It is the world’s number three cancer that affects women. About 14,000 women in America are diagnosed with cervical cancer every year out of which around 3,900 succumb to their illness.
Cervical cancers usually begin in the cells lining the cervix. These cells first undergo precancerous changes before turning into cancerous cells. These precancerous changes, which include cervical intraepithelial neoplasia (CIN), squamous intraepithelial lesion (SIL), and dysplasia, can be detected by a Pap smear test. The patient can undergo treatment at a precancerous stage itself thereby prevent cervical cancer from developing.
Unlike other cancers, cervical cancer is caused by a highly contagious virus called as Human Papilloma Virus (HPV). It is the world’s number three cancer that affects women. About 14,000 women in America are diagnosed with cervical cancer every year out of which around 3,900 succumb to their illness. World over, this figure rises to around 273,500 deaths annually.
There are many myths about cervical cancer, especially pertaining to the HPV and the Pap smears. Some of them are:
1. There is no way to prevent cervical cancerAn infection with HPV is a prerequisite for cervical cancer to develop. It usually develops slowly after the infection and first appears as a precancerous dysplasia. Gardasil, the vaccine against HPV, when given to girls as young as 9 years old, can provide protection against the high risk strains of HPV. Regular screening for dysplasia with Pap smears and HPV tests can detect the precancerous stage and taking treatment at this stage can prevent cervical cancer. Avoiding known risk factors for the disease like multiple sexual partners and smoking can also help in preventing the disease.
2. There are no warning signals for cervical cancerSeveral symptoms like bleeding during sexual intercourse, between the menstrual cycle and after menopause must ring the bells for a possibility of development of cervical cancer. The patient may also experience pain in the lower abdomen or abnormal discharge from the cervix.
3. Pap test is not essential for women who have received HPV vaccineA Pap test should begin at the age of 21, or three years after the first sexual intercourse. Frequency of testing depends on the age of the patient, her sexual life and the result of the previous test. The HPV vaccine is effective against four strains of HPV but does not provide protection against all types of HPV that can lead to cancer. Therefore it is important to go for regular screening to detect any precancerous changes.
4. Pap test is not required after 60 years of ageThough the average age of patients is 48 years, there has been an increase in the incidence of cervical cancer in older women. So it is better to continue with the Pap tests even after menopause, hysterectomy or 65 years of age unless your doctor advises otherwise.
5. A Pap test is same as a pelvic examinationDuring a pelvic examination, the doctor physically assesses the different parts in the pelvis to rule out any abnormal growth. A Pap smear is taken to collect the cells from the cervix for the purpose of examination. Both the tests are important to detect early stages of cervical cancer.
6. Women infected with HPV will develop cervical cancerAlmost 80% of the women are exposed to HPV sometime in their life but in majority of cases, the infection dies on its own within two years. There are many strains of HPV and only a few are linked with cervical cancer. The high risk HPV infection lasts longer and can lead to dysplastic changes. An HPV test can determine the presence of HPV infection in a woman and whether the strain involved is of the high risk type.
7. Condoms offer protection against HPVCondoms may protect against HPV infection in 70% of cases. But one must remember that besides sexual intercourse, HPV can also be transmitted orally or by any other form of contact as it is highly contagious, so condoms provide only limited protection. However, their role in offering some protection against HPV cannot be negated. They play a role even in patients who have received vaccination against HPV. The HPV vaccine is effective against four strains of HPV. Condoms protect against the other types of HPV as well as different types of sexually transmitted diseases.
8. Cervical cancer can only be treated by undergoing hysterectomyHysterectomy, whereby the uterus and cervix are surgically removed is often done for treating early stage cervical cancer. However, in certain women of reproductive age group, a cone biopsy is done in order to preserve the uterus. In this procedure, only the infected tissue is removed along with a rim of healthy tissue. In another procedure called as radical trachelectomy, just the cervix is removed leaving behind the uterus. These procedures allow the woman to conceive a child after the treatment for cervical cancer is over without compromising on her chances of survival. Radiation therapy and chemotherapy are also available for women who do not want to undergo hysterectomy or in such women where the disease is at an advanced stage making hysterectomy infeasible.
9. Treatments like hysterectomy done for cervical cancer may lead to menopauseThe patients undergoing hysterectomy for treating early stage cervical cancer, who are in their reproductive phase, often undergo a procedure whereby the ovaries are spared. It is only the uterus which is removed along with the cervix. This is done keeping in mind that cervical cancer seldom spreads to the ovaries. In such a scenario, the menstrual cycle of the patient is not disturbed. It is only in the patients who undergo pan-hysterectomy, where bilateral ovaries are also removed, or in patients who receive radiation or chemotherapy as part of their treatment, that menopause results.
10. Hormonal replacement therapy may lead to development of cervical cancerUnlike breast and ovarian cancers, hormonal therapy plays no role in the treatment of cervical cancer. These cancers are unresponsive to hormones. Hence, low dose hormonal replacement therapy used for treating symptoms related to menopause, does not play any role in the development of cervical cancer.
There is almost 92% survival rate in patients where cervical cancer is detected and treated at an early stage. After a follow up period of five years, chances of recurrence are extremely low. But if left undiagnosed or undetected, cervical cancer is a giant killer. Therefore, it is imperative for all women not to fall prey to the malicious rumors about the disease, get their facts right and follow proper screening and treatment guidelines to beat the cervical cancer at an early stage of the disease.