doctor talking to female patient
Cervical cancer. While those two words will frighten any woman, the good news is that remarkable strides in prevention and detection have been made in recent years.
“Cervical cancer is highly preventable, and hopefully women are getting screened,” said Stephanie Piver women’s health educator at NCH Healthcare System. If you think the screening is an inconvenience, consider that according to the American Congress of Obstetricians and Gynecologists (ACOG) the use of the Pap test has reduced deaths by more than 50 percent over the past 30 years.
We also know what causes cervical cancer. “The number one cause is the human papillomavirus, or HPV,” Piver said.
“HPV is a virus that is usually passed from one person to another during sex and probably half of all sexually active people will get it at some point in their lives,” Piver said. “There is a vaccine now to prevent that infection to begin with but most of the time it goes away by itself within two years and does not cause a problem,” she explained. However, “it does not go away if your body is unable to clear the virus or if you have any kind of immune problems that would make you susceptible. It can lie dormant in the body and after many years may cause cancer.”
The HPV vaccine is highly encouraged. Both the ACOG and the American Academy of Pediatrics recommend it for teenage girls, with the aim of preventing the infection from happening. The Centers for Disease Control and Prevention recommends that girls who are 11 or 12 years old get three doses of the HPV vaccine and the same with females ages 13 to 26 who were not vaccinated earlier. If you wait until your daughter is sexually active and she has gotten HPV, the vaccine will not help. “It is a touchy decision for parents because they do not want to sound like they are endorsing sexual activity but also want to make sure they prevent the possibility of cervical cancer,” Piver said.
The warning signs
While women with cervical cancer may be asymptomatic, there sometimes are warning signs: abnormal vaginal bleeding, spotting or discharge, bleeding after sex or signs of advanced cancer like pain, problems urinated or swollen legs. The best means of detection is the Pap test, to locate abnormal cells on the cervix. According to ACOG, sexually active women 21 through 29 and those younger than 21 who have been sexually active for at least three years need the Pap test.
Women between ages 30 and 64 who have had three or more normal annual pap tests are considered low-risk, and can be screened every two to three years. “If you are between age 65 and 70 you no longer have to have Pap smears done as long as the cytology was normal the last three times,” Piver said.
The Pap smear is part of the gynecological exam. “It is not painful; some people use a little brush, some use a little rubber spatula or little wooden scraper,” Piver said. The cell sample is put on a slide and sent off for analysis. “You should have a baseline regardless if you have had sex,” she noted. Usually results are rechecked if findings are questionable and then a plan is made.
“Depending on what is going on, they can do a procedure called a colposcopy or they can do a cone biopsy where they go in and look at a little piece of the cervix,” Piver said. The doctor and patient decide how to proceed together. “If there is a way to treat somebody who is still childbearing age without having to do extensive surgery, that is going to be the preference,” she said.
When you are proactive, you can fight cervical cancer and win. “It is not a fast-growing type of cancer so we can usually treat it in the earlier stages,” Piver said. Of course making healthy lifestyle choices does not hurt. Not smoking, limiting the number of sexual partners and using condoms during sex all help it decrease the likelihood of transmitting HPV.
Having an open relationship with your healthcare provider is also a big help. Cervical cancer should be taken seriously but should not scare you. According to ACOG, the cure rate for cervical cancer is more than 90% when discovered early.
Jamie Lober, author of Pink Power (www.getpinkpower.com), provides information on women’s and pediatric health topics. She can be reached at email@example.com.