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Cervical cancer: Women’s second worst enemy

CERVICAL cancer is one of the most common cancers afflicting women around the world with 500,000 new cases and 250,000 deaths each year, according to the Geneva-based World Health Organization (WHO).

In the Philippines cervical cancer kills 12 women each day. This must be the reason the country is joining the world in commemorating May as Cervical Cancer Awareness Month.  Recently, the Department of Health (DOH) launched “Babae, Mahalaga Ka” as its yearly campaign banner of the disease.

Health Undersecretary Teodoro Herbosa, who launched the campaign at the Jose Reyes Memorial Medical Center in Manila, pointed out that cervical cancer is curable if detected early.  It can be actually prevented by getting vaccinated for the human papillomavirus (HPV), the major cause of cervical cancer.

Among the programs to be observed during the campaign month include free cervical-cancer screening nationwide for the whole month of May in regional DOH hospitals and symposiums to educate medical practitioners and the public about the disease.

In Metro Manila DOH hospitals that offer free screening include Jose Reyes Memorial Medical Center, Dr. Jose Fabella Memorial Medical Hospital, East Avenue Medical Center, Tondo Medical Center, Quirino Memorial Medical Center, Amang Rodriguez Medical Center, Rizal Medical Center, Las Piñas General Hospital and Satellite Trauma Center, Valenzuela General Hospital, San Lorenzo Ruiz Memorial Hospital and Jose N. Rodriguez Memorial Hospital.

Cervical cancer, which also afflicts men, is women’s enemy No. 2.  “In the Philippines cervical cancer is second to breast cancer as the most common malignancy that afflicts and kills women with conservative estimates between 35,000 and 70,000 cases, with almost 7,000 new cases added every year,” reports Dr. Cecilia Ladines-Llave, former chairman of the University of the Philippines-Philippine General Hospital Cancer Institute.

Between breast cancer and cervical cancer, the latter is the deadliest.  As Rina Jimenez-David, a recognized advocate in reproductive health, puts it: “While breast cancer is the most common form of cancer for women in the country, it is not the most deadly.  The death toll from cervical cancer is higher than for breast cancer, and this is mainly because by the time its victims come for treatment, it is already too late.”

Cervical cancer results from the abnormal growth and division of cells at the opening of the uterus or womb—the area known as the cervix.  Usually, it takes about 10 years before cancer develops.

Unlike some cancers, cervical cancer presents early signs. “In the early stages, cervical cancer usually causes no symptoms.  It may cause spotting or heavier bleeding between periods, bleeding after intercourse, or unusually heavy periods.  In later stages, such abnormal bleeding is common,” says the second home edition of The Merck Manual of Medical Information.

Other symptoms may include a foul-smelling discharge from the vagina, pain in the lower abdomen, and swelling of the legs.  The urinary tract may be blocked, without treatment, kidney failure and death can result.

About 99.7 percent of cervical-cancer cases are caused by HPV, a sexually transmitted infection that is often without symptoms.  Dr. Philip Chua, a medical practitioner who writes a column for a national daily, explains: “HPV, which causes genital warts, invades both sexual partners’ system during sexual intercourse.  The virus lives in the body permanently, even after treatment, and can lie dormant for years, only to become active when the person’s immune system is low.”

As such, cervical cancer is regarded as a sexually transmitted disease.  As Dr. Chua points out: “The risk of developing cancer of the cervix is inversely related to the age at first sexual intercourse and directly related to the number of sexual partners over the lifetime of the woman.”

In other words, the younger a woman when she had sexual intercourse and the more sex partners she has had, the higher her risk of cervical cancer.  While women may contract HPV when they are young, cervical cancer is most likely to develop in women 35 years or older.

David assures: “While cervical cancer is sexually transmitted, it doesn’t necessarily mean that you’ve been sexually promiscuous [or a prostitute!] if you should develop cervical cancer. Even if you’ve been monogamous, your partner may not have been, and even just a single encounter with an infected partner could end up infecting him with HPV which he, in turn, could pass on to you. Remember, while HPV does not generally affect the health of a man, it can lead to cervical cancer in a woman.”

In fact, there are several other factors that may trigger cervical cancer among women.  These factors include early age at first birth, having many births, tobacco use, prolonged use of hormonal contraceptives, and an impaired immune system, particularly related to HIV infection.

If detected early, cervical cancer is curable.  “There is no reason for any woman to die of cervical cancer,” deplores Noe Tuason, a research scientist at the University of San Francisco Comprehensive Cancer Center.

In a statement, DOH Metro Manila head Eduardo Janairo said: “All women are at risk of having cervical cancer and most occurs during reproductive age and starts at the age of 30 onward. And the only way to prevent this from happening is to have a regular screening and proper HPV vaccination.”

He also advised “all reproductive-age women to undergo the routine screening to be able to prevent the disease from developing.” In addition, he urged women to “practice healthy lifestyle such as proper diet and nutrition, don’t smoke and be monogamous to avoid having the disease.”

According to the National Cancer Institute in the United States, treatment options for cervical cancer depend on the following: the stage of the cancer, the size of the tumor, the patient’s desire to have children and the patient’s age.

“Treatment of cervical cancer during pregnancy depends on the stage of the cancer and the stage of the pregnancy. For cervical cancer found early or for cancer found during the last trimester of pregnancy, treatment may be delayed until after the baby is born,” NCI advises.

Treatment for cervical cancer involves surgery and radiation therapy. Sometimes, chemotherapy or biological therapy is used.  Surgery removes abnormal tissue in or near the cervix. If the cancer is only on the surface of the cervix, the doctor may destroy the cancerous cells in ways similar to the methods used to treat pre-cancerous lesions.

Radiation therapy (also called radiotherapy) uses high-energy rays to damage cancer cells and stop them from growing. Chemotherapy is the use of drugs to kill cancer cells. It is most often used when cervical cancer has spread to other parts of the body. The doctor may use just one drug or a combination of drugs. Biological therapy is treatment using substances to improve the way the body’s immune system fights disease.

“Cervical cancer has a major impact on women, particularly women in developing countries,” says Jacqueline Sherris of Program for Appropriate Technology in Health, an international nongovernmental organization based in Seattle.

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