Cervical Cancer is the most common cancer found in Thai women and women in developing country. Those in lower social groups are more at risk. Luckily about 80% of cervical cancer can be prevented, provided an annual pelvic examination is taken to check for abnormal cells. Laurence Civil recently met with Dr. Viruch Charoeniam, Gynecological Oncologist, Wattanosoth Hospital.
"Women who are sexually active before the age of 18 years old are most likely to be at risk due to tissue damage allowing the infection to enter the body," says Dr Viruch. "Likewise those who have had multiple sex partners; those who have only had one sex partner but he had multiple sex partners; those who smoke and anyone who have continuously taken oral contraception for a period of more than five years."
He explained that cervical cancer can’t be prevented but research suggests that sexual activity and the physical effect of giving birth has on the body increases the risk.
"At puberty the columnar cells in the cervix change to squamous cells" he say " This is the normal process in healthy women, however if they are infected with HPV it becomes pathological and the cells become premalignant. This is precancerous lesions which are medically called CIN(Cervical intraepithelial neoplasia or dysplasia ). These precancerous cells can progress to cancer, which usually occure approximately 3-5 years after high grade lesion ."
There are three stages in the development of CIN. At the first stage, clinically known as CIN1 the abnormal cells are no more than 1/3 of thickness of cervix covering. It is usual that the area is also infected with the wart virus. 50 - 80 % of women with grade 1 disease will normally recover if there body has strong immunity.
When a woman is diagnosed with grade 1 level of the disease if she has been smoking she should stop, keep fit, and sleep well and avoids foods that contain chemicals and preservatives substance. Practice careful sex and always use a condom as it prevents the transfer of possibly infected body fluids, avoid using oral contraceptive pill more than 5 yrs. Every four to six months she should make an appointment with her doctor for a Pap smear checkup. If the condition persists for more than two years or the abnormal cells grow to grade 2 or 3, you may need to undergo surgery around the cervix which is the case for 70% of women.
"In most cases the change to be cancer starts in women from the age of 35 years upwards but cases have been reported as young as 18 years old," he adds. "I would therefore recommend women start having annual PAP smears three years after their first experience. The earlier we can detect the early change the easier it is to treat."
"The PAP smear is simple and painless we simply insert a speculums into the vagina to take a sample of fluid. We would also insert a finger to check the size of the uterus and the ovaries. The test takes a few minutes and will cause no disruption to your daily lifestyle. To make an appointment simply call to the hospital the day before. We recommend abstaining from sexual activity and to avoid douching two to three days before the appointment. We can give the results within three days of the test which have and accuracy of at least 95 %.
"When treating young patients who are at stages one or early two the best results can be achieved with a radical hysterectomy, though for women who still want to have children we will do the best we can to preserve the uterus but the health of the patient is the priority," he says.
"Taking folic acid can reduce the risk," he adds "like wise the reduction of stress. Another option is to take an HPV vaccine prior to becoming sexually active but there are some minor side effects and the cost per injection is about THB 5,000 and a course of three is required."
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