Healthy Living
Targeting Cervical Cancer - Regular Pap Tests and HPV Vaccines Help Combat This Sometimes Deadly Disease
by Henry Alpert
While scientists still do not know exactly which factors make cancer afflict some people and not others, cervical cancer provides a rare exception. It is linked just about 100 percent of the time to a virus known as the human papillomavirus, or HPV. In a way, this is good news. By knowing that HPV is a precondition for cervical cancer, doctors are offered a clear target for detection and prevention.
February is Cervical Cancer Awareness Month. In order to assist in the cause of raising awareness, New Orleans Living magazine spoke with Dr. Lisa Bazzett of Ochsner Health System to learn some basic facts about cervical cancer. As a gynecological oncologist, Dr. Bazzett’s professional expertise is in the treatment of women with malignancies of the female reproductive organs, including cancers of the ovary, uterus, cervix, vagina and vulva.
What causes cervical cancer?
We know it is necessary for HPV to be present in the body for cervical cancer to occur. But not everyone who gets HPV will develop the disease. In fact, for the majority of people who get HPV, their immune system fights it, and it goes away on its own. Additional factors make HPV more likely to persist or progress into cervical cancer.
For example, smoking encourages the virus to progress. Also, if you’re very young when you first start to have intercourse, that increases your risk. So do multiple sexual partners, because you’re more apt to be exposed to HPV. But even a single sexual encounter can put you at risk for an HPV infection and cervical cancer.
What are common symptoms of cervical cancer?
When cervical cancer becomes advanced, women can experience irregular vaginal bleeding or bleeding after intercourse and pelvic pain. Eventually, the cancer can spread and be fatal. But if you detect the cancer early, there are no symptoms at all. That’s why we in the medical profession urge women to come in for their regular Pap smears, so we can catch potential problems in their early stages.
How common is this cancer?
There are about 11,000 new cervical cancers each year in the United States. Half a million cases a year appear worldwide. It’s a huge problem in developing countries, where they don’t have access to screening tests. Worldwide, cervical cancer is the second most common cause of cancer death in women.
Can condoms prevent the spread of HPV?
They help, but they’re not 100 percent effective. It’s more like 75 percent. The problem is that the virus is not transmitted in bodily fluids. It spreads through surface-to-surface contact of genital areas.
Is there an HPV vaccine?
One has been available since 2006 and another came out in 2009. It’s really remarkable. Knowing that this cancer is caused by a virus, there’s a way to prevent cancer that we’ve never seen before. The vaccines build up your immune response so when and if you’re exposed to HPV, your body can attack it. It’s best to get vaccinated before sexual activity if possible, but [the vaccines] are recommended for anyone age 9 to 26. They’re available in Louisiana for free up to age 18.
How do you screen for cervical cancer?
The Pap smear. The main point of a Pap smear is to test for abnormal, precancerous cells (severe dysplasia) caused by the HPV. If any are found, we can do a minor procedure to cut them out of the cervix. However, this is not a treatment for the HPV itself. Currently, we have no treatment for the virus and have to rely on a person’s own immune system to clear it, which it usually does over time.
Where did the name “Pap smear” come from anyway?
It’s named after a Greek doctor named Papanicolaou. He’s famous in Greece, and his image is on one of the bills of their currency. The “smear” is because the sample is smeared on a slide for viewing through a microscope.
What are the treatment options for women with cervical cancer?
It depends on when it’s detected. We can do minor procedures if we find it early and save the cervix and uterus. Again, that’s why Pap smears are so important. Advanced treatments use radiation and chemotherapy, and in many cases, a hysterectomy is necessary. Even if a woman wants to have children, there’s often no way around that if we want to save her life.
In cases where a doctor presents more than one treatment option, how does a woman decide what to do?
Surgery is typically a better option for younger patients. It allows them to keep more of their sexual function over the long term. Chemo-radiation is reserved for more advanced cancers or for older patients who may not tolerate surgery well.
Why do some women not get regular Pap smears?
We wish we knew the answer to that one. A lot of people think they don’t need one after a certain age or after they’ve finished having children. Sometimes, it’s complacency. Cost or insurance shouldn’t be a factor. In Louisiana, you can find many options for free Pap smears. You just have to seek it out.
Do you think rates of cervical cancer will go down now that there’s an HPV vaccine?
Yes, but I think it’s going to take a while. The number of candidates for the vaccine is much larger than the women actually getting it. We have to do more education and public outreach.
Dr. Lisa Bazzett can be reached at (504) 842-4165.
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