Wednesday, August 19, 2009

'Screening can stop cervical cancer'

If you are a woman aged 25 and above, you have or you have had multiple sex partners, or, in fact, your partner sees other women, you could be in a big health trouble.

You need to go to hospital and get screened. You might be carrying the human papillomavirus (HPV) which causes cancer of the cervix.

Cancer of the cervix, otherwise known as cervical cancer, is the leading cause of death among all cancers affecting women. It could also be described as one of the most intricate diseases. One suffering from the disease cannot easily detect it in its early stages.

“There is a lengthy period between the time one contracts the virus and the time the disease develops. It may take between 10 and 30 years for the disease to develop,” says Dr Frank Taulo, Director of the Centre for Reproductive Health (CRH) at the Malawi College of Medicine.

“The majority of women are able to clear the virus after contracting it and never develop the disease. But up to about 30 percent of those who contract it are unable to do so and harbour the virus and if there is no screening, they would develop the disease.”

The irony of the disease, however, is that the HPV is carried by men but they do not suffer from the disease. But like mosquitoes spreading the malaria virus each time they bite people, men spread the virus to as many women as possible with whom they have unprotected sex.

Once in the woman, the virus plays a harmless waiting game. You cannot suspect you have it. That is why only screening is paramount. The virus only starts leading to abnormal growth of cells at the mouth of the womb (the cervix) after more than 10 years. This abnormal growth of the cells is the cancer.

At this point, the infected woman experiences abnormal bleeding from the reproductive system. This happens mostly between regular menstrual periods and after sexual intercourse. Those infected also experience menstrual periods that last longer and are often heavier than before.

According to Medicine Net, an online healthcare media publishing, those infected also bleed after menopause. This is usually between the ages of 45 and 50.

“There are also stinking vaginal discharges released by those that are infected. Those infected also experience difficulties in emptying the vagina and there is no sleeping because of abdominal pains,” adds Taulo.

“This is no point of return, and it is advisable that medical personnel should recommend thorough examination rather than just giving antibiotics. Antibiotics are not a treatment.”

According to Taulo, every woman “with a womb and who has had unprotected penetrative sex” is at risk. This group, he says, mostly comprises women aged 25 and above. That is why screening is particularly recommended for such an age group.

He, however, says this does not automatically mean that those under 25 are free from the virus. He says all those who have had sex before attaining the age of 20 should also go for screening because they are also at risk.

Research conducted by the Malawi Cancer Registry between 2004 and early 2006 indicates that cancer of the cervix tops the list of all cancers affecting women with 33 percent. The other cancers affecting women are Kaposi’s sarcoma (25.5 percent), cancer of the breast (6.9 percent), cancer of the oesophagus (6.7 percent) and cancer of the urinary bladder (3.1 percent).

The research registered the largest number of cases of the disease among those aged above 40.

Dr Charles Dzamalala, Medical Director of the Malawi Cancer Registry and Consultant Pathologist at the Malawi College of Medicine, says there are more cases of the disease in the advanced ages because of the time the disease takes to develop.

He says: “One can get the virus at say 25 but they will only start showing signs of the disease when they are around 40 or 45. The disease takes time to develop from the time one contracts the virus.”

According to the cancer registry, by mid 2006, there were 6,772 cervical cancer cases out of a total of 38,292 cancer cases registered in the country. Dzamalala says the figure could be higher now and that would only be confirmed by recent research.

Taulo says this high figure is a result of failure by the women at risk to go for screening.

“When one goes for screening, there are chances for early detection of the virus hence the chances for treatment. When there is no screening, there cannot be any treatment which means more and more women keep dying of the disease,” he says.

This is undoubtedly a worrying situation. Most of the women within the affected age group are breadwinners in their families. They are also those who look after the family.

Consequently, death of such women mirrors a troubled and compromised future. The entire family is affected and the impact is far reaching. School going children might stop going to school because they miss the care of a mother at home.

Screening services for cancer of the cervix are offered in most hospitals across the country. There is also treatment for pre-malignant stages of the cancer although only a few hospitals offer the service.

But according to Taulo, this is not enough as other services have to be offered as well. He says for a comprehensive cancer treatment programme, up to four services have to be offered. Malawi currently offers three, the other being palliative care for cancer patients. It does not offer radiation therapy which comes at stage three.

“It is everybody’s duty. Let us support and encourage women to go for screening. There is also need to invest in the problem. Currently, it is only lip service,” adds Taulo.

“There is need to educate the masses and train people to deal with the problem. Current indications are that training is declining. Not many are trained in the area.”