By Nickky Faustine P. de Guzman, Reporter
Cervical cancer can happen to any woman who is sexually active, and women are becoming sexually active at a younger age. The good news is that it is easily preventable.
Cervical cancer is most often the consequence of an infection with the human papillomavirus (HPV). Cervical cancer happens when “abnormal cells in the cervix — the entrance between the vagina and uterus — grow big. It is caused by the persistent infection with HPV,” said Dr. Leah Manio, GlaxoSmithKline (GSK) Medical Affairs Manager, and a specialist in high-risk pregnancy. She was speaking at a press conference about a cervical cancer awareness campaign on May 23.
Cervical cancer is not hereditary. “Unlike breast cancer that is, in some cases, caused by genes, cervical cancer is caused by exposure, meaning, the transmission of the virus by penetration or skin-to-skin genital contact,” she said.
There are two kinds of HPV: low grade (this causes warts) and the high grade (this causes cancer). But then, it doesn’t necessarily mean that if a women gets HPV she’ll automatically get cancer, “It depends if her immune system is strong,” said Dr. Manio.
Unfortunately cervical cancer has no signs and symptoms in its early stages. At later stages there are symptoms including irregular bleeding between periods; abnormal bleeding after sex; pain in the back, legs, and pelvis; weight loss; vaginal discomfort or odorous discharge; and a single swollen leg.
Cervical cancer is no respecter of age. “You can still get cervical cancer at 55 years old and beyond,” said Dr. Manio. And sexually active Filipinas are getting younger: they often start having sex at 15 — this means infection with cervical cancer-causing HPV happens at an equally younger age. Studies say the incidence of HPV infection is highest at ages 15 to 19.
Engaging at sexual activity at a young age is one of the risk factors in getting cervical cancer. The other factors are: having multiple births; having a weak immune system; smoking; having or having had a sexually transmitted disease; and having rarely taken, or not yet had, a Pap smear test, a screening procedure for cervical cancer.
MISCONCEPTIONS
Many women are reluctant to have a Pap smear because they think it is painful.
Dr. Maria Julieta Germar of the Society of Gynecologic Oncologists of the Philippines said that only 9% of the 28 million Filipinas at risk of getting cervical cancer have had a Pap smear.
“It’s a small number,” she said, disappointed.
She attributes this to two major factors: there is no national program for Pap smear testing, and the misconceptions about the test. She said Pap smear does not hurt (“if the head of a baby can get through [the vagina], why not a smaller device?”) and besides, one can ask for a smaller sized speculum, a device used to widen the vagina, to be used during the test.
Some people believe that cervical cancer is a result of poor hygiene. It is not. Swimming in public pool or using a public toilet also do not cause cervical cancer said Dr. Germar.
While condom use may prevent pregnancy, it only “partially protects against HPV transmission,” she added.
Cervical cancer also isn’t necessarily synonymous with promiscuity because doctors said women can get the disease even if they have just one steady partner.
VACCINATION AND SCREENING
The doctors couldn’t overemphasized that prevention is better than cure. The best way to prevent cervical cancer is through screening and vaccination.
While the cost of HPV vaccination depends on the doctor or hospital, a shot is at least P2,500 — full coverage comes with three shots, the second taken a month after the first, and a third six months later. No booster is needed. Girls aged nine to 14 should get two shots before they become sexually active. Women over 21 are required to get three shots and should also have an annual Pap smear.
The risk of persistent infection with cancer-causing HPV increases with age, and is highest when a woman is over 66 years old. Thus, screening is recommended starting age 21 to detect cervical abnormalities that lead to cervical cancer. Vaccination, studies say, remains beneficial for older women to prevent HPV infections.
IT CAN HAPPEN TO ANYONE
One reason why women do not get Pap smears and don’t get vaccinated, said the doctors, is because they do not believe it can happen to them.
One of these women was Rose Manzano, the mother of celebrity Andi Manzano-Reyes.
Ms. Manzano said she exercises and eats right, “so the Big C came as a surprise. My world crashed.” She was diagnosed with stage one cervical cancer in 2013. She did chemotherapy every day for two and a half months. “It was draining,” she recalled.
Now that she’s cured, she urged all her four daughters to get vaccinated.
Also present on the press conference was Abbygale Arenas-de Leon, a member of the Brave Heart Coalition of the Philippines, which aims to have a cervical cancer-free Philippines. Ms. De Leon had her vaccinations in 2007, and, through word of mouth and her organization, helps in disseminating information on the importance of the treatment.
“We should remember three letters and three words: 2-80-7 and A,S,V,” she said.
• 2 — because cervical cancer is the second leading cause of death among women in the world.
• 80 — because 80% of the Filipinas are susceptible to getting cervical cancer
• 7 — because seven out of 10 women who get cervical cancer will die from it.
She encourages ASV: awareness, screening, and vaccination.
