Cervical cancer: Why early screening is the only sure card

The thought of cervical cancer and the first thing that will cross the minds of most people is death. Some women even vow not to go for screening because the thought of being diagnosed positive scares them to the bone. Dr Achille Manirakiza, a resident clinical oncologist at Mubimbili University in Tanzania, says that cervical cancer is still unfortunately the most common gynaecologic cancer in Eastern Africa, and is among the three most deadly cancers. Being one of the most common malignancies affecting women, especially in developing countries, several measures have been undertaken locally by the Ministry of Health to sensitise women about prevention of cervical cancer WHAT ARE THE CAUSES? “Cervical cancer is said to be due to infection by the human papilloma virus. Women become prone to it due to starting sexual activity at an early age. Having multiple sex partners and poor sex hygiene are also another risk factors,” says Rachna Pande, a medic at Ruhengeri Hospital. She also cites people with reduced immunity such as those living with HIV/AIDS as being at increased risk of contracting it. Pande, however, says it’s more rampant in women aged 50 years and above. Dr Manirakiza explains that the biggest concern regarding cervical cancer now is that it first causes an in-situ disease, or better known as indwelling condition, well-shelled and not presenting outside. Studies are revealing a range of 20-30 years between its development and its real first manifestation, thus the early stages being best dubbed as silent. “By the time it manifests outside, very little can be done in the country currently as it would mean use of radiation therapy, which we don’t have here. Little by little the cancer extends to the neighbouring structures, and carries on later on, as all other cancers to distant organs. “The best that we can do is to focus on its prevention. The country is doing great with vaccination of young girls at the end of primary school (aged 12-13), but a systematic way of having older women screened is yet to be found,” he says. Dr Manirakiza adds that, a yearly, three-year and three-year based screening should be done according to age and risks. These initiatives help gather information, but also stop the increasing incidences of cervical cancer significantly. ALARMING SIGNS Pande points out that sometimes it’s hard for one to notice the signs and symptoms of cervical cancer as they normally surface in their late stages. She advises that when one experiences any sign pointing to this infection they should immediately visit a hospital for a checkup. “A person with cervical cancer can have vaginal discharge, experience painful intercourse, painful urination, swollen inguinal lymph nodes in the groin. Besides, due to the spread of cancer to the backbone, one can experience chronic severe back pain. Patients can also have persistent weakness and unexplained weight loss,” she says. Joseph Muganda, a gynecologist in Kigali, says cervical cancer is a silent killer to many women as most go for treatment when it is in advanced stages. “The good news about cervical cancer though is that when diagnosed in its early stages, specialised surgery can be done to ensure total healing of the patient. The case is different when in advanced stages as surgery and chemotherapy is done only to provide relief not cure,” explains Muganda. He adds that apart from being expensive, chemotherapy comes with many side effects besides being very painful. PREVENTION Dr Francis Kazungu, a general practitioner in Kigali, says prevention is always better than cure.He urges everyone to make an effort to go and get tested for their own good. “Every woman above 40 years of age is advised to undergo screening for cervical cancer. This is particularly important for those having abnormal vaginal discharge at this age. One should also avoid multiple sexual partners as well as unprotected sex,” he advises. Kazungu says the government is providing vaccination for cervical cancer to all school-going girls who have attained puberty, adding that parents should encourage their daughters to be vaccinated and to go for early screening. According to Kazungu, anyone who is sexually active should commence testing for cervical cancer. “Women should start having Pap smear tests soon after they have started being sexually active. Also, screening is vital at least every after three years,” he says. Kazungu further explains that women aged 40 and above should go for both Pap smear test as well as HPV after every five years. He, however, says for a woman whose uterus or cervix has been removed, there is no need for them to be screened since cervical cancer originates from the cervix, noting that everyone should continue screening until the age of 70 and above. Dr Muganda also cautions that women should practice good hygiene, especially when it comes to their genital parts because it helps in preventing infections and reduces the risk of one developing cancer. editorial@newtimes.co.rw