It’s another January, and another opportunity to spread awareness and share critical information about cervical cancer, towards driving down its prevalence. This piece is geared towards emphasizing the significance of timely diagnoses and subsequent treatment of cervical cancer.
What is cervical cancer?
Cervical cancer is a type of cancer that occurs in the cells of the cervix (the entrance of the womb from the cervix). Almost all cervical cancer cases are caused by persistent infection of the cervix with the sexually transmitted human papilloma virus (HPV). The virus causes changes in cells of the cervix thereby rendering them neoplastic. These neoplastic cells have the tendency of spreading beyond the cervix itself to deeper tissues and other neighboring organs. Infection with the human papilloma virus is mostly not symptomatic initially, but it can as well manifest as genital warts in both males and females. Cervical cancer is the most common type of cancer among Gambian female population. It is estimated to be culpable for the deaths of about 260,000 women annually worldwide.
Although the Human papilloma virus infection is involved in more than 90% of cervical cancer cases, it is noteworthy that human papilloma virus infections are not uncommon and that not all those infections end up predisposing victims to cervical cancer. Out of the more than 100 strains of the human papilloma virus, only a few strains have been known to cause the disease, with the strains HPV18 and HPV16 causing greater chunk of the disease.
Importance of early diagnosis
It said the passing of time of waits for no man. Well, the same is true for an infection with the human papilloma virus. Whenever it establishes itself in any victim, it waits not for your response or consent.it may develop slowly over a lengthy period, but it will quietly and surely run its natural course if no intervention is done to remedy it. Early diagnosis is definitely of the essence in catching the disease on its track, timely, rather than waiting for it to run its natural course. With time, precancerous cervical cells turn cancerous and then begin ascension from stage one (the least severe form of the disease) to stages: 2, 3 and 4 (the severest stage of the disease, indicating that the disease is widespread in the body).
Time of presentation is an indispensable factor in determining the outcome of any treatment. The EFSTH which happens to be the capital of all hospitals in the country, is much acquainted with the late presentation of patients suffering from not just cervical cancer, but all other diseases that could have been easily treated, cured or even prevented. Only if they had been diagnosed timely.
This occurrence has been happening for far too long with no visible signs of it ending soon. Late presentation of any patient to any doctor, may deprive both the healthcare worker and the patient of the luxury of a less invasive and cheaper treatment, but rather, a more invasive treatment modality. In the worst case scenario, the patient can only be accorded palliative care due to the widespread nature of the disease.
Every hour that clocks, every second that ticks, marks an irretrievable tendency of the precancerous cervical cells turning into cancerous cervical cells.
To lower the risks of morbidity and mortality, the importance of timely screening and early diagnosis cannot be overemphasized.
When to visit hospital
The human body responds to adverse phenomenon by way of symptoms, which we complain of. Knowing when to complain or seek medical consult is halfway from being diagnosed. But the innate apathy to seek conventional medical consult amongst Gambians has not been helpful. The practice of prioritizing traditional healing methods over conventional medical treatment presents somewhat of a headache to doctors and nurses in our hospitals. This is not to say that traditional healing does not work or its bad, but it lacks the research and evidence based knowledge that the conventional treatment methods offer. Hospitals are the go-to place whenever you feel unwell.
The Initial symptoms may be too subtle to notice on your own but as the disease progresses, the symptoms become more obvious. Here are some symptoms that may be suggestive of cervical cancer in situ:
o Vaginal pain during or after intercourse
o Unexplained heavy vaginal bleeding, such as after intercourse, between periods, or after a pelvic exam.
o Any other unusual vaginal discharge
o Unexplained pelvic pain, back pain bone pain
o Unexplained weight loss and lack of appetite
o Leakage of urine or uncontrolled urination
o A persistent feeling of tiredness
These above mentioned symptoms alone are not conclusive for a cervical cancer diagnosis. They may also predict many other conditions other than cervical cancer. This makes a visit to the hospital imperative once the aforementioned symptoms are observed, to possibly rule out or otherwise confirm the diagnosis.
The following groups are people who are more likely to have the disease:
o Women with multiple sexual partners are at an increased risk of getting the disease
o Cigarette smokers
o People who take birth control pills for a long period of time
o Young girls who become sexually active at a very young age
o People who are immunocompromised
Hospitals offer an up-to standard screening and diagnostic test to diagnose cervical cancer. Neoplastic changes in cervical cells can be detected with a papanicolaou test (pap smear) and high risk HPV testing. With a pap smear, cells are collected from the surface of cervix, mounted on a microscope and analyzed by a technician. A positive smear test alone is not sufficient enough to make a diagnoses. A positive smear test warrants for the collection of cervical tissue in a procedure known as biopsy. The tissue sample is then sent to n a pathologist for analysis. Depending the level of spread of the cancerous cells, the cervical cancer is staged.
Prevention and trearment
As the saying goes: prevention is better than cure. Cervical cancer is preventable by removing the factors which predispose one to getting the disease. The behavioral predisposing factors can be remedied by lifestyle modification. The most efficient form of prevention is the use of HPV vaccine. The vaccine protects against between two and seven high risk strains of the human papilloma virus family.
The modality of the treatment depends on the extent of the severity of the disease. Surgery, chemotherapy and radiotherapy are the treatment options available for cervical cancer. If the cancer spreads to the womb, a surgical procedure known as hysterectomy, is done to surgically remove the womb. After such a procedure, the patient is unable to conceive again.
