i congratulate all women on the occasion of the International Women Month. Women are in many ways unique. Even certain ailments occur or are more prevalent in women. This may be due to our anatomy or the effects of the changing hormone levels in the life of a woman.
The cervix is the lowest part of the uterus (womb). It is the part within the vault of the vagina. Cancer occurs when the cells begin to grow abnormally; and may spread to other parts of the body (metastasis).
Cervical Cancer have been found to be slow growing such that when precancerous cells are detected in a woman in her 20s or 30s, it is not until she is in her 50s that she develops full blown cancer. This mean there is ample opportunity to manage the disease if detected early.
What are the predisposing factors to developing this disease?
Infection with the Human papilloma virus (HPV), tend to set persons up for having Ca cervix later in life. Other factors are,
- Early onset of sexual intercourse especially below the age of 16 years or within a year of starting menstruation.
- Having multiple sexual partners.
- Being in the low socio-economic level.
- The use of oral contraception as persons using this tend not to use barrier methods which would have prevented contact of body fluids.
- Cigarette smoking; the chemicals in cigarettes interact with the cells of the cervix, causing precancerous cells to become cancerous much earlier than it would ordinarily have happened. Smokers have a 2 to 5 times chance of developing Ca cervix than the rest of the general population.
What informs a person of the likelihood of having the disease?
Typically, it is asymptomatic. Symptoms develops in the late stages. It is marked by;
- Pains in the pelvis.
- Painful sexual intercourse.
- An abnormal watery vaginal discharge.
- Bleeding from the vagina after sexual intercourse.
- Bleeding from the vagina in a menopausal woman.
In cases where it has metastasized, it may include symptoms based on the spread to the affected organs, like kidney failure in the case of spread to the urinary tract or bowel obstruction in the case of the intestine.
Early detection is key to successful management and cure.
Papanicolaou test (Pap test) this is a smear that is made of the surface of the cervix and examined for abnormalities. The presence of abnormal cells is an indication for doing a tissue biopsy. A small tissue of the cervix is taken for pathological examination. Other tests are;
Colposcopy, a special microscope is used to view the cervix after staining it with acetic acid. This magnifies the cells about 8 to 15 times making it easy to identify anomalies. It can also be possible at the same time to apply treatment measure cold cautery. Very cold probes of liquid nitrogen is applied to abnormal cells to burn them off.
Where abnormal cells is found only on the surface tissue, it is classified as Squamous Intraepithelial Lesion (SIL). This could be low grade or high grade depending on the number precancerous cells identified.
Invasive cancer is when the lesion spreads deeper in the cervix and to other organs.
How can this be prevented?
We go back to avoiding the predisposing factors where possible. In addition, Vaccines are available to prevent Ca cervix and HPV in men. This vaccine is given to both males and females between the ages of 9 to 26 years.
Regular Pap smear for sexually active women. To be done every 3 years between the age of 21 to 30 years and every 5years for persons over 30 years.
Really the frequency of re-check is based on the findings in the current examination. Now, we probably understand the advantage of prevention.
However in the unfortunate event of Ca cervix, the treatment modalities depend on the stage of presentation. This varies for cryrotherapy that is the use of extreme heat or cold to burn off the surface of the lesion.
Chemotherapy, using drugs. Hysterectomy which is the removal of the wombfor people who have completed their family or are not planning to have children.
Radiotherapy.