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HPV Vaccination and Regular Screening: Key to Preventing Cervical Cancer

Dr. M.G. Janaki, Consultant Radiation Oncologist at Ramaiah Memorial Hospital, shares her expertise on cervical cancer, its risk factors, treatment options, and the importance of prioritising cervical health. In this conversation, Dr. Janaki highlights the significance of HPV vaccination, regular screening, and early detection in preventing and treating cervical cancer.


What are the most significant risk factors associated with cervical cancer and how can women reduce their risk?The most important cause for cervical cancer is the HPV infection. Usually, women get that infection during the first sexual intercourse and then the infection starts.


    • Most of the time, most of the people, this infection subsides without any problem. But when this infection continues, there are some changes in the cervical epithelium, which over the years of 10 to 15 years can give up to the cause of malignancy. So, HPV infection happens.

      Infection will be there for some time. If it persists, in the long run, in 10 to 15 years, it can go for malignancy. This is the most common thing and it is seen in almost 85 to 90% of women.

      Other than this, there are many other factors such as, especially this is seen in rural areas. So, genital hygiene, if it is not maintained well, can cause it. And age or diabetes, multiple children, hybrid and we will get into that or having multiple sexual partners.

      These are the most common things that can cause cancer, renal cancer, other than HPV vaccination. And the other one, nowadays we have found that in urban population, especially those who smoke, there are also higher chances of cervical cancer. These are the most common things.

      Can you explain the importance of HPV vaccination in preventing cervical cancer? And who can actually receive that vaccine?

      HPV vaccination is crucial to prevent HPV infection. Like other vaccinations, it raises immunity to prevent the infection from persisting. It's essential to give the vaccination before the infection happens, ideally between 9-14 years of age or before first sexual contact. It can also be given up to 40-45 years, with differing doses. Vaccination should be given before exposure to the infection, just like any other infection.

      And what is the latest advancement in cervical cancer and how often must women undergo the screening?

      Between HPV infection and cervical cancer development, there's a 10-15 year window. During this period, cellular changes like dysplasia occur. Screening methods can detect these changes:

      Pap smear test: starts at 25 years, done once in 3-5 years, continued up to 60-65 years

      • Visual inspection with acetic acid: a simple, bedside test to identify unhealthy mucosa
      • Liquid cellular arrangement and HPV DNA analysis: newer tests that detect cellular architecture and HPV presence
      • HPV pap co test: combines pap smear and HPV DNA testing, done once in 5 years

      Early detection through these methods can prevent cancer development. Awareness among women and doctors is crucial for regular screening and early intervention.

      What kind of treatment options are available for cervical cancer? How do you actually determine the best course of treatment for each patient?

      Treatment for cervical cancer depends on the stage. Clinical examination determines if it's early or advanced cancer. Treatment options:

      · Early Stage 1: Removing affected part of cervix, preserving fertility

      · Advanced Stage 1: Hysterectomy (removing entire cervix and uterus)

      · Stage 1B and above: Radiation (external and brachytherapy) with or without chemotherapy, as surgery would require subsequent radiation

      Goal is to provide minimal treatment with minimal side effects. Early detection offers high cure rates, emphasizing the importance of patients seeking treatment as soon as possible.

      How has the high dose rate of brachytherapy impacted cervical cancer treatment? What kind of role does it play in modern radiation oncology?

      Radiation therapy for cervical cancer involves two types:

      1. Teletherapy: External radiation delivered from a machine, similar to a CT scan. This treats a broader area to address potential microscopic disease.

      2. Brachytherapy: Internal radiation where the source is placed within the tumor. In cervical cancer, empty tubes are inserted into the vagina and cervix, and then connected to a high dose rate (HDR) brachytherapy unit.

      HDR brachytherapy offers several advantages:

      • Treatment duration reduced from 30-40 hours to 3-4 minutes
      • Patient-friendly, allowing for easier care and attendance
      • Staff safety improved, minimizing radiation exposure

      This approach enables precise, high-dose radiation delivery, improving treatment outcomes for cervical cancer patients.

      Why do you think it is important for women to prioritize their cervical health?

      It's crucial for women to prioritize their health, just like managing diabetes or hypertension, as they are often the primary caregivers for their families.

      Early detection is key, with a complete cure possible if cervical cancer is caught early. However, women often hesitate to discuss private symptoms, such as bleeding during sexual intercourse, due to societal and cultural factors.

      It's essential to convey the importance of cervical health, especially during Cervical Cancer Awareness, emphasizing that women's health is equally vital as any other family member's.

      With early detection and treatment, 85-90% of patients can be completely cured. Advances in treatment have improved significantly, allowing patients to recover without side effects and resume their normal lives.

      Women should identify early symptoms, undergo regular screening (every 3-5 years), and address any issues promptly to live healthy lives with their families.


( Source : Deccan Chronicle )
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