JANUARY IS CERVICAL CANCER AWARENESS MONTH.
WHAT CAUSES CERVICAL CANCER AND HOW DO WOMEN GET IT?
Almost all cervical cancer is caused by Human Papilloma Virus or HPV. HPV is an extremely common virus that is passed from person to person through sexual contact. Over 90 million people in the US have been exposed to HPV. But only a small fraction of women who are exposed to HPV get cervical cancer; in most women, their immune system allows them to stop the cancer-causing virus in its tracks.
SO WHY IS IT ONE OF THE MOST COMMON CANCERS AFFECTING BLACK WOMEN IN PARTICULAR?
Cervical cancer is about 1.5 times more common, and 2 times deadlier in Black women than White women in the United States. Black women over 65 years old have the highest death rates from cervical cancer among any group of women.
We don’t know for certain why Black women have higher rates of cervical cancer; but the reason they are more likely to die of their disease is due to lower screening rates and being less likely to having access to treatment by the right type of doctor, a gynecologic oncologist.
CAN IT BE PREVENTED?
Getting vaccinated against Human Papilloma Virus can prevent over 91% of cervical cancers. The HPV vaccine protects against 9 different types of the virus including types that cause anal cancer and head and neck cancer as well as cervical cancer. All boys and girls in the U.S. should get vaccinated against HPV at age 11 or 12 to prevent them from every getting one of these cancers. The HPV vaccine was recently approved for men and women up to age 45 years old; so Black women who haven’t yet developed cervical cancer or pre-cancer should get vaccinated.
AT WHAT AGE SHOULD YOU START GETTING REGULAR CERVICAL CANCER SCREENINGS?
Women should get regular cervical cancer screening beginning at age 21; but all girls and women should see a gynecologist and have an exam as soon as they start having sex and should see a gynecologist at least once a year for a pelvic exam.
WHAT ARE SOME OF THE SYMPTOMS OF CERVICAL CANCER?
Bleeding that is outside of your normal pattern is the most common symptom of cervical cancer including spotting after sex, bleeding in between periods or heavy periods. But don’t wait for symptoms; get vaccinated and get screened for cervical cancer on a regular basis.
IF YOU’VE HAD A HYSTERECTOMY, SHOULD YOU BE CHECKED FOR CERVICAL CANCER?
If you had your cervix removed when you had your hysterectomy then you don’t need to be screened for cervical cancer. But many women don’t know for sure if their cervix was removed; it is best to see your GYN and get examined and she can tell you if you need to be screened after a hysterectomy.
ONCE DIAGNOSED, SHOULD I GET A SECOND OPINION BEFORE CONSIDERING TREATMENT OPTIONS?
If you are diagnosed with cervical cancer, the most important thing is to get an opinion from a GYNECOLOGIC ONCOLOGIST-a specialist who has had many years of training just to be able to take care of women with cervical cancer.
A Gynecologic Oncologist can advise you on all the available options for treatment including clinical trials. To find a Gynecologic Oncologist near you- go to the Society of Gynecologic Oncology website at https://www.sgo.org/seek-a-specialist/ .
WILL TREATMENT AFFECT MY DAILY ACTIVITIES?
Treatment will only affect your daily activities in the if you are diagnosed with a higher stage of cervical cancer that requires radiation treatment. Most cervical cancers are diagnosed early and are cured with various types of surgical procedures.
WHAT WILL YOU DO IF THE TREATMENT DOESN’T WORK OR IF THE CANCER RECURS?
For early stages of cervical cancer it is very rare for the cancer not to be cured with treatment. But for women with advanced cancer that comes back, there are many options for treatment including precision medicine and immunotherapy. If you have advanced stage cervical cancer or any cervical cancer that has come back; it is critical that you see a Gynecologic Oncologist and ask about clinical trials.
AFTER TREATMENT, WILL YOU STILL BE ABLE TO HAVE CHILDREN?
Since most cervical cancer is diagnosed at an early stage; the option to treat the cancer without having a hysterectomy is becoming more and more common; there are many options to treat cervical cancer that can allow a woman to still have children but you need to see a Gynecologic Oncologist to hear about these options and find out if you are a candidate.
IF YOUR PAP RESULTS COME BACK IRREGULAR SHOULD YOU BE CONCERNED?
A: If you have an abnormal pap smear; DON’T PANIC! Most abnormal paps ARE NOT cervical cancer. If your pap comes back abnormal, you will have another test where your doctor will look at your cervix and possibly take some biopsies. In most cases an irregular pap will not be cervical cancer.
ONCE DIAGNOSED WHAT ABOUT THE COSTS AND INSURANCE COVERAGE FOR TREATMENT — IS HELP AVAILABLE?
Breast and cervical cancer screening must be covered by all insurance plans with no co-pay thanks to President Obama and the Affordable Care Act. Almost every state in the US has a program for free cervical cancer screening for women with no insurance and there is still a federally funded program that will provide Medicaid coverage for women who are diagnosed with cervical cancer after being screened at one of these federally funded sites.
Dr. Brown answers your “Text Tom” questions on the next page: