What we need to know about cervical cancer

As per WHO cervical cancer is the second biggest cause of female cancer mortality worldwide with 288, 000 deaths yearly. About 510, 000 cases of cervical cancer are reported each year with nearly 80% in developing countries. Most of the deaths could be prevented, if more women had tests to find cervical cancer early. 

RISK FACTORS/ CAUSES

• HPV infection
• Multiple sexual partners
• Promiscuous partners
• Early sexual intercourse
• Early child bearing
• Multiple pregnancies
• Prior sexual transmitted diseases
• Cigarette smoking
• Immunodeficiency

PREVENTION

• Avoid being exposed to HPV: You can prevent most pre-cancers of the cervix by avoiding exposure to HPV. Certain types of sexual behaviour increase a woman's risk of getting HPV infection, such as: 
• Having sex at an early age 
• Having many sexual partners 
• Having a partner who has had many sex partners 
• Having sex with uncircumcised males 
• Get a regular Pap smear. 
• Quit smoking or avoid second hand smoke. Smoking cigarettes increases your risk of developing many cancers, including cervical cancer. Smoking combined with an HPV infection can actually accelerate cervical dysplasia (a precancerous condition). Your best bet is to kick the habit.
• If you are sexually active, use a condom. Having unprotected sex puts you at risk for HIV and other Sexually Transmitted Diseases (STD's) which can increase your risk factor for developing cervical cancer. 
• Follow up on abnormal Pap smears. If you have had an abnormal Pap smear, it is important to follow up with regular Pap smears or colposcopies. If you have been treated for cervical dysplasia, you still need to follow up with Pap smears or colposcopies. Dysplasia can return and when undetected, can turn into cervical cancer. 
• Get the HPV vaccine. If you are under 27, you may be eligible to receive the HPV vaccine, which prevents high risk strains of HPV in women. The vaccine is most effective when given to young women before they become sexually active. 

EARLY DETECTION

• Regular Pap smears (cytology)
• HPV testing - complements Pap smear
• Visual inspection techniques (VIA/VILI) by health workers is an option for villages and small townsCervical cancer screening i.e. annual pelvic examination and Pap smears will detect cervical cancer at a stage when there are no symptoms at all.

WARNING SIGNS

• Abnormal vaginal bleeding or discharge 
• Low back pain 
• Blood in your urine 
• Pelvic pain 
• Swelling in one leg 
• Unexplained weight loss or gain If any of these symptoms persist, see your gynaecologist / gynaeoncologist immediately.

WHAT SHOULD YOU DO TO INCREASE THE ACCURACY OF YOUR PAP TEST? 

There are things you can do to make your Pap test as accurate as possible

• Try not to schedule an appointment for a time during your menstrual period. 
• Do not douche for 48 hours prior to the test. 
• Do not have sexual intercourse for 48 hours before the test. 
• Do not use tampons, birth control foams, jellies, or other vaginal creams or vaginal medications for 48 hours before the test. 

TREATMENT

Depending on the type of cancer (diagnosis) and how far it has spread (staging) it is treated with surgery, radiotherapy, brachytherapy, chemotherapy and often various combinations of these.  It is therefore important that, if someone you know, develops a cancer, he / she should go to a comprehensive or dedicated cancer care super speciality hospital with NABH accreditation, where a correct diagnosis, staging and planned treatment can be carried out after tumour board evaluation.

ADVANTAGES OF TUMOUR BOARD EVALUATIONS

• A panel of cancer experts i.e. medical oncologists, radiation oncologists, surgical oncologists, gynae oncologists, paediatric oncologists, onco-pathologists, radiologists and imaging experts,  get together to review and plan suitable modality or modalities of treatment. 
• Treatment is need driven and not doctor driven. 
• Patients get the choice of surgery or radiotherapy, if the results are same by both modalities. 
• Patients are saved from unnecessary surgeries, if the surgeries cannot be performed. 
• Patients get complete treatment. This prevents recurrence due to incomplete treatment. 
• Chances of cure / improvement in quality of life are much higher because of right and optimum treatment.
• Patients are saved from medical shopping and get expert opinion under one roof by spending one consultation fee only.

HOW TO INCREASE CHANCES OF CURING CANCER CERVIX

• Getting pre-cancer and early cancer diagnose when there are no symptoms.
• Staging work up to find out the stage of the disease.
• Tumour board evaluation by a group of cancer experts including gynae oncologist to plan the standard treatment as per national / international protocols
• Treatment of cancer at dedicated cancer centres specially NABH accredited hospitals, where all modalities of diagnosis and treatment are available under one roof.
• Getting cancer surgeries done from gynae oncologist.
• Faith in self, god and the treating team
• Positive attitude and the will to fight cancer

ADVANTAGES OF GETTING TREATMENT AT NABH ACCREDITED CANCER HOSPITAL

• High end technology and infrastructure
• Highly trained team of oncologists
• Very high standards of treatment
• Patient safety and confidentiality
• High survival rates
• Environment and legal compliances
• Continuous surveillance of systems by Quality Council of India