A cancer diagnosis, no matter the type, can be sobering for any patient. Cervical cancer in particular can be frightening for women with fears that the diagnosis eliminates their chance to have children, or worse. As a gynecological oncologist, helping women understand the importance of preventative care can mitigate many of the threats associated with cervical cancer.
With the breadth of treatment options available today, women who have received a cervical cancer diagnosis are better equipped than ever to overcome the disease and live a normal, healthy life. That said, there is still no guaranteed cure for the disease so women must remain vigilant about testing for precancerous abnormalities. In fact, up to one in five women has an abnormal Pap smear every year. Furthermore, thousands of women in the U.S. die yearly from cervical cancer, which is especially tragic given the vaccines and screening tests available to prevent almost every case.
The first preventative measure to consider is a vaccine for human papillomavirus (HPV), a cancer-causing virus (e.g., genital warts and oral cancers) and source of almost all cases of cervical cancer, according to the Centers for Disease Control and Prevention. HPV can be transmitted from one person to another through intercourse or by skin-to-skin contact with an infected area of the body. However, the vaccine is usually recommended for young men and women before they become sexually active. Additionally, men and women who are sexually active already may have been exposed to the virus but may still benefit from the vaccine.
Beyond a vaccine, another preventative measure is a simple Pap smear, a screening test that detects abnormal cervical cells consistent with a precancerous condition. Many physicians use the Pap smear along with HPV testing, a practice commonly referred to as combination testing. By analyzing the structure and function of precancerous cells, combination testing can better identify patients at risk before cancer progresses.
Encouraging family and friends to schedule a routine Pap smear, which should be a central component of any routine health assessment, is paramount. Pap smears and HPV tests for women between 21 and 65 should be scheduled once every one to three years. If you are ever faced with a diagnosis, discuss the risks of cervical cancer with gynecologic oncologists who can explain the array of the treatment options available.
For example, a cone biopsy, also used to diagnose cervical cancer, may be the only treatment needed for women with early stage cancer who want to have children. Also, women have been able to carry to term and deliver healthy babies by cesarean section after a trachlectomy. This type of treatment allows for the entire cancerous cervix and the upper part of the vagina to be removed while the uterine fundus is retained. Normal intercourse, conception and pregnancy remain possible after a trachelectomy. Depending on the unique needs of the patient, treatment can be customized with consideration given to the patient's values and a variety of other factors.
Another method that allows for a less invasive surgery is neoadjuvant chemotherapy. Designed to downstage an advanced cancer before the patient begins her primary treatment, this approach is just one example of an alternative to radical surgery and radiation therapy. Similarly, combining surgery after radiation and chemotherapy can reduce the amount of radiation needed. Multiple treatment methods can also be combined in different proportions to minimize toxicity from any one treatment.
Outside of regular testing, women should eat a healthy diet rich in fruits and vegetables, drink green tea, avoid smoking and exercise regularly. Doing so will boost immune health and help prevent the HPV virus from becoming a chronic infection and potentially cancerous.
It is a testament to the strength of modern cancer screening that cervical cancer deaths over the last 50 years have decreased by close to 70 percent. While this statistic is no doubt encouraging, it means little today without proper screening and early detection. Understanding the options available and taking action is essential to avoiding a preventable and potentially fatal disease.
Giuseppe Del Priore, MD, MPH is national director of gynecologic oncology & Southeastern Regional director at Cancer Treatment Centers of America at Southeastern Regional Medical Center in Newnan, Ga.