January is Cervical Health Awareness Month – a time to highlight issues related to cervical cancer, HPV disease and the importance of early detection. It’s also a time to celebrate all of the wonderful progress that has been made in the United States over the last four decades to diagnose, prevent and treat the disease. Cervical cancer is now almost 100% preventable and curable if detected early.
Cervical cancer is a slow-growing cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina), generally with no symptoms unless it has progressed to more advanced stages. It was once the leading cause of cancer death for women in the US, but has seen a dramatic decline in incidence and mortality rates because of regular screening programs, the cervical cancer vaccine and improved treatment options.
In the U.S., the cause of the majority of cervical cancers is linked to two particular high-risk types of the human papilloma virus (HPV), types 16 and 18. Since HPV is passed from person to person through sexual contact, most men and women will become infected at some point in their lives and fortunately most infections clear up on their own. But when a woman has a persistence of one of the high-risk HPV types and it causes pre-cancerous changes of the cervix, she may need treatment of these pre-cancer changes and closer follow-up with her doctor.
The single most important thing a woman can do is to have a regular Pap test as part of a routine pelvic exam. Not only does the Pap test identify cancer cells but also abnormal cells that are pre-cancerous and could lead to cervical cancer. Early detection means treatment, such as surgery, radiation therapy or chemotherapy, is more likely to be effective.
Vaccines have been developed in recent years to prevent acquiring the high-risk HPV infection, essentially stopping cervical cancer before even the first step can begin. The vaccines are recommended for girls, ages 11 and 12, allowing the immune system to be activated before a girl is likely to be exposed to HPV.
Researchers have also been developing surgical techniques to cure localized cancers while preserving as much normal tissue as possible. Dr. Peter Rossi and I are currently conducting a study at the Winship Cancer Institute of Emory University, researching how much actual radiation is delivered against cervical tumors. This type of “GPS” for the body is being evaluated in order to deliver radiation more accurately and targeted directly to the cancerous tissue. If successful, the effectiveness of radiation treatment may be improved and more importantly, unwanted side effects may be reduced.
Any woman can get cervical cancer, but it occurs more often in African-American and Hispanic women than in non-Hispanic white women. Those who are most at risk for the disease, though, are women who do not have regular checkups that include Pap tests. So, talk to your doctor today and schedule a Pap test. It could save your life.
Dr. Makhija is Director Gynecologic Oncology and Associate Professor of Gynecology and Obstetrics. Her research interests include chemo-resistance in ovarian cancer and the development of novel, targeted therapeutics including monoclonal antibodies and gene therapies for ovarian cancer. Additional research interests include the extension of cervical cancer clinical trials to under-served women, particularly in India, as well as education and participation in the HIV Prevention Trials Network. She has published numerous peer-reviewed scientific papers and review articles in journals such as International Journal of Oncology, American Journal of Obstetrics and Gynecology, Oncogene, and Women’s Oncology Review.