I am Dr. Jayanti Kamat, director of Srishti Fertility Care Centre and Women's Clinic I am an IVF Consultant, an obstetrician and gynecologist practicing for the last 20 years.
So today I will be talking about Cancer of the cervix, Cancer cervix is the commonest cancer found in Indian women after breast cancer. Every year according to WHO studies 1, 24,000 cases have been detected and annually there are 64,000 deaths, so cancer cervix is a very deadly disease. So what is this cancer cervix, the cervix is the mouth of the uterus? Now, what are the causes of Cancer cervix there are many causes of Cancer cervix but the commonest cause is a virus called as HPV or Human Papilloma Virus, now this virus is responsible for 70% of cases of Cancer cervix. HPV is a very common virus it is usually contracted during sexual intercourse so what does this HPV virus do, it enters into a normal cell and it changes the mechanism and the machinery inside the cell and once it changes the mechanism in machinery of the cell, the cell start behaving little differently and then these abnormal cells they multiply and once they multiply they form a tumor called as cancer cervix. Now, what are the other causes of Cancer cervix that is an early age of marriage then repeated pregnancies the more the number of pregnancies more is the incidence of Cancer cervix, then sexually transmitted diseases, smoking also increases the incidence of cancer cervix? Now this HPV virus it is not that every woman who is infected with HPV virus will develop cancer cervix it all depends on the dose of the virus which infects the cells and the immunity of the person as well. In some women the HPV infection becomes a self-limiting disease in the sense, it gets cured by itself. And in some women say after the period of 5, 10 or 15 years it can cause dysplasia or changes in the cells which later on formed cancer cervix. Fortunately, friends, cancer cervix is one of the few cancer which can be detected at an early stage very easily and how can we do it, there is the simple test called for Pap Smear and also we do have vaccines as of today or HPV vaccines which helps to prevent this HPV infected cells to get converted into cancer. HPV vaccine, now this HPV vaccine is one of the few vaccines which have been invented for the prevention cancer, so we are lucky to have such a vaccine. So this vaccine it has to be given to all girls between the ages of 9 and 26 days before they become sexually active. So this vaccine will prevent the HPV cells from HPV infected cells from developing into cancer there are three roses of this vaccine which have to be completed within 6 months. Now what is this Pap test is a very simple test it can be done on a small clinic or in a big hospital it can be done anywhere, it is an OPD procedure the patient does not have to go for fasting nor it is painful, nor does it required anaesthesia. So when should this Pap test is ideally done, Pap test should be ideally done after menses preferably between the 5th and 10th day of menses and what should you expect during the Pap test procedure the gynaecologist will examine you and take a few cells from your cervix with the help of a spatula and then send those cell to the pathologist for examination. So by examination these cells the pathologist will know whether the cells are normal or abnormal. So what are the advantages of Pap smear so when the gynaecologist examine you she or he will also find out whether your cervix is normal or whether the cervix has Erosion. So this erosion can also cause white discharge so what is that erosion the cells from inside the cervix they just come out so the treatment for this erosion can be done by cautery or just burning the tissue. The gynaecologist will also see that if you have some cervical polyp that also will be visible during the Pap test procedure. So if the polyp is there the polyp can be removed at the same sitting. Now, what is the Pap test come abnormal, the next step will be colposcopy. What is colposcopy? Colposcopy is when the cervix is visualized with an instrument called as colposcope which magnifies, which gives a very magnify review of the cervix. So what does the doctor see through the colposcope, the doctor will see whether the cells are normal or abnormal, there are different criteria blood vessels, the pattern of blood vessels etc and by observing all these things the doctors will be able to make out whether there is some suspicious area which is indicative of malignancy. So from such a suspicious area the biopsy is taken and the biopsy is again sent to the pathologist, so ensure the biopsy will be the test in which we can find out whether the lady has cancer or not. So now what are the symptoms of cancer cervix, so cancer cervix in its early stage has no symptoms at all and that is why we do Pap smear? Pap smear my dear friends is a screening method and not a diagnostic method, what is the screening method that we try to find out the early stages of the disease even before the patient has symptoms and why do we do that because if this cancer is detected in early stage the treatment is very simple and if it is detected in the later stage, the treatment can get complicated and goes much agony and pain to the patient. Now cancer in the little later stage will give rise to symptoms such as white discharge, blood stained discharge, discomfort, pain during sex, bleeding immediately after sexual intercourse and even with the small gynaec examination also the patient may start bleeding, patient may have swelling of feet, sudden loss of weight or pain during urination so all these can be the symptoms of cancer cervix. So whenever lady has these symptoms she has to go and consult her gynecologist. Now what if the biopsy report comes as positive for malignancy there are various methods in which cancer cervix is treated, one is surgery where we remove the cancerous part. The next is radiotherapy, radiotherapy can be two types of radiotherapy, one is external radiotherapy whereas the radioactive source is kept outside the body of the uterus and there is another method called as the intracavitary radiotherapy whereas the radioactive source is kept inside the body of the lady. Then we have chemotherapy as well or sometimes the patient may require a combination of various therapies. So, friends, it is my earnest request to you please get a Pap test done today itself and Pap smear has to be done once in every 3 years for all women under the age of 40 and after 40 it has to be done every year, the Pap test has to be done every year after the age of 40 combined with the HPV testing as well. So we can reduce the incidence of Cancer cervix by being very vigilant, by following safe practices, by avoiding things like smoking and of course getting a Pap smear and an HPV testing done just as we have eradicated polio from India, I strongly believe that if all of us are vigilant we can surely reduce the incidence of cancer cervix in India today, thank you.
If you have any queries about Cancer Cervix, please contact me on Lybrate.