Tuesday, 9 August 2016

Women with multiple sex partners at higher risk of cervical cancer- Dr. Okunade

Cancer is a disease dreaded by many people, it comes in different forms to cause not only untold physiological hardships, but also costs millions of Naira in management and treatment, depending on how long it takes to get cured.

In some cases despite the huge amount of money spent, the patient may never get cured. Dr. Kehinde Okunade. The World Health Organisation, WHO, 2014 report, states that  about 2.083 people have died of cancer in Nigeria; there are 100,000 new cases of cancer annually, with about 80,000 people succumbing to the disease. Cervical cancer is one of the commonest cancers and the second leading cause of death in Nigerian women. Currently, reports show that the dreaded disease is ravaging many women across the country.

Good Health Weekly spoke to Dr. Kehinde Okunade, a Consultant Oncologist at the Lagos University Teaching Hospital (LUTH) shortly after a free screening programme in Lagos recently.  Okunade who is also the Project Director, Cervical Cancer Programme of Sebeccly Cancer care and Support centre, said regular screening has saved many lives from cervical cancer  gave reasons why women who have persistent HPV infection are at higher risk.  

Excerpts: What is cervical cancer? First, let me start by explaining what the cervix is. The cervix is the lower part of the uterus (womb) in the human female reproductive system (neck of the womb).  Cervical cancer is the most common gynaecological cancer and a leading cause of cancer deaths among women in Nigeria.

It starts with disorders  abnormal growth of the cells of the cervix.  These abnormal cells then turn into cancer and the change normally takes between 10 and 15 years. The main cause of cervical cancer is persistent infection with genital Human Papillomavirus, (HPV).  Genital HPV is a virus that is spread by sexual intercourse.

There are many different types of HPV – up to 150.  Certain “high-risk” HPV types can cause cell changes and cervical cancer. How common is the virus? Unfortunately, most men and women who have had sex have been exposed to HPV.  

At least 80 percent of most sexually active women have been exposed to HPV by age 50.  A person could have been infected with HPV years ago but only recently had it confirmed in a test.   Out of ignorance, people believe that you can only get cervical cancer when you are promiscuous. But that is not true. However, HPV is not a sign of unfaithfulness. It is not possible to know when you got HPV or who gave it to you.   You may have had HPV for many years before it shows up. Anyone who has ever had sex is at risk of acquiring HPV.

Again, anyone who has had more than one sex partner and anyone whose sex partners have had more than one sex partner are at higher risk for HPV. Also, having HPV does not mean you will get cancer. Most people get HPV infection, but very few get cervical cancer.  This is because in most cases, HPV infection goes away on its own. Sometimes, the HPV infection does not go away after many years. This type is called persistent and can lead to cervical cancer. Those at risk Women who have persistent HPV infection and who smoke have multiple sexual partners, women who do not follow up with testing or treatment after an abnormal Pap test and women who are HIV positive are at risk of cervical cancer.

Also, women who had transplanted organs, women on steroid medications and on chemotherapy are also at risk of cervical cancer. Prevention To prevent cervical cancer, it is important for women to limit the number of sex partners they have. It is also important for women to choose a sex partner who has had none or few prior sex partners.  Keeping a healthy diet and lifestyle is important.

There is also the  need for women to protect themselves during sex. For instance, the use of condoms consistently and correctly during sexual activity. It is also important for women to get regular screening (Pap smear) and follow up, if necessary.

Mothers should also ensure that their girl child is vaccinated with HPV vaccine by the age 9 to 26 years.  Also HPV DNA test can find “high-risk” HPV types.   You can prevent cervical cancer with screening.  Screening is the search for diseases, such as cancer, in people without symptoms.  Cervical cancer is the easiest female cancer to prevent through screening and it has saved thousands of lives. There are various types of screening for cervical cancer.

These include; cervical cytology (standard), Pap smear, Liquid based cytology (LBC), Human papillomavirus (HPV) testing, visual inspection with – acetic acid (VIA) and lugols iodine (VILI) amongst others. In the case of Pap test, a woman should do her first test three years after she had her first sex and no later than age 21 and she will continue with the test every three to five years till age 65. Burden of cervical cancer Worldwide, over 500,000 new cases are seen yearly with over 80 percent of them being from the developing countries.  Out of the estimated 14,550 women who are diagnosed with the disease in Nigeria annually, 9,659 will die from it.

Soap and genital washing Soap kills the natural fauna and flora, thereby exposing the female genitals to harmful germs, and the vagina won’t be able to readily fight back. Women should stop using soap to wash their vagina because it disturbs the natural flora of the female genitals, thereby compromising its natural defense mechanism.  Douching can change the necessary balance of vaginal flora (bacteria that live in the vagina) and natural acidity in a healthy vagina. A healthy vagina has good and harmful bacteria. The balance of bacteria helps maintain an acidic environment. The acidic environment protects the vagina from infections or irritation.


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