Early detection of cervical cancer is the key

Based on data collected through the Population Based Cancer Registries (PBCR), oncologists say that among women, breast cancer has overtaken cancer of the cervix. But the incidence of cervical cancer has not come down due to increased awareness and better treatment. Cervical cancer is off the radar because of the disturbing trend of women opting out of treatment. According to health professionals, “socio-economic factors, stigma, and inability to pay for the treatment are pushing women to compromise on their health.”

Dr Elizabeth Vallikad, professor and head, Gynaecologic Oncology, St John’s Medical College and Hospital, Bangalore, has spent over three decades treating, documenting and tracking the prevalence of cervical cancer. She says, “We need massive health education for medical professionals, too. About 35% of the phenomenon is because of medical negligence. Due to lack of proper training, doctors miss the symptoms.” Although doctors are medically trained, screening cervical cancer does not figure in their checklist.

Cervical cancer awareness is comparatively low. In an ideal situation, and according to international standards, women should take their first pap smear within one year of active sexual activity. In case a condition is detected, the patient can be sent immediately for treatment. If not detected, then the pap smear should be done once every three or five years. A pap smear helps detect premalignant lesions — in other words, the lesion can be monitored and treated accordingly becomes it cancerous.

Dr Vallikad says that doctors in Primary Health Centres (PHC) and Auxillary Nurse Mid-wives (ANM) should be equipped with the right knowledge. Accepting that there is a crunch in infrastructure that hampers the setup of proper labs, she says, “The simplest method of examination is visual inspection, which can help detect the cancer at stage one.” She explains how this would help: “Women often come to doctors only when they have reached stage three — when the disease has already spread from the cervix to the pelvic region. The advantage of visual inspection is, that cases can be identified in stage one, when it can be controlled better.”
So, prevention is the key. “Sticking to one sexual partner is the best bet,” says Dr Vallikad, “Or if that’s not possible, then women should ensure a barrier contraception like condom is used.” Quickly adding, “we don’t know if this helps, but it certainly is a precautionary measure.”

Focus on breast preservation
Doctors are unable to point out specifically why there is an increase in breast cancer cases. However, they do feel that dietary and lifestyle changes are mostly to blame. The good news is that more women are coming forward to talk openly about it, thus creating awareness. “Speaking out has helped tremendously as it lessens fear,” says Dr Ajaikumar, chairman and oncologist, HCG, Bangalore. Early detection ensures treatment, and with advances in technology, more women are able to preserve their affected breast. “The focus has shifted from treating the disease to maintaining a better quality of life,” points out Dr G Kilara, director, consultant radiation oncologist, MS Ramaiah Curie Centre of oncology, Bangalore.

The technological advances in breast cancer treatment are now focusing not only on treating the cancer, but also on breast preservation. He elaborates, saying, “Those who undergo chemotherapy often suffer side effects — nausea, vomiting and a fall in their white blood cell count. Today, we have drugs to deal with these.”

After complete treatment, the patient-survivor can be rehabilitated back into routine life. “Breast cancer treatment surgeries are minimalistic, so as to reduce trauma. Even for chemotherapy, patients don’t need to be poked multiple times. They can be fitted with ports — equipment that is inserted into the body so that blood can be drawn through it and drugs can be injected, instead of finding new access-veins at every session,” he says. Moreover, with increased focus on organ or function preservation, lesser mastectomies (removal of breast) are being performed.