Saving the world`s woman from cervical cancer

“SAVING THE WORLD’S WOMEN FROM CERVICAL CANCER”

By Vimbai Heather Mukarati

 

Many of you might be wondering why much emphasis is being put on cervical cancer prevention these days. Some do not even know what cervical cancer is !! I often hear questions like ; What are the causes and risk factors?What are the symptoms ?How can it be prevented ?Can cervical cancer be treated ? Some don’t even understand  why women are always  being encouraged to go for cervical cancer screening !Are you one of these people ? Do not worry , by the time you get to the end of this article, you will be more acquainted.

DID YOU KNOW??

The cervix  ;

• Is the narrow part of the lower uterus which is sometimes referred to as the neck of the uterus
• Helps menstrual blood to flow
• Is important for the production of cervical mucus
• Can openly dilate during child birth
• Can prevent or encourage pregnancy
• Usually sits straight at the top of the uterus, potentially leaning forward towards the belly. However, some women have a tilted womb making the cervix lead more towards the back which can make it harder to see during a cervical screening (which I will explain in detail later on! )

What is cervical cancer?!

Cervical cancer is a cancer that arises in the cervix of the uterus.The cervix itself contains 2 types of cells that line the outer cervix-squamous cells and cells that line the interior channels of the cervix-glandular cells.  The point at which these 2 cells types meet is known as the transition zone and this is the area where most cervical pre-cancers and cancers begin to grow. Up to 90% are known as squamous cell carcinomas with most of the remaining tumors coming from glandular cells-adrenocarcinomas. Adrenosquamous carcinomas as well as small cell and large cell neurocine carcinomas occur less commonly. Cervical cancer occurs in 4 stages which are as follows :

1. When the cancer is in the neck of the womb and nearby lymph nodes
2. The cancer has spread beyond the cervix and uterus,but not as far as the walls of the pelvis or the lower part of the vagina
3. Cancer cells are now present in the lower part of the vagina or the walls of the pelvis and it may be blocking the ureters
4. When the cancer has spread to the bladder or rectum and is growing out of the pelvis

Can people survive stage 4 cervical cancer?

The answer is yes!!! This one fact surprised me too! Around 5 out of 100 women will survive their cancer for 5 years or more after being diagnosed.

What are the statistics? !

Cervical cancer kills about 260,000 women annually and nearly 85% of these deaths occur in developing nations where it is the leading cause of cancer deaths in women.Disparities of health and poverty play a large role in this high mortality rate. Due to lack of screening, most women in Zimbabwe are diagnosed with cervical cancer at an advanced stage which has a prognosis of 63% 5-year survival rate ,57% remission rate with treatment and 42% reoccurance rate. In Zimbabwe,2270 women are diagnosed annually with a 64% mortality rate. Worldwide, 35.5% of the cervical cancer victims are black women and 2.8% are non-back women annually. What is the reason for this absurd difference in percentage? ! Think about it ! Some of the reasons are ;many non-reported cases , poor access to health facilities in rural areas , later stage diagnosis, less-aggressive treatment. Cervical cancer is frequently diagnosed in women between 35 and 44 years. In 2012, the International Agency for Research on Cancer recorded 527 624 new cases and 265 672 related deaths.Cervical cancer is a very dehumanising cancer,” says Severine Caluwaerts, MSF obstetrician-gynaecologist . I’m sure after reading about these statistics, we can all related to what he meant by this statement.

What are the causes and risk factors of cervical cancer?!

• Human papilloma virus (HPV) infection -this is the most common sexually transmitted infection. Cervical cancer is mainly caused by sexually acquired infection with certain types of HPV. This virus leads to the conversion of normal cells on the surface of the cervix into cancerous cells.
• Having many sexual partners
• Smoking
• Birth control pills used over long term
• Engaging in early sexual practices
• Immune system suppression
• Having 3 or more full term pregnancies
• Overweight
• Family History . The link between cervical cancer and inheritance is not fully understood
• HIV infection may cause cervical dysplasia or abnormal growth of cervical cells which is considered precancerous

Symptoms :

Bleeding between periods, bleeding after sexual intercourse,bleeding in post menopausal women , discomfort during sexual intercourse, vaginal discharge mixed with blood ,vaginal discharge with a strong odour as well as pelvic pain.Of course these symptoms can have other causes but I would like to urge all the women reading this article to visit the doctor whenever they experience these symptoms! In the early stages of cervical cancer , a person may experience no symptoms at all therefore women should visit a doctor regularly for screening .To all of you who don’t know what this whole screening process is about, it’s time to pay more attention! !

Screening and why women should go for screening!

Screening should be a part of every woman’s health checkup!! There are who types of tests,the PAP test and the HPV test, remember the HPV I talked about earlier on?! For both, the doctor or nurse collects cells from the surface of the cervix. With the PAP test ,the lab checks the sample for cancer cells or abnormal cells that could become cancer . Screening may detect these changes before they become cancer . Screening for HPV is also important because if you have that virus, it raises your risk for developing cancer and this may be prevented by inhibiting the activity of the HPV . However, the HPV vaccines are expensive and available in private healthcare in Zimbabwe. Majority of the people are informally employed, rely heavily on public healthcare . Therefore in order to make vaccines available to all women ,regardless of socioeconomic status, the vaccination program needs to expand into the public sector at lower price through subsidiary funding programs or donors .The problem with most Zimbabwean women (obviously including myself ) is that, we have a poor health seeking behaviour and this might be the reason why there are many cervical cancer related deaths in this country. I’ll say this to the women reading this article once again ” I urge you all to go for cervical cancer screening frequently!! ” because truly speaking , early detection is the best prevention.

 

 

First lady of Zimbabwe Auxillia Mnangagwa waiting to be screened for cervical cancer during her nationwide tour to raise awareness on cervical cancer

You must have heard people saying that ” Cancer is an unpreventable death ” . To be honest, this made me think that cancer had no treatment at all. But Guess What??! Cervical cancer can be treated !

Treatment

Cervical cancer treatment depends on the stage of the cancer . Treatment includes surgery , radiation and chemotherapy. Medical procedures such as cryosurgery and loop electrosurgery are used for squamous carcinomas and hysterectomy is used for adrenocarcinomas.

A number of cervical cancers can be found in pregnant women, 70% being stage 1 cancers. Treatment plan is determined by the tumor size , whether the nearby lymph nodes have cancer or not , how far long the pregnancy is , the specific type of cervical cancer.

 

 

 

 

 

Margaret Muza, a 57 year old Zimbabwean woman survived cervical cancer because she was lucky enough to have access to treatment. 

What’s being done in Zimbabwe ?

I know we can all agree that this is the most commonly asked question in this country “So what is the government doing to solve the problem ?”

Currently , Mr Darrell Ward of Better Healthcare for Africa , Dr. Lowell Schinipper of Beth Israel Deaconess Medical Center and collaborators at St Albert’s Mission Hospital, a rural hospital in Zimbabwe, are seeking fund to develop a hospital-based cervical-cancer screening and education program. The “screen and treat ” program uses a simple inexpensive and proven method to detect precancerous lessons on the cervix ,and a relatively simple and proven technology to remove those lesions and thereby prevent the development of invasive cervical cancer, for which few treatment options exist in rural Zimbabwe. This program will establish a cervical screening clinic at the hospital that includes training in cervical cancer for staff and support a distinct-wide community cervical-cancer prevention campaign and weekly screening at three of the hospital’s 11 outlying clinics . Cervical cancer screening is now being done for free in every governmental hospital. Girls below the age of twelve are now being given the HPV vaccine. The Visual Inspection with Acetic Acid and Cervicography (VIAC) national cervical cancer screening program is being adopted into the current healthcare system.   Zimbabwe’s First Lady  Auxillia Mnangagwa has called for more efforts to raise awareness on the problem of cervical cancer in Zimbabwe to prevent women from dying from cervical cancer.During her nationwide campaign to raise awareness on cervical cancer Zimbabwe’s first lady encouraged women to be screened and treated early of the disease which is killing many women in the country.  She said women who are found with the cancer should be assisted to get treatment as quickly as possible.To address the rising cancer burden, this first National Cancer Prevention and Control Strategy advocates for a comprehensive cancer control policy and programme. This Strategy therefore focuses on reform and re-organisation of the way cancer services are delivered in Zimbabwe, in order to ensure that future services are consistent and associated with good clinical outcomes for all cancer patients and quality care for the patients and their caregivers. The strategy will also seek to ensure that cancer prevention and care across the whole country is equitable and of the highest possible standard, through the establishment of a National Cancer Forum whose mandate will be to monitor performance of the national cancer prevention and control programme and advise the Minister of Health and Child Care accordingly.

Limitations and what needs to be done for improvement

Limitations in resources, infrastructure, manpower,delays in treatment and patient knowledge play a role in the high morbidity and mortality of cervical cancer in Zimbabwe. The Ministry of Health needs to increase funding to expedite the availability of HPV vaccine and screening programs. Community engagement initiatives to raise awareness on cervical cancer should be established to provide education on how to prevent the development of cervical cancer,as well as promote screening for early detection . Which reminds me , how many of you guys know about the breast cancer awareness campaign that happens in October annually? ! Many or rather ,all of you, right ? But how many people know that January is the Cervical cancer awareness month ?? A few, less than 30% I assume .So tell me, how will we help in the reduction of cervical cancer cases in Zimbabwe when we don’t even engage in any cervical cancer awareness campaigns . We need to make some noise and spread the knowledge about cervical cancer to the rest of the world . This article is not just for you guys to read and comment, but consider this information as a basketball that’s crying out and shouting at a player for him to pass the ball to the next player , we need to spread the word ,we need to encourage our mothers, sisters , friends, wives to go for cervical cancer screening. We can’t just expect a change without making the changes . My main objectives are ;to raise awareness about cervical cancer among women, to promote prevention and early detection . This will all be achieved if every woman decides to go for cervical cancer screening regularly and this will really help us to reduce the number of deaths caused by cervical cancer. People need to understand that even after being diagnosed with cancer , they have a chance of survival . We all need to remember what Jim Valvano said, “Cancer can take away all of my physical abilities. It cannot touch my mind , it cannot touch my heart and it cannot touch my soul. To all the males reading this article, you’re also responsible for the changes that need to occur , you should also raise cervical cancer awareness. This way, we’ll help each other to Save The World’s Women From Breast Cancer.