fter hearing from
the nurse
practitioner,
“You have
abnormal
cervical cells,
and HPV.”
Kristell’s first
reaction was to
freak out. “I
thought I had
cancer, when you
hear abnormal
cells it just
doesn't sound
good.” It wasn’t
for until two
and a half years
later, in late
March 2007 that
21 year old,
Kristell’s
thoughts became
a reality.
According to the
Online Mayo
Clinic, cervical
cancer is one of
the most common
cancers that can
affect a woman's
reproductive
organs. Cervical
cancer is cancer
of the cervix.
Various strains
of the human
papillomavirus (HPV),
a sexually
transmitted
infection, are
the cause for
most cervical
cancer cases.
When exposed to
HPV, a woman's
immune system
typically
prevents the
virus from doing
any harm. If she
does become
infected with
certain types of
HPV, abnormal
cells can
develop in the
lining of the
cervix. If these
abnormal cells
are not
discovered early
and treated,
they can become
cervical
pre-cancers and
then cancer.
Earlier this
year when
Kristell found
out her two and
a half year
struggle with
HPV had turned
to cervical
cancer, her
world came down
around her. “I
was in complete
shock, I
couldn't cry, I
couldn't move, I
couldn't even
answer the
Doctor when he
asked me if I
was ok... all I
heard was
cancer.”
HPV infections
are most
commonly
diagnosed with a
Pap test in
sexually active
teenage girls
and women under
the age of 25.
Half of cervical
cancer cases
occur in women
between ages 35
and 55. Thanks
largely to Pap
test screening,
the death rate
from cervical
cancer has
decreased
greatly over the
last 40 years.
Still, every
year nearly
4,000 woman die
of cervical
cancer.
Am I Putting
Myself At Risk?
According to the
Online Mayo
Clinic, five
factors greatly
increase a
woman’s risk of
cervical cancer.
Early sexual
activity-
Immature cells
of adolescents
are more
susceptible to
the precancerous
changes caused
by HPV.
Multiple sexual
partners- The
greater the
number of sexual
partners a woman
has had,
combined with
the number he
partners have
had, equal a
greater chance
of acquiring HPV.
Other sexually
transmitted
diseases
(STD’s.)- other
STDs, such as;
Chlamydia,
gonorrhea,
syphilis or
HIV/AIDS,
increase the
chances for both
sexes acquired
HPV.
A weakened
immune system-
Most women who
are infected
with HPV never
develop cervical
cancer. However,
if they have an
HPV infection
and their immune
system is
weakened by
another health
condition, they
may be more
likely to
develop cervical
cancer.
Cigarette
smoking- The
exact system
that links
cigarette
smoking to
cervical cancer
isn't known, but
tobacco use
increases the
risk of
precancerous
changes.
Disturbingly,
many women, like
Kristell, go
uninformed of
these risk
factors and
unknowingly
contract HPV. “I
wasn’t informed
of the risk
factors by a
doctor until
after I had HPV.
Although, even
if I was aware
of the risks I
don’t think that
I would have
changed anything
in my life. My
thought is
everything
happens for a
reason.”
How Do I Know If
I Have It?
Most people who
are infected
with HPV do not
know that have
it. “I really
haven't noticed
any signs, I
felt like
nothing had
changed, if I
didn't go to the
doctor then I
wouldn't have
had a clue that
I had cancer,”
Kristell
recalls.
According to the
Center of
Disease Control
and Prevention,
“The virus lives
in the skin or
mucous membranes
and usually
causes no
symptoms. Some
people get
visible genital
warts, or have
pre-cancerous
changes in the
cervix, vulva,
anus, or penis.”
In some cases as
HPV progresses
to cancer, these
signs and
symptoms may
appear;
Vaginal bleeding
after
intercourse,
between periods
or after
menopause.
Watery, bloody
vaginal
discharge that
may be heavy and
have a foul
odor
Pelvic pain or
pain during
intercourse
What Can My
Doctor Do To
Detect It?
Simple and
inexpensive Pap
tests are
important in
detecting the
presents of HPV.
A newer approach
to Pap screening
uses a liquid to
transfer the
sample of cells
to a lab. A
doctor collects
the cells by
brushing cells
from the cervix,
the narrow neck
of the uterus,
and then rinses
the instruments
in a special
liquid, which
preserves the
cells for
examination
later.
In nearly all
cases, a Pap
test allows for
the detection of
abnormal cells.
If the abnormal
cells or
Dysplasia, are
present only in
the outer layer
of the cervix
and haven’t
invaded deeper
tissue, the
cells are then
considered in
the precancerous
stage. If
untreated, the
abnormal cells
may convert to
cancer cells,
which may spread
in various
stages into the
cervix, the
upper vagina,
pelvic areas and
to other parts
of the body. If
the cancer or
precancerous
conditions are
caught early on,
they are rarely
life-threatening
and typically
require only
outpatient
treatment.
If I Do Have It,
What Can Be
Done?
According to the
American Cancer
Society (ACS),
all women with
pre-invasive
cervical cancer,
abnormal cells
affecting only
the outer layer
of the lining of
the cervix, can
be cured with
appropriate
treatment. The
nurse
practitioner
recommended that
Kristell get a
colposcopy and
biopsy done
after her
initial testing.
Kristell did not
receive further
treatment until
January 2006 due
to being
pregnant.
Kristell
remembers her
first biopsy
being very
traumatic. “They
had a television
screen up right
next to me and I
saw the whole
thing. For me,
seeing the
procedure done
was absolutely
awful, if they
hadn't done
that, then maybe
it wouldn't have
been so bad. My
second biopsy
however,
was virtually
painless, my
doctor numbed me
with Lidocane
and I was out
within a half an
hour.” Later
this spring
Kristell is
scheduled to
have a loop
electrosurgical
excision
procedure done
(explained
below).
The Online Mayo
Clinic reports
that treatment
of cervical
cancer in the
pre-invasive
stage may
include;
Conization- a
simple surgery
involves
removing with a
scalpel a
cone-shaped
piece of
cervical tissue
where the
abnormality is
found.
Laser surgery-
an operation
uses a narrow
beam of intense
light to kill
cancerous and
precancerous
cells.
Loop
electrosurgical
excision
procedure (LEEP)
- a technique
using a wire
loop to pass
electrical
current, which
cuts like a
scalpel and
removes cells
from the mouth
of the cervix.
Cryosurgery- a
technique
involves
freezing and
killing
cancerous and
precancerous
cells.
Simple
Hysterectomy- a
major surgery
involving
removal of the
cancerous and
precancerous
areas, the
cervix and the
uterus, only
when there is an
invasion of less
than 3
millimeters into
the cervix.
This procedure
usually
preserves one or
both ovaries
along with their
estrogen
production,
which is
important in
maintaining bone
strength.
Many women are
also treated
successfully for
invasive
cervical cancer
and live full,
productive
lives. According
to the American
Cancer Society,
a five-year
survival rate is
more than 90
percent when the
cancer is still
confined to the
cervix. Invasive
stage treatment
may involve;
Radical
Hysterectomy-
removal of the
cervix, uterus,
part of the
vagina and lymph
nodes in the
area. This is a
standard
surgical
treatment when
there's an
invasion of
greater than 3
mm into the
cervix and no
evidence of
tumors on the
walls of the
pelvis.
Radical
Trachelectomy-
removing the
cervix and the
lower part of
the uterus.
Enough of the
uterus is left
in place that so
that a child is
still able to be
carried. Lymph
nodes in the
pelvis are also
removed during
this procedure
to determine
whether the
cancer has
spread.
Radiation- is
high-energy rays
that shrink
tumors by
killing the
cancer cells.
The radiation
destroys the
ability of
cancer cells to
reproduce.
Pre-menopausal
women will
experience
menopause
because their
ovarian
functions are
destroyed by the
radiation.
Chemotherapy- is
an anti-cancer
drug that enters
the bloodstream
and travel
throughout the
entire body.
Chemotherapy
enhances the
effects of
radiation in the
treatment of
cervical cancer.
Hycamtin- the
new, 2006, Food
and Drug
Administration
(FDA) approved
drug, is the
first medication
to treat
cervical cancer
that's unlikely
to respond to
surgery or
radiation
therapy.
Hycamtin is used
in combination
with
chemotherapy.
What Can You Do
To Prevent
Cervical Cancer?
HPV can spread
through
skin-to-skin
contact with any
infected part of
the body. The
best ways to
prevent HPV and
Cervical Cancer
without the help
of a doctor are
to;
Delay the first
time having
intercourse
Use a condom
Limit your
number of sexual
partners
Avoid smoking
* Regular Pap
Tests
Routine Pap
tests are the
most effective
way to detect
cervical cancer
in the earliest
stages. Work
with your doctor
to determine the
best schedule
for Pap tests.
Current
guidelines
suggest an
initial Pap test
should be within
three years of
when you begin
having sex or at
age 21,
whichever comes
first. From ages
21 to 29, a
regular Pap Test
every year or a
liquid-based
test every two
years. From ages
30 to 69, a
regular Pap test
every two years
or a
liquid-based
test every three
years if you've
had three normal
Pap tests in a
row.
* Cervical
Cancer Vaccine
According to
Gardasil’s
website,
“Gardasil offers
protection from
the most
dangerous types
of HPV. Gardasil
is the only
vaccine that may
help guard
against diseases
caused by HPV
Types 16 and 18,
which cause 70%
of cervical
cancer cases,
and HPV Types 6
and 11, which
cause 90% of
genital warts
cases.” The drug
has proven to be
remarkably safe.
The national
Advisory
Committee on
Immunization
Practices
recommends
routine
vaccination for
girls as young
as ages 9 to 12.
A “catch up”
immunization is
recommended for
woman ages 13 to
26. Similar to
the Chicken Pox
shot, the
cervical cancer
vaccine is
already part of
a childhood
vaccination
schedule.
According to
their press
release, “The
price for
Gardasil has not
been finalized,
however the cost
will be approx.
$400 for the 3
doses of
Gardasil
required to
complete the
vaccination
course.”
The vaccine is
most effective
if given to
girls before
they become
sexually active.
Gardasil is
given as 3
injections over
6 months.
Although the
vaccine could
prevent up to 70
percent of
cervical cancer
cases, it can't
prevent
infection with
every virus that
causes cervical
cancer.
Is There
Anything Else I
Should Know?
HPV and Cervical
Cancer can be a
scary thing to
face by
yourself.
Thankfully, in
Kristell’s case,
her family has
been very
supportive, her
husband
especially. “He
is in Iraq right
now, so he can't
be here
physically to
help me get
through all of
this, but he has
been a great
emotional
support.”
Kristell
advises, beside
from taking all
the proper
physical
precautions,
“Definitely
educate
yourself. Talk
to doctors or go
online. Now that
I have educated
myself a little
bit more, I feel
more at ease
with knowing
that I can be
successfully
treated. You
just feel better
knowing you have
all the
facts.” ~
Want To Know
More?
Advisory
Committee on
Immunization
Practices-
http://www.cdc.gov/nip/acip/
American Cancer
Society-
http://www.cancer.org/docroot/home/index.asp
Gardasil -
http://www.gardasil.com/
Mayo Clinic-
http://www.mayoclinic.com/health/cervical-cancer/DS00167
