Transcript What is Cervical Cancer?

Cervical Cancer and it’s Prevention
Our Topics For Today
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What is a Cervix?
What is Cervical Cancer?
Why is it important?
What causes it?
What are the symptoms of Cervical Cancer?
How is it treated?
Related diseases
How can you protect yourself?
What you should know about screening
What you should know about vaccination
What is a Cervix?
What is cancer?
Normal:
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Normal cells multiply all the time
Old cells die and fall off
New, completely formed, mature cells replace them
They take over the regular function
Cancer…..normal gone berserk:
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Normal mechanism can be disturbed by many factors
(ex: virus, chemicals in Tobacco, repeated damage)
Cancer cells are abnormal cells which multiply too fast
Old cells refuse to die
New cells don’t mature but keep growing – become a
bulk called “tumour”
Cannot function normally and start competing with the
normal cells
Can spread and grow anywhere else in the body and
choke off the normal cells (ex: brain, lungs, liver)
What is Cervical Cancer?
• Cancer that affects the “mouth” of the uterus
What does Cervical Cancer look
like?
What the doctors see at each stage
An actual photograph
What causes Cervical Cancer?
• A virus
HPV
(Human Papilloma Virus)
The 4 most important types of
HPV
HPV 16
HPV 18
>75% of Cervical Cancer5,6
>50% of Vaginal & Vulvar Cancer5
HPV 6
HPV 11
90% of Anogenital warts5
1.Schiffman M, Castle PE. Arch Pathol Lab Med. 2003;127:930–934. 2. Wiley DJ, Douglas J, Beutner K, et al. Clin Infect Dis. 2002;35(suppl 2):S210–S224. 3. Muñoz N, Bosch FX, Castellsagué X, et al. Int J
Cancer. 2004;111:278–285. Reprinted from J Virol. 1994;68:4503–4505 with permission from the American Society for Microbiology Journals Department. 4. Walboomers JM, Jacobs MV, Manos MM, et al. J
Pathol. 1999;189:12–19. 5. X. Castellsagué, S. de Sanjose, T. Aguado, K. S. Louie, L. Bruni, J.Muñoz, M. Diaz, K. Irwin, M. Gacic, O. Beauvais, G. Albero, E. Ferrer, S. Byrne,F. X. Bosch. HPV and Cervical
Cancer in the World. 2007 Report. WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). Available at: www.who.int/hpvcentre6. Bhatla N et al.Vaccine (2008;26; 2811-17
HPV infections – what you
should know
• Large number of women get HPV infection sometime
during life time (80% by the age of 50).
• There are no symptoms – you may not know you have it
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Majority would clear infection without developing any
disease.
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Few women develop precancerous lesions and cervical
cancer over a period of time (few months to 9 years).
• We don’t know which ones will!
Why is Cervical Cancer
important to you?
> 200 women die every day in India
Cervical Cancer is the
commonest cancer in
Indian Women
8 women die every hour
1 woman every 7 minutes
Why is Cervical Cancer
important to you?
India makes up only 16% of the world’s population
But has 27% of the world’s total cervical cancer cases and deaths every year
India - 27%
Rest of World - 73%
New cervical cancer cases
diagnosed annually
India : 1,32,082
World : 4,93,243
Deaths due to cervical
cancer annually
India : 74,118
World : 2,73,505
1. X. Castellsagué, S. de Sanjose, T. Aguado, K. S. Louie, L. Bruni, J.Muñoz, M. Diaz, K. Irwin, M. Gacic, O. Beauvais, G. Albero, E. Ferrer, S. Byrne, F. X. Bosch. HPV and
Cervical Cancer in the World. 2007 Report. WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). Available at: www.who.int/hpvcentre
Far more common than other
cancers in Indian women
1. X. Castellsagué, S. de Sanjose, T. Aguado, K. S. Louie, L. Bruni, J.Muñoz, M. Diaz, K. Irwin, M. Gacic, O. Beauvais, G. Albero, E. Ferrer, S. Byrne, F. X. Bosch. HPV and
Cervical Cancer in the World. 2007 Report. WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). Available at: www.who.int/hpvcentre
What are the Symptoms of
Cervical Cancer?
• Usually no symptoms in early
stage
• When advanced, there can be the
following symptoms:
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A little bleeding between periods
Bleeding after sexual intercourse
Abnormal vaginal discharge
Sometimes – pain
• During intercourse
• Continuous
• Low back-ache
• Unexplained loss of weight
• Pail face and nails (anemia)
How is Cervical Cancer
Treated?
• Treatment options depend on the following:
• The stage of the cancer.
• The size of the tumor.
• Your age.
• Your desire to have children.
Early Stage Cervical Cancer
• Conservative treatment
(save the uterus and part of the
cervix)
• Burn the abnormal part of cervix
with electric current
(electro-cautery)
• Destroy the abnormal area by
freezing it
(cold co-agulation)
•Excellent chance of saving life
•Can have babies
(may have some difficulty)
Later Stage of Cervical Cancer
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Surgery
1. Medium spread of cancer –
remove uterus with cervix,
tubes and ovary
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Good chance of survival
Can’t have babies
2. Late Stage
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Extensive surgery
removing other parts of the
body as well
Needs radiation therapy
and chemotherapy
Chances of survival vary
Related Diseases
• HPV causes other diseases:
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Vaginal pre-cancer
Vaginal cancer
Vulva pre-cancer
Vulvar pre-cancer
Genital Warts
vulva
Percentage
Genital Warts are on the rise in
India
20
18
16
14
12
10
8
6
4
2
0
18%
11%
10.5%
6%
1990-93
1994-97
1998-01
Study Period
*Ray K et al, Indian J Med Res 2006; 124: 559-568 – Population studied – STD clinic OPDs
2002-04
How can you protect yourself?
Awareness
Vaccination
Screening
What you should know about
screening: “PAP’s smear”
Simple, quick painless procedure – takes 5 minutes
How is it done?
A smooth, sterilized instrument is
gently inserted to see the cervix
A small spatula or brush is swiped
across the cervix to loosen cells
The brush is smeared on a clean
glass slide
The slide is later examined by an
expert to spot abnormal cells
•This test should be done every
year after onset of sexual
relationship till the age of 64
•Should be done within 10 days
of the end of your period
What you should know about
vaccination
• Vaccination is the only true form of
“prevention” – stops the disease
from happening in the first place
• There are two vaccines available
today:
• Quadrivalent (“four type”)
• Protects from 6,11,16,18
• Partial protection from 33, 35, 41 and
7 other types
• Bivalent (“two type”)
• Protects from 16, 18
• Partial protection from 33, 35 and 41
What you should know about
vaccination
• How does the vaccine work?
It gets your body to produce antibodies
against the HPV virus. These antibodies
protect your body from an HPV infection by
fighting the virus when it tries to attack the
cervix.
• Who should take the vaccine and when?
Ideally, the vaccine should be taken as early
as possible after the age of 9 years but girls
and women of any age up to 45 can benefit
from this vaccine.
Expectant mothers should not take the
vaccine during their pregnancy.
What you should know about
vaccination
• What is the dose schedule of the vaccine?
The quadrivalent vaccine is given in three doses as follows:
Now
2 mths
6 mths
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In special cases ( ex: impending marriage or travel, planning a pregnancy soon etc.), the
doctor can "abbreviate" the schedule to 0,1 and 4 months.
The bivalent is given in a similar schedule at 0,1 and 6 months.
• How soon will the protection work?
Usually, the full protection comes into effect usually within a month of the last dose. It is
important to complete the schedule.
• How long will the protection last?
So far the data has shown that vaccinated women have been significantly protected from
the disease since they got the vaccine (8.5 yrs according to published data).There is a good
chance of life-long protection as well. Only time will tell.
This is being tracked worldwide till we know for sure when people would need a booster, if
at all.
• What about side effects?
The vaccines have been studied and is safe and well tolerated.
What have you learnt today?
• Cervical Cancer is the most common cancer affecting
Indian women
• It is a preventable disease
• You can protect yourselves and your daughters and be
almost 100% safe with a combination of vaccination and
screening
Thank you
Please ask Questions