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The `C' word

Cervical cancer is one disease that is completely preventable

SHOWING THE WAY For a healthier life Photo: K. Ananthan

"It is not exactly the most graceful or dignified of postures to assume, but the fact that a Pap smear test can make the difference between life and a painful death should make it worth the momentary embarrassment or discomfort," says Ramya, who recently returned from a test at a hospital as part of a cancer-screening programme.

There are frightening statistics on the incidence of cervical cancer. Thousands of women are afflicted by it in our country. But there is a silver lining. Since it is the only cancer detectable at a pre-cancerous stage, it is completely preventable. But, to be detected, women have to go for regular check-ups. Sadly, as Dr Mirudhubhashini Govindarajan, director, Women's Center, says, "The response rate of women is very poor. Women are still uncomfortable talking about their bodies. It is okay to talk of diabetes and high BP, but breast cancer and cervical cancer are somehow unmentionables".

What is cervical cancer?

The cervix is made up of cells that divide to produce more cells when the body needs them. Sometimes new cells are produced even when the body does not require it. As a consequence, a mass of extra tissue is formed which is called a growth or a tumour.

All tumours are not cancerous or malignant. "This point cannot be emphasised enough," says Dr P. Guhan, Director and consultant oncologist, Sri Ramakrishna Institute of Oncology and Research. He explains how a Pap smear may reveal some abnormalities that need not be cancerous. But these abnormal changes in the cells of the cervix could be the first step in a series of slow changes that can lead to cancer years later.

This is where a regular Pap smear can save lives and prevent a lot of heartache and trauma, says Dr Mirudhubhashini and reiterates that it is vital that women know that abnormalities detected during a Pap smear are not a death knell. These abnormalities can regress, persist or progress. Only when these pre-cancerous abnormalities are allowed to lie undetected, they can gradually invade deeper into the cervix or to the other tissues or organs and turn cancerous.

Pap smears detect pre-cancerous abnormalities that can be treated before cancer develops. Like two women in their mid-40s, who want to remain unnamed, found out. Ironically, they had volunteered to assist doctors in conducting Pap smear tests for a cancer-screening programme.

Having never undergone such a test themselves, they decided to have one. They were found to have pre-cancerous abnormalities and were promptly treated and today they are happier for that. "These women are from an educated background but had never thought it necessary to get themselves checked. In the U.S., the incidence of cervical cancer detected in its last stages is almost nil and this has been the case from the 1930s; here 70 years down the line we are still struggling to educate the women about it even in urban areas," says Dr. J. Ramanathan of the Vasantha Memorial Trust for cancer care and cure.

But he warns that just one Pap smear will not do the job. "Whether the test results are normal or otherwise a woman must follow up with tests once a year, or as the doctor prescribes," he asserts and says it is shocking that there are a lot of women out there who have not visited a gynaecologist after the birth of their last child.

Even women who have undergone a hysterectomy are advised to go in for Pap smear.

FAQ

What causes cervical cancer?

A virus that could remain dormant for years, sometimes for as long as 15-20 years

Early sexual activity

Several sexual partners

High-risk males (who have had more than one partner)

Early childbirth

Multiple pregnancies

When should women go for a Pap smear?

At 18 years or as soon as she becomes sexually active

If there is continuous white discharge

Persisting leg pain

Post-coital bleeding

Hereditary factors (if members of the family have had cancer)

Best time to have the test

10-20 days after the first day of menstruation

Good news about cervical cancer

Long lead time

Easy to spot (surface of the cervix)

Easy to reach (does not require expensive and invasive tests)

Screening is risk-free

The test is easy to administer with minimum discomfort

It is easy to repeat and is inexpensive

PANKAJA SRINIVASAN

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