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Our Correspondent
Kohima, Sep. 2 (EMN): Cervical cancer is the second most prevalent cancer in the country, next to breast cancer, informed Dr. Nounenuo Terhase, consultant obstetrics and gynaecologist, at a webinar organised by the Family Planning Association of India, Nagaland branch on Wednesday.
She said that cervical cancer takes years for development, and if detected early, it is curable. She explained that some of the early signs and symptoms of the disease are chronic PH discharge, foul smell and abnormal vaginal discharge.
‘Whereas in the later stage, when the tumour becomes big and when the blood is just in front of the womb and the rectum just behind the womb, it comes with obstruction like having difficulty in passing urine, hematuria, rectal bleeding and lower abdominal pain,’ she explained.
She informed that in the late stage, ‘they can say that a patient has cervical cancer just by the appearance’. She added that the diagnosis of this disease can be done by Pap smear, and in a low research setting with no pathologist or doctor available, and visual inspection of the cervix with acetic acid (VIA) is practiced.
The doctor informed that the primary prevention of cervical cancer is through educating the public about safe sex and use of protection, ‘because condom not only prevents all the STDs, reproductive infections etc. but also prevents the HPV infection and cervical cancer in the long run’.
She also elucidated on how studies show that male circumcision decreases the chance of cervical cancer. She highlighted how the female children around 9-14 years of age are vaccinated with HPV infection, and if they have skipped this vaccination, then they can do a ‘catch-up vaccination’ till 26 years of age; and these vaccines are commercially available.
‘Secondary prevention is nothing but cleaning with Pap smear, VIA and HPV DNA and screening with those diagnostic tools and treatment of any pre-cancers lesions,’ she informed.
She also shared that ‘experts suggest all women who are 30 years of age to go for pap smear screening every three years till they are 65 years of age, and if they are to go for a Pap smear with HPV test, it can be done after every five years’.
Speaking about the management of pre-cancer stage, she said that if the Pap smear test result is abnormal then ‘we can send for HPV DNA testing, and if it is positive, we can go for colposcopy’.
‘We do colposcopy and if there is any abnormal lesion, we take the biopsy of the specimen and send for histopathological examinations; so this is how we do the management,’ she informed.
On treatment, she said that there are many treatment options if it is detected early. ‘We can just do cryotherapy, a procedure that freezes a section of the cervix using nitrogen gas to destroy the targeted area, and another one is we use excision of the abnormal cervix and also conisation of the disease,’ she explained.
‘Suppose the cancer is detected very early but stage 1a, then you can go for simple hysterectomy, but if you still want a baby then you do not have to remove the uterus but just remove the diseased cervix and you can be pregnant and have children but the delivery has to be by caesarean sections, and after delivering baby you can go for hysterectomy,’ she explained.
‘If the cancer is detected at stage II, then the womb and tissues nearby can be removed. And if the cancer is detected in very late stages and not fit for surgery then you have to go for chemotherapy and radiotherapy sessions,’ she added.