However the organisms emerged at first, higher organisms give birth only through fertilized eggs. There is lack of proper understanding of the uterus that carries the fertilized eggs and therefore we lose precious lives daily. Cervical cancer is one such disease related to uterus that causes death of millions of women in the world. Despite taking many precautionary measures to prevent cervical cancer the deaths due to it have been difficult to contain. One of the statistics states that ‘every day 200 women die of cervical cancer in India’. Hence, it has emerged as a serious health challenge in India. World Health Organization states that ‘worldwide 2,80,000 women die of cervical cancer every year’. Out of them 90% represent from poor and moderate countries.
Human Papilloma Virus, HPV is the important cause of cervical cancer. This virus spreads from the infected to the other easily during intercourse. Medical world states that there are more than 150 varieties of HPV. As per the World Health Organization, there are only two varieties that cause 70% of the cervical cancer.
Excess bleeding during menstruation or during intercourse
Excess pain during intercourse
Severe pain on hip, back and legs
Loss of body weight
Stages of cervical cancer
State 0: Thickening of the cervix region (this condition precedes cancer)
Stage I: Cancer at the mouth of cervix
Stage IA: Can be observed only through microscopy
Stage IA1: Tumor, spreading 3 millimeter deep, 7 mm or less than that in length
Stage IA2: Tumor, spreading 3-5 millimeter deep, 7 mm or less than that in length
Stage IB: Tumor, spreading more than 5 millimeter deep, more than 7 mm in length
Stage IB1: Tumor, spreading 4 centimeter or less than that in size
Stage IB2: Tumor, spreading more than 4 centimeter but not spreading to other parts
Stage II: Spreading from the mouth of cervix to other parts
Stage IIA: Spreading from the mouth of cervix to the neighboring tissues
Stage IIA1: Tumor, 4 centimeter or less than that in size. No tumors in the lymph nodes
Stage IIA2: Tumor, more than 4 centimeters. No tumors in the lymph nodes
Stage IIB: Tumor, spreading to parametrial area fully. But not spreading to other parts.
Stage III: Tumor, spreading to pelvic wall. This leads to inflammation of kidneys and dysfunction for some.
Stage IIIA: Tumor, spreading to fallopian tube, up to its third part but not to other parts.
Stage IIIB: Tumor, growing in the pelvic region. This leads to kidney dysfunction. It affects the lymph nodes as well. It can be of any size.
Stage IVA: Cancer spreading to bladder and colon but not to other parts.
Stage IVB: Cancer spreading to other parts of the body.
Do we have adequate awareness about the cervical cancer that has been killing millions of women? Doctors concern that the number of death has been increasing only due to lack of awareness about it. Has the government shows concern over this type of cancer?
There was an awareness campaign conducted on 8th February 2018 at the Government Medical College Hospital, Chennai, on cancer. The Health Minister, Vijayabaskar attended the campaign. He spoke that ‘PET scan centers will be established at the Government Medical College and Hospital, Chennai, and Madurai Rajaji Medical College and Hospital. Further, in the districts of Chennai, Kovai, Thirunelveli, Tanjore, Regional Cancer Centers will soon be established at the cost of 60 crores’.
Dr Shanmugavadivu, Obstetrics and Gynaecology expert, speaks about cervical cancer among women ‘Cervical cancer is mostly caused by intercourse. The virus, HPV is transferred from a male to a female during intercourse. The HPV will stick to the mouth of cervix, not allowing any injuries at the infected part, leading to cancer. It can be prevented if diagnosed at the early stages.
Its key symptom is white discharge. Prior to marriage there will be white discharges due to hormonal changes. But after marriage there the discharges will be thick, colored, and foul smelling. Cervical cancer cannot be detected through scanning. It can only be observed through eyes. Those women who come to me complaining hip pain and white discharge will be checked for cervical cancer at my clinic.
If there is bleeding during intercourse it should immediately be checked for cervical cancer. Bleeding is one of the important symptoms of it. Some women might experience pain during intercourse without bleeding. If it is so it should be diagnosed immediately. There are five different stages of cancer progress, from 0 to 4 with cervical cancer. If the stages are early it can be treated. There are vaccinations available against HPV infection. It can help in preventing the women from HPV. It is especially important to have vaccinated prior to marriage. There are three injections, second injection after one month of first injection and the third is six months after the second injection.
There are adequate instruments at the government hospitals to diagnose cervical cancer. But there are no adequate training imparted to the doctors to use those instruments. Further, hysterectomy is carried out as soon as cervical cancer is diagnosed even at the early stages. It’s wrong. Obstetrics and Gynecology doctors do not conduct surgeries of hysterectomy. Uterus is considered to be a child bearing machine. The women who underwent hysterectomy face many health problems including heart related diseases. Uterus is a very important organ for women. It is seriously wrong to remove uterus using inappropriate instruments. Cervical cancer can be cured without removing uterus. It is enough to remove only the affected part. The problem can be sorted out through laparoscopy. It’s my opinion that lady specialist doctors would not remove uterus without reason. Government should not provide insurance coverage for hysterectomy. Only when the government stops this provision doctors will seek for alternative ways of treating this cancer. Those who underwent surgical removal of cervical cancer should have three injections after the surgery. Dr Shanmugavadi stated that if there is increased awareness about it, then fatalities due to cervical cancer can be prevented.”
We discussed with an oncology specialist, Dr Saravanan who said, “It requires ten years for a woman to develop cervical cancer after being infected of HPV during intercourse. During these ten years there will be various changes taking place around the cervix. These changes can be read through Pap smear method and monitored. Therefore, before developing an infection into cancer the affected part can be removed. The surgery can be carried out through Loop and Leap method prior to development of cancer. We lose thousands of women due to lack of awareness about Pap Smear test. The vaccines, Cervarix and Gardasil will not protect one from cervical cancer completely. About 80% of this cancer can easily be cured by surgery at the early stages or radiation therapy. But there are no treatments at the late stages of this cancer. Radiation therapy, surgery and chemotherapy can be alternated for the advanced stages. But cure cannot be fully assured. The vaccines against this cancer are also expensive. This can be offered free like polio vaccine by the government. Then only it is possible to prevent deaths due to cervical cancer. Awareness can be created in rural areas so as to minimize deaths due to cervical cancer.”
(This article written in Tamil by Ilavarasan has been reproduced in English by V Amalan Stanley)