Could this be cervical cancer?

Q: I am 52- years- old and my sister was diagnosed with cervical cancer. I have several concerns regarding her diagnosis.

Is cervical cancer hereditary? How can I prevent myself getting it? I have avoided going for a pap smear for the past 10 years because I had a very bad experience during my last one – I found it very invasive and painful.

I am having irregular menstrual bleeding and sex with my husband is also quite uncomfortable (sometimes, I even get some spotting). Is this happening because I am perimenopausal or is this a symptom of cervical cancer?

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The perimenopausal period can be a difficult one for a woman. The symptoms of cervical cancer often overlap with some menopausal ones.

What are symptoms of cervical cancer?

• Abnormal bleeding: Bleeding between menstrual periods, after sex, or after menopause is not normal.

• Pain during sex during the perimenopausal period can be due to vaginal dryness, but it can also be a symptom of cervical cancer. Before you resort to buying a lubricant to deal with your painful intercourse, get screened for cervical cancer.

• Abdominal or pelvic pain: The abdominal pain affects the lower belly.

• Abnormal vaginal discharge: Every woman is aware that her body produces a different texture and colour of discharge depending on her hormonal cycle.

Often, this discharge is non-foul. Any unusual discharge should alert one to the possibility of either an infection or possibly cancer.

Pap smear

It’s unfortunate that you had a painful experience during your last pap smear, however, do not let it discourage you from going for your next one. A pap smear can save your life. Pap smears are currently the fastest and easiest way of detecting abnormal cells in your cervix.

The nature of the procedure is invasive but it should not be painful. When you go for your next pap smear, explain to the gynaecologist what made your last one uncomfortable.

He/she will certainly do their best to ensure that you do not experience the same problem again. You also need to understand that if your doctor finds an obvious growth on your cervix, he/she will have to do a biopsy for further testing.

Cervical cancer can be cured

If cervical cancer is detected in its early stages, it can be cured. If it is detected when it has spread to surrounding or distant organs, your treatment options are limited.

For this reason, pap smears are crucial.

HPV and cervical cancer

HPV refers to human papilloma virus. Infection with certain subtypes of this virus has been found to be associated with the development of cervical cancer.

It is the same virus that causes warts and is also associated with anal cancer.
The HPV subtypes that are associated with cervical cancer are sexually transmitted. It is important to note, however, that not all women who get infected with HPV develop cervical cancer.

What are risk factors for cervical cancer?

You mentioned that your sister has cervical cancer. There are several factors that have been associated with cervical cancer.

• Early sexual activity (young age) and having many sexual partners: The greater your number of sexual partners, the greater your chance of acquiring HPV.
• A weak immune system: Conditions that weaken your immune system such as HIV/Aids increase your risk of developing cervical cancer.
• Sexually transmitted infections (STIs): Having other STIs such as chlamydia, gonorrhoea and syphilis increases your risk of HPV.
• Smoking increases your risk of developing multiple health problems including certain subtypes of cervical cancer.

Is it preventable?

The development of a vaccine for cervical cancer has been found to help reduce the incidence of cervical cancer. At 52 years of age, the best way to reduce your risk of getting cervical cancer by practising safe sex.

Pap smears do not prevent cervical cancer but they are a useful screening tool that can help detect harmful changes in your cervix at an early stage.

Cervical cancer vaccine

The cervical cancer vaccine is available in Kenya and has been proven to reduce the incidence of cancer in women. Ideally, the vaccine should be given before a girl’s sexual debut.

Currently, the vaccine is given to girls/women aged between nine to 26 years. Unfortunately, the vaccine is not freely available in the Kenyan public sector.

How bad is the situation in Kenya?

Cervical and breast cancer are the two leading cancer killers amongst women in Kenya. Great strides have been made to raise awareness about breast cancer, sadly the same cannot be said about cervical cancer.

Most women in the rural areas have never heard of a pap smear. Most local clinics do not offer pap smear services despite it being one of the simplest (and safest) procedures to perform.

Close to 90 per cent of cervical cancer cases are detected when they have some degree of spread.

Treatment services in the public sector are also a challenge with many women experiencing weeks (even months) of delay before they can access cancer therapy and surgery.

All this has meant that we are losing thousands of women annually to a potentially curable cancer.