By Dave Warner
Hope and progress mixed with the grim reality of a still possibly fatal disease come together when you consider cervical cancer.
Fact one: The death rate and incidence of the cervical cancer dropped by some 60 percent after the development of the Pap smear in the 1950s.
Fact two: Human papillomavirus (HPV) is the main cause of cervical cancer. The development of a HPV vaccine promises to spare many in the next generation of women from the agony of the disease; although the shots became controversial as they entered the political arena in 2011.
Fact three: Experts predicted that some 12,000 women in America would be diagnosed with the disease in 2011, with 4,000 of them expected to die from it.
Beyond these hard facts are human pain and gripping personal stories.
Meet Tamika Felder, 36, of the Washington D.C. metro area, a 10-year cervical cancer survivor who runs her own Web site devoted to providing information on the disease.
Her journey began in 2001 when she went to a doctor for a boil under her arm, which led to a physical, which led to a Pap smear.
“I got the shock of my life: a diagnosis of cervical cancer,” she writes on her site.
“Cervical cancer came in and changed everything.”
“I was thinking about the end of my life, with my hopes wishes and dreams not yet fulfilled,” she writes. “At this early stage in my life I could only think, ‘This is it?’”
She received the treatment trifecta – surgery, radiation and chemotherapy. All of that ended with her being cancer free.
The two types of vaccines to combat HPV – Cervarix and Gardasil – protect against most, but not all of the HPV types that cause cervical cancer. This is the same for genital warts, where Gardasil is used. These vaccines only provide protection if given before exposure to HPV, which is why the recommendations call for giving the vaccine to 11-12 year old boys and girls. Obviously, this is a topic of some controversy. In the meantime, it is important to know the numbers: the vaccines will protect against about 70 percent of cervical cancer HPVs and Gardasil will protect against 90 percent of genital wart virus.
Some things to know about all of this:
- Most people have been exposed to HPV at some point, but most of those infections clear up on their own.
- Smoking slightly increases the risk for women.
- Your risk is greater if your immune system is not hitting on all cylinders.
- Women who have had many sexual partners have a higher risk, as are women who have sex with men who have had many partners.
- Long term use of birth control pills – more than 5 years – slightly increases the risk.
- Having more than 5 children can also increase risk.
Getting your Pap smear is especially important because cervical cancer in the early stage tends to have no symptoms.
As the disease progresses you may notice abnormal vaginal bleeding, sometimes between your menstrual cycle, sometimes after intercourse, or sometimes after menopause. Pain in your pelvis or pain during sex can also be symptoms.
As was the case with Felder, you would have three possible treatments, or a combination of them – surgery, radiation and chemotherapy.
Surgical options can vary in degree, depending on how far the cancer cells have spread. Radiation is used in some early-stage cases or after surgery to make sure all cancer cells are killed. And chemotherapy is often used in combination with radiation.
Felder has seen all of that, and offers this advice to women:
“Really read the information, have a conversation with your doctor.”
“Today I’m cancer free and enjoying life,” she writes. “I know that one day women will stop dying of cervical cancer.”
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