For a disease that takes up to at least ten years before any symptoms show up, cervical cancer usually goes undetected until it’s too late.
Over 90 percent of cervical cancer cases are contracted sexually and over 50 percent of the cervical cancer patients who are recorded, succumb to the disease. A frightening reality for a disease that mercilessly and silently kills our mothers, sisters and daughters.
Woman magazine caught up with the Chairperson of Tanzania Association of Women Doctors better known as MEWATA, Dr Serafina Mkuwa who explained that the only existing statistics on cervical cancer cases are only those from hospitals.
In 2010 out of the 6,200 cervical cancer patients 4,000 died. Almost 30 percent of the cancer cases brought to the Ocean Road Cancer Institute are cervical.
It was against this background that MEWATA decided years ago to propel a campaign to create awareness of cervical cancer together with breast cancer and encourage more women to go for cervical screening.
A voluntary role played by members, Dr Mkuwa says, “As women it is easier for us to appeal to fellow women who find it easier to open up to female doctors.” She further went on to say that the women specifically want to be examined by female doctors who are not too young.
This year as part of the commemoration of Women’s Day, MEWATA is headed for Mwanza where they will conduct mass education and screening tests on March 8th and 9th. Back to basics, Woman magazine asked Dr Mkuwa to explain in lay man’s language what cervical cancer is. She explained that it is a cancer that affects the opening of the cervix.
The cancer causes a change in the cells around the cervix. The cervix is the organ that connects the uterus and vagina. A slow growing cancer symptoms may not show until ten years after contracting the disease that is mainly caused by the human papilloma virus (HPV) infection that is ironically got from men.
Other high risk factors include Human Immunodeficiency Virus (HIV), the virus that causes AIDS, damaging the immune system putting women at higher risk for HPV infections. The immune system is important in destroying cancer cells and slowing their growth and spread.
In women with HIV, a cervical pre-cancer might develop into an invasive cancer faster than it normally would. According to Dr Mkuwa women who have AIDS are four times likely to contract cervical cancer and are required to go for annual screening annually.
Symptoms of cervical cancer include pain during sexual intercourse, abnormal spotting (bleeding) vaginal discharge that may have a foul smell, lower abdominal or back pain and anemia. If a woman over the age of 30 years has any of the above mentioned symptoms it could be a sign of cervical cancer.
The aim to have screenings done before the symptoms pop up. Dr Mkuwa says this is the difficult part as most people see no reason to see a doctor when they are not feeling well.
Asked what is the reaction first reaction from women after they are sensitised on cervical cancer Dr Mkuwa says that for many the information is an eye opener while the older women are relieved that they can finally talk about the symptoms they are undergoing.
She elaborated that older women find it disturbing explain to medical personnel, issues concerning their reproductive health as they do not want to be labeled as promiscuous so they would rather suffer in silence until it is too late. So what does a cervical screening involve?
Well for starters a woman has to be comfortable enough to take off her underclothes for the physical examination so that the medical personnel may look at the cervix. With the use of forceps and ascetic acid the medical personnel will be able to detect the presence of lack of lesions around the cervix.
Screening tests look for pre-cancerous changes in the cervix that could develop into cervical cancer. If the abnormal tissue or cells can be removed, then the disease can be prevented from developing and causing problems. The tests can also diagnose the disease by identifying cancer cells that are already present.
Every woman between the ages of 30 and 50 should go for cervical screening. Below the age of 30 it is difficult to detect the precancerous cells. Women are encouraged to check at the nearest public hospital for the service. The other option is to go to private facility if funds allows.
An alternative test is the pap smear which is more costly. To reduce the risk of contracting cervical cancer women are advised to practice safe sex. Reduce the number of sexual partners and where possible avoid sexual partners who in turn have many partners.
Another prevention method is the HPV vaccine which has to be given to girls around the time of puberty. The vaccine is given out in three doses over a period of three months. Given too early or too late the vaccine is rendered ineffective.
In the absence of screening programmes, a woman’s risk of cervical cancer may depend less on her own sexual behaviour than on that of her husband or other male partners. Men should practice safe sex and stick to one faithful partner.
Men should encourage the women in their lives be they partners, family members or friends to go for cervical screening. Not working alone, MEWATA has a number of partners they collaborate with in creating awareness of cervical cancer in the country.
One partner is TMARC that has a project to screen 10,000 women in Iringa by working closely with community and faith based organisations. Other partners include the Ministry of Health and Social Welfare, WAMA, Marie Stopes, THPS and many more.
On the whole the prevention of cervical cancer requires the cooperation of men and the courage to go for screening.