lay slides sept 08

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What every woman should know about Cervical Cancer let's talk girl!

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In the Philippines, every 8 minutes, a Filipina dies of cervical cancer.

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What is CERVICAL CANCER? Cervical cancer is a cancer affecting women. It develops in the cervix, the entrance between the vagina and the uterus.

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What is CERVICAL CANCER? Cervical cancer occurs when normal cells in the cervix change into cancer cells.

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Normal Cervix Cervical Cancer What is CERVICAL CANCER?

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Is CERVICAL CANCER a Global Concern? Cervical Cancer is the second most common cancer affecting women worldwide 1 , 500,000 women are diagnosed with cervical cancer each year. 2 Worldwide, every 2 minutes, a woman dies of cervical cancer. 2 1. Franco E et al. Vaccine Vol. 23 2005 2. Ferlay J et al. Vaccine Vol 23 2005

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Quality of life is diminished among women with cervical cancer due to: severe emotional distress anxiety physical impairments diminished sexual response relationship problems

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What is the burden of Cervical Cancer in the Philippines? Cervical cancer is the 2 nd most common cancer among filipino women It is also the 2 nd -highest killer cancer in women. 1 Incidence starts rising steeply at age 35. 2 affecting “ Pinay” at the prime of their lives. 1. Ferlay J et al. Globocan 2002. IARC 2004 2. Philippine Cancer Facts and Estimates

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What is the burden of Cervical Cancer in the Philippines? In the Philippines, it is usually diagnosed late 56% of Filipino women with Cervical Cancer will die within 5 yrs

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What causes Cervical Cancer? Cervical cancer is caused by Human Papilloma Virus (HPV). 1 1. Munoz N. et al. N Engl J Med 2003; 348:518-27

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What else do I need to know about HPV? 1. Munoz N. et al. N Engl J Med 2003; 348:518-27 HPV is a very common virus and is easily transmitted It is resistant to heat and desiccation

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Human Papilloma Virus (HPV) can be easily transmitted You can get it through skin-to-skin (rubbing) genital contact 1 : Even without sexual penetration 2-3 . - oral - manual etc. Condoms may reduce the risk but are not fully protective 1 . Even dead cells shed during intercourse can contain HPV and remain infective for days 4 . McIntosh N. Human Papilloma Virus and cervical cancer, JHPIEGO 2000 Gravit PR et al. Infect Dis Clin North Am 2005; 19:439-58; Winer RL et al . Am J Epidemiol 2003;157:218-26 4. Roden R et al. Jinfect Dis 1997;176:1076-9 Non-sexual routes via fomites can also occur 4 (prolonged exposure to shared contaminated clothing)

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There are many types of HPV but only cancer-causing strains could lead to cervical cancer 1. Munoz N. et al. N Engl J Med 2003; 348:518-27 Worldwide, HPV strains 16,18 , and 45 and 31 together account for more than 80% of Cervical Cancer. 1 Can all HPV cause Cervical Cancer?

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What are the risk factors? If your body has cancer-causing HPV strains, the following may increase your risk in developing cervical cancer: Young age at sexual debut High number of pregnancies Smoking (current) Long-term use of oral contraceptives Sexually transmitted infections

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What are the signs that I should look out for if I have cervical cancer? Early cervical cancer generally produces NO signs or symptoms .

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What are the signs I should look out for if I have cervical cancer? As the cancer progresses , these signs and symptoms may appear: Vaginal bleeding after intercourse, between periods or after menopause Watery, bloody vaginal discharge that may be heavy and have a foul odor Pelvic pain or pain during intercourse

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Who is at risk? Every woman is at risk.

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Why is everyone at risk? Up to 80 percent of women will acquire an HPV infection in their lifetime. - 50 percent of these women will be infected with cancer-causing types While infections clear-up naturally in most women, we do not know which of these women will develop persistence that may lead to the development of cervical cancer . Unlike other viral infections (measles, chickenpox), past infection with HPV will not protect you from future re-infections. The older a woman gets , the higher her risk of persistent HPV infection (one that does not go away on its own) 1. Baseman JG et al. J Clin Virol 2005; 32 Suppl 1; S1624; 2. Ho GY et al. N Engl J Med 1998; 338: 423–8; 3. Brown DR et al. J Infect Dis 2005; 191: 182–92; 4. Bosch FX et al . J Natl Cancer Inst Monogr 2003; 313; .

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How is cervical cancer detected? Regular screening can detect pre-cancerous lesions thru either: PAP smear Visual inspection with acetic acid However, screening DOES NOT prevent Cervical Cancer 1. Sankaranarayanan et al Int J Gynaecol Obstet 2005; 89 Suppl 2: S4-S12

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When to get a PAP smear? Begin testing about 3 years after start of sexual activity. Get a Pap Smear every year until age 30. After age 30, women who have had 3 consecutive normal results on annual Pap smear can be re screened every 2 to 3 years. Screening may be done if the woman has abnormal vaginal bleeding, pain, sores, or itching. 1. National Cancer Institute. Screening for cervical cancer. 2005. The risk of developing Cervical Cancer is 5 times higher in women who are not regularly screened. 1

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How is cervical cancer treated? Cervical cancer management may involve: Surgery Radiotherapy Chemotherapy Rehabilitation Palliative care Advanced cervical cancer that involves neighbouring organs is difficult to treat and has a high mortality rate.

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How do we prevent Cervical Cancer? Can we do something to prevent cervical cancer? Secondary Prevention Cervical screening Early detection and treatment of HPV-associated pre-cancerous lesions Primary Prevention Lifetime mutual monogamy Vaccination to prevent the initial HPV infection

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How do we prevent Cervical Cancer? It is important to get all 3 doses to ensure maximum effectiveness How is cervical cancer vaccine administered and what is the schedule? 3 Doses Vaccination Schedule: 0, 1, 6 , months It is injected intramuscularly in the deltoid area (upper arm)

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How do we prevent Cervical Cancer? What are the adverse effects that I might experience after getting the shot? The vaccine causes no serious side effects. The most common side effect is pain at the injection site, in others it might be redness or swelling. These adverse effects are temporary and may last only for 2 to 3 days.

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How do we prevent Cervical Cancer? Do I need to re-start vaccination series if I miss my 2 nd or 3 rd dose? There is no need to re-start the vaccine series. If you miss the 2 nd dose, you may get the shot as soon as you remember and get your 3 rd dose after 12 weeks. If you miss the 3 rd dose, you may get the shot as soon as possible.

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How do we prevent Cervical Cancer? Can I be vaccinated if I have a cold or fever? Mild common illnesses (such as cold, diarrhea, upper respiratory infections) are not contraindications to vaccination.

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How do we prevent Cervical Cancer? Who should get cervical cancer vaccine? Young girls and older women 10 years old onwards Because all women are at risk.

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How do we prevent Cervical Cancer? In the Philippines, cervical cancer is the second most common cancer in women next to breast cancer. 2. Human Papilloma Virus is the necessary cause of cervical cancer. 3. Every woman is at risk of cervical cancer. 4. The virus is transmitted through genital skin to skin contact. Condoms do not offer full protection. 5. Vaccination alongside screening provides the best protection against cervical cancer. 6. Cervical cancer affects lives - not just of women afflicted by the disease but also her family’s as well. In Summary

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How do we prevent Cervical Cancer? Cervical cancer kills women. Cervical cancer is PREVENTABLE . Ask your doctor for the vaccine that can best protect you against cervical cancer. Thank you!

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