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WOMEN AND WELL BEING

Don’t skip the pap test

Photo: Nagara Gopal

Stay safe: Nothing can replace healthy lifestyles.

Imagine if I told you that there is a cancer for which we know the cause, have a simple and inexpensive test for early detection, and have safe and effective treatments available; yet it is the second leading cancer among women in the world and the l eading cancer among women in India. This is the reality of cervical cancer.

Nearly one in four cases of cervical cancer around the globe occurs in India. Even worse, cervical cancer is a disease of the young; it peaks between the ages of 35-50 and not only takes the lives of young women, but also devastates their families along the way.

Despite this, there’s good news: cervical cancer is preventable. By arming ourselves with the knowledge necessary to take responsibility for our health, we can begin to erase this major chapter in the book of women’s health.

Over 99 percent of cervical cancers are caused by the Human Papillomavirus (HPV). There are several types of HPV, but only about 15 cause cancer. HPV causes disease in both men and women, but cervical cancer is the most serious. Genital HPV infections are sexually transmitted, and most of them are “silent”; people who carry the virus don’t know they have it and transmit it freely to their sexual partners. Nearly 90 percent of HPV infections resolve spontaneously within 24 months, so HPV rarely causes disease.

In a minority of people, however, the infections persist as a result of a weakened immune system due to factors like stress (and who doesn’t have stress!), smoking, poor nutrition, certain medications, having sex at an early age, multiple pregnancies, and HIV — all of which can propel HPV infections to cause precancerous and cancerous lesions of the cervix. Additionally, one’s sexual history and their partner’s also play a role; having multiple sexual partners and/or unprotected sex makes a person more prone to HPV infections. From a medical and wellness standpoint, it’s important to realise that sexual experimentation before marriage is becoming more prevalent, and even if our children wait until marriage to have sex, there is no guarantee that they won’t be exposed to the virus through a partner who didn’t; HPV doesn’t necessarily mean promiscuity because you can get the virus from a monogamous relationship!

The most widely used test, the Pap test, detects changes in the cells of the cervix caused by HPV. If left untreated, it may progress to cervical cancer. Unfortunately in India, Pap testing is not performed extensively; hence the high numbers of cervical cancer. Moral of the story, get your Pap test today!

Unfortunately, there is no treatment to rid HPV from the body. Only the diseases caused by HPV such as warts, precancerous and cancerous lesions can be treated. Even then, there is no guarantee that the virus has left the body. But the ABCDE’s can help keep HPV at bay: Abstinence, Being faithful, Consistent condom use, Delayed sex and Education.

And don’t forget, healthy lifestyles such as our home-grown yoga techniques can boost our body’s immune system in general and help fight diseases, including those caused by HPV.

As far as prevention goes, there are now two new vaccines for cervical cancer: Gardasil and Cervarix. Both are preventive and, therefore, recommended for girls 10-12 years old, when antibody titres are high and when children visit their doctor’s offices for other booster shots.

You may wonder why one should get the vaccine when there is a Pap Test. An ounce of prevention is always better than a pound of cure! The Pap test only detects abnormalities after the virus has infected the cervix, whereas the vaccines prevent it in most cases. However, as the vaccines don’t prevent all cervical cancers (they protect against 70-80 per cent). Pap testing is still required to detect the remainder of cervical cancers.

Two issues have plagued parents: will the vaccine promote sexual promiscuity and is it safe? Being a parent myself, I fully understand these concerns; but having researched this subject, I know the top two things that adolescents fear about sex are pregnancy and HIV, both of which are not prevented by the vaccines. Think of it this way: Getting a car with an airbag means the car is safer in the long-run, but it isn’t a reason to drive recklessly! The bottom line is, we as parents have one simple desire: to protect our children from as many diseases as possible.

For those parents who are concerned about the “newness” of the vaccine, the latest report from the Centers for Disease Control shows that there are no signs to directly link Gardasil (the only vaccine thus far available in India and the U.S.) to any serious adverse effects to date. The CDC will continue to be vigilant and monitor safety data on an ongoing basis.

No one can deny that vaccines are miracles of modern medicine. But scientific challenges, public acceptability, ethical dilemmas and the injustice of uneven access to the vaccines remain controversial even today. One thing is certain: though the HPV vaccine is one of the most cost-effective ways to prevent cervical cancer, it will not, should not and cannot replace pursuing healthy lifestyles and safer sexual practices.

The writer is a New York based gynaecologist, primary care physician and author of The HPV Vaccine Controversy: Sex, Cancer, God and Politics. The book is written without the influence of any pharmaceutical companies or special interest groups.