Cervical Cancer Can Be Treated If Discovered Early

By Melati Mohd Ariff This is the final of three features on cervical cancer, the third most common malignancy in Malaysian women after breast and colon cancer. KUALA LUMPUR, Oct 4 (Bernama) -- Across the globe, one woman succumbs to cervical cancer in every two minutes while in the Asia-Pacific region, the fatality rate of this disease is one woman for every four minutes. According to Dr Dalilah Kamaruddin from the National Cancer Society of Malaysia (MCSM), cancer of the cervix is the third most common cancer affecting women in Malaysia. Dr Dalilah is the head /medical officer of NCSM's Women's Cancer Detection Centre (above). According to her, public awareness on cancer of the cervix is still low, particularly that of women, which is at about half on the scale of 1-10. AWARENESS Speaking to Bernama at the NCSM office here, she said that the awareness level among Malays is still relatively low as compared to other communities. Dr Dalilah also shared her experience during a talk on cervical cancer at a secondary school that involved form four and five students. Ironically, it were the boys who asked the most questions during the talk while the girls refrained from doing so, only to ask questions after the session ended. Dr Dalilah said that it was the same when the talk was held in a college, where the male students were the ones asking questions. Citing examples, Dr Dalilah spoke of an unmarried 25 year old Chinese patient, who wanted to go for a pap smear test due to regular sexual activity and wanted to protect herself from contracting cervical cancer. She also spoke of a 27 year old Malay woman who agreed to the pap smear test due to her sexual relations. Overall, those aged in their 20s and 30s are easier to be advised as compared to women in their 40s. "Women in the older age bracket think that since they are no longer sexually active, they are safe but they forget that the infection could have been contracted 10 years earlier," she said. CERVICAL CANCER Cervical cancer can afflict any woman, regardless of age or background. Dr Dalilah said that this cancer can start in the cervix - uterus and ovary and if not treated early, can have grave consequences. Cancer of the cervix is caused by the Human Papillomavirus (HPV) of which there are 100 types, most of which are harmless. Out of these, 15 can cause cervical cancer - including types 16, 18, 45 and 31. "Seventy per cent of cervical cancer cases are caused by the HPV type 16 and 18," she said, adding that cancer cases in Malaysia pointed out that women in their 30s were prone to the cancer. "The average age where people have sexual relations is 15-20 years old and this virus can be dormant in our body for up to 10 years before becoming active. "That is why we see such cases occurring in women in their 30s. However, there are even instances of women aged 65 years, who have contracted cervical cancer. SPREAD OF INFECTION Dr Dalilah said that many women had the wrong perception that the virus only spread through sexual contact, but it can also spread by skin contact, and use of dirty underwear and surgical gloves. During delivery, a baby can also be infected if the forceps used have been contaminated by the virus. A woman with multiple sex partners is also susceptible to the virus, as are those with low body immunity such as HIV patients. Speaking of warning signs, Dr Dalilah said that pain and bleeding, particularly while having sexual intercourse or urination are signs that a woman could be suffering from cervical cancer. Among other signs are pain in the lower back, leg or pelvis. Bleeding signs should be heeded when it happens outside of the menstrual cycle or if there is bleeding in the vagina during sexual intercourse. "Women who are with menopause also are at risk to cervical cancer," she said. PREVENTION Dr Dalilah emphasised on 'prevention being better than cure'. She said that the main prevention of cervical cancer is through vaccination and getting the pap smear test done. Elaborating vaccination procedures she said that there is a programme run by the Malaysian health authorities for girls aged 13 years and the vaccine can be taken by women as old as 45 years. Citing her own example, she said that she administered the vaccine to a nine year old girl and 57 year old woman. According to her, the vaccine given to the young can provide 100 per cent protection as their immunity is strong. So far, there have been no side effects to the vaccine or its administration and it can be taken in three doses within six months and the cost for each dose is RM200-RM280 (US$1 = RM3.06). PAP SMEAR However, many women are not happy with the most effective manner to detect cervical cancer. The pap smear test involves the examination of the cervix via the vagina and is a cause of embarrassment to many women. The test was introduced in Malaysia in the 1970s to detect abnormal growth of cells in the cervix. "Many are unclear with the pap smear test. One reason, they are shy as it involves the inspection of the vagina and secondly, there is a lackadaisical attitude. Lastly, denial, as many feel that the chances of them being diagnosed with cervical cancer are remote. "Anyhow, nobody likes to talk about it either to friends or family," she said. As for detections, Dr Dalilah said that out of 200 pap smear tests, only one or two reveal abnormal growth of cells. There are voluntary takers for the test but there are also those women who are need convincing when they come in for mammogram examinations. According to Dr Dalilah, almost 80 per cent who come to the NCSM are Chinese and most of them are in their 30s. REASONS But are there any additional reasons for shying away from the test? One of the most common reasons cited is that it is too ‘costly’. Generally the cost to treat a patient with cervical cancer can be as high as US$163,604 (RM500,000). "People find it hard to pay for the vaccination but do not mind paying for new mobile phones," lamented Dr Dalilah on the attitude of women towards the threat of cervical cancer. "If you want to save money, then start having the vaccination now". Some even chose to be ignorant as they believe knowledge would only lead them to worry. She also said there are parents who refuse to allow their daughters to get the free vaccination. Surprisingly, there is a high instance of such cases in urban areas while parents in rural areas have not created such problems. "Then, there are those who bring home the forms but fail to ask for their parents’ signature," she added. Advising women across all segments and ages, Dr Dalilah feels that they should take the test and vaccination as insurance for themselves and their families. -- BERNAMA