Forewarned is forearmed, so goes a popular saying. So, girls, you better watch out. Teenagers who had their first encounter with sex at an early age are most likely to be afflicted with cervical cancer.
This was bared by Dr. Geoffrey Que in a recent forum in Davao City. “There is a direct correlation between early sexual debut and cervical cancer since their cervix is not yet developed and that is where the virus will progress,” said Que, spokesman of the Philippine Obstetrical and Gynecological Society.
The cervix, the lowest portion of the female sex organ, juts into the vagina where it can be felt, seen and examined by the gynecologist. Its lips surround an aperture that opens into a canal leading into the interior of the uterus. That’s the route the sperm follows for its rendezvous with the egg. During pregnancy, the cervical lips become progressively softer so that they can dilate sufficiently when it is time for the baby to exit the womb.
“The cervix sees lots of action in the lifetime of most women, from the trauma of innumerable penile thrusts to a variety of infections,” noted Dr. Isadore Rosenfeld, the author of The Best Treatment. “No small wonder, it is often the seat of cancer.”
The cervices of teenagers are not yet fully developed and once broken, the human papillomavirus (HPV) may hide somewhere. “You never know what cancer-causing agents a lover may bring to your cervix,” Rosenfeld said. “It is especially important to be prudent in your pre- or early teens because that’s when the cervix is probably ‘set up’ or primed for cancer developing later in life.”
HPV is the most common sexually transmitted infection worldwide. So common that Alex Ferenczy, Canadian professor of pathology and obstetrics and gynecology at McGill University, calls it the “genital flu.” This simply means that if you don’t practice safe sex, or have had more than one sexual partner, you’re definitely at risk. “HPV affects an estimated 50 percent to 80 percent of sexually active women at least once in their lifetimes,” the Population Reference Bureau (PRB) report noted.
More than 70 types of HPV have been identified, but only 23 of these infect the cervix. In the Philippines, the most common types of HPV are the types 16 and 18, both of which caused 70 percent of cervical cancer. The two types also cause 40 percent to 50 percent of vulvar cancers and 70 percent of vaginal cancers, said Dr. Rey de los Reyes, a noted Filipino gynecologic oncologist.
While HPV is so common, not too many women know about cervical cancer that it causes. “Each woman has to be well informed about this disease,” urged Dr. Mildred Yutuc, a practicing obstetric-gynecologist. “In this way, she will be aware of its presence before it is too late.”
“While all women with cervical cancer have had HPV, less than 5 percent of women with HPV ultimately develop cervical cancer,” said Preventing Cervical Cancer Worldwide, published by the PRB and Alliance for Cervical Cancer.
Several factors may influence whether a woman with pre-cancer is likely to develop cervical cancer. Aside from early sex, other factors may also include an impaired immune system, particularly related to HIV (human immunodeficiency virus) infection; and hormonal factors, including early age at first birth, use of hormonal contraceptives and having many births.
Although nobody really understands why, more women who smoke cigarettes have greater chances of acquiring cervical cancer than do nonsmokers. “Their cervical mucus, and that of passive smokers, too, contains a large amount of nicotine,” Rosenfeld explained. “So, if you’re worried about getting cancer of the cervix – not to mention cancer of the lung, bladder, mouth or pharynx, or a heart attack—stop smoking, right now, and never start if you haven’t already done so.”
Cervical cancer may be deadly but it can be treated if discovered early. But despite this, it remains to be 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. It is considered as 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 added cases every year,” reported 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 more deadlier. Rina Jimenez-David, a recognized advocate of reproductive health, puts it this way: “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.”
Like most cancers, cervical cancer does not produce any symptoms, although it presents some 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,” the Merck Manual of Medical Information said.
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 and, without treatment, kidney failure and death can result.
An ounce of prevention is better than a pound of cure, so goes another adage. Unlike other cancers, the progression of cervical cancer is really slow and has a huge interval (which takes five to 10 years, or even 15 to 20 years).
In industrialized countries, screening has saved a lot of lives of women—but not yet in the Philippines. “Most Filipinas are hesitant to undergo screening,” pointed out Dr. Eric Tayag of the Department of Health. “They are either shy or they don’t want to find out that they may be carrying the disease.”
According to the National Cancer Institute (NCI) 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 advised. 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.
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