Is your cervix healthy?

This is not a question asked on a regular basis.  Well, maybe it should be. According to CANSA Cervical cancer is the 2nd most common cancer among South African women, but the cancer women die of most in our country. Women in South Africa have a 1 in 42 lifetime risk of cervical cancer. Keeping your cervix healthy probably reserves a higher slot on your list of priorities.

For this reason, we have decided to feature this article right in the beginning of the year, in line with Cervical Health Awareness Month which is celebrated in the US during the month of January. This is a good time to get some screening done, while resolutions are still strong and before the year gets too busy.

Below are the answers to the most common questions asked about cervical cancer.

Where exactly is your cervix and how does cancer grow there?

Your cervix is the lower, narrow end of the uterus that forms a canal between the uterus and vagina. Cervical cancer starts on the surface cells of the cervix, and it develops slowly. In the initial phases abnormal pre-cancerous cells are called dysplasia. These cells can take years to develop into true cervical cancer. If it is diagnoses in the early phases, it can be treated easily and usually with 100% efficacy.

Because cervical cancer is so slow-growing and has no symptoms in its early phases, it is often only diagnosed once it has become advanced and has spread to organs like the bladder, intestines, lungs and liver.

Why does cervical cancer occur?

Almost all cervical cancers are caused by the human papilloma virus (HPV). This is a very common group of sexually transmitted viruses that most people who are sexually active will contract at some stage of their lives. There are many different types of HPV, and some of these can cause the cells in a woman’s cervix to become cancerous over time. Only in a few cases will cervical cancer not be caused by a human papilloma virus.

People who are HIV positive and those who smoke tobacco also have an increased risk of developing cervical cancer. This is due to the effect of these things on the immune system.

What are the symptoms of cervical cancer?

In the early phases cervical cancer will have no symptoms. As time passes the following are common symptoms of cervical cancer (note that most of these can be caused by something else as well, so see you doctor to help you find an accurate diagnoses):

• Abnormal vaginal bleeding between periods, after having intercourse or after menopause.
• A chronic vaginal discharge that does not go away. It may be pale, watery, pink or brown. It may have some blood in it and may have a bad smell.
• Periods that suddenly become longer and heavier.
• Pain during intercourse.
• Urinary frequency (the need to pass urine very often).

Once cervical cancer has advanced and spread there maybe be further symptoms:

• Pain in the back, pelvis and legs.
• Fatigue and loss of appetite.
• Weight loss.
• A single swollen leg
• Leaking urine or stools from the vagina

How is cervical cancer diagnosed?

There are two types of screening tests for cervical cancer.

• An HPV test that looks for the virus that causes the cell changes on the cervix.
• A Pap smear, that looks for precancerous and cancerous cells in the cervix.

The CDC makes the following recommendations for cervical cancer screening:

• Women should start getting Pap smears between the ages of 21 and 29 years. If all is well the tests can be repeated every three years.
• Between the ages of 30 and 65 years old your doctor can help you decide on your risk, and on whether you should do a Pap smear only or combine it with an HPV test. If all is well the test should be repeated every 3- years.
• After the age of 65, if there have been two normal test results in the last five years, you may be advised to stop screening.

You can book a Pap smear at our Parentwood Baby and Family Wellness Centre in Rietondale, or speak to your doctor or public clinic. You can also contact CANSA to enquire about community clinics and initiatives.

How is cervical cancer treated?

This will depend on the stage of the cancer, which is determined by looking at the size of the cancer and on whether it has spread to other organs.

Generally treatment will be a combination of surgery with chemotherapy and radiation therapy.

Can cervical cancer be prevented?

Because human papilloma virus infections are the most common cause of cervical cancer, preventing HPV will prevent cervical cancer as well. CANSA recommends doing this in a few ways:

• By delaying sexual debut
• Reducing the number of sexual partners
• By increased condom use.
• By getting an HPV vaccine, preferably before you become sexually active.
• Male circumcision reduces the incidence of both HIV and HPV infections in men, which will reduce their risk of spreading these to women.

You should also go for regular Pap smears and HPV screening. These are simple and affordable tests which can save you from the horrible journey of cervical cancer.