate, urinary bladder and kidney cancers in addition to general urologic problems in men and women. An MBBS, MS (Surgery), DNB (Urology), MNAMS with 15 publications, including 3 book chapters, to his credit in leading medical journals and with work experience at some of the most respected hospitals in India.?
Dr. Indu Bansal Aggarwal is Director and Senior Consultant, Department of Radiation Oncology, Narayana Superspecialty Hospital, Gurgaon. She has done her Postgraduation in Radiation Oncology from PGIMS Rohtak. She is a specialist in sophisticated techniques of radiation such as 3 DCRT, IMRT, IGRT, VMAT, DIBH and electron treatments. She has published several articles in national and international peer reviewed journals, newspapers and has authored more than 10 books' chapters.??