Cervical cancer kills over 274,000 each year worldwide and
is still one of the leading causes of death in Indonesian
women, and now we have a vaccine to prevent it! The cervical
cancer vaccine Gardasil, designed by Australian Doctor Ian
Frazer, has been approved by Australia’s Therapeutic
Goods Administration (TGA) for use on boys aged nine to 15
and girls aged nine to 26; while the US Food and Drug Administration
(FDA) has approved its use in girls and women aged from nine
to 26. Europe and the UK are now also using the vaccine; however
it has yet to be approved by the Indonesian authorities for
use here.
One of the leading causes of cervical cancer is the Human
Papilloma Virus or HPV (a sexually transmitted genital wart).
About 80 percent of sexually active women (and men) can expect
to have and HPV infection at some point in their lives.
Gardasil works against the sexually transmitted human papillomavirus
(HPV), which causes changes in cells that leads to cervical
cancer, it protects against cervical cancer caused by HPV
strains 6, 11, 16 and 18, and also against genital warts.
In worldwide clinical trials involving more than 20,000 mostly
sexually active women, Gardasil was 100 percent effective
in preventing cervical cancers, and 99 percent effective in
preventing two types of warts.
The vaccine is given in three doses over a period of 6 months.
So if you are thinking of getting your teenegers vaccinated
while you are oveseas, you may need to bring the 2 booster
doses back to Bali with you. (If this is the case I would
be more than happy to administer the follow on doses. Please
contact me on 081 2366 0000 for more info).
How else can we detect and prevent cervical cancer?
The best way to prevent cervical cancer (kanker leher rahim)
is by having regular Papanicolou (Pap) test. A Pap test can
detect viral infection (such as human papillomavirus) and
other cancer-causing conditions. Early treatment of these
conditions can stop cervical cancer before it fully develops.
A woman can have cervical cancer and not know it because she
may not have any symptoms.
The occurrence of cervical cancer has decreased because of
Pap test screening. Many women (millions) are found to have
abnormal Pap tests each year. Most of them are early stage
and are easily cured with a simple procedure.
Risks factors for cancer of the cervix
- Multiple sexual partners (or sexual partner who have had
multiple partners)
- Starting sexual intercourse at an early age
- Viral infection, such as human papillomavirus (HPV), human
immunodeficiency virus (HIV), or herpes simplex virus (HSV)
- Weakened immune system
- Previous cancer of the lower genital tract
- Smoking
When & how often should you have a PAP smear?
- Cervical cancer screening is recommended yearly strating
at age 18 years or when a woman becomes sexually active, if
younger than age 18.
- Less frequent screening is done if you have a negative Pap
test 3 years in a row, or if you are not sexually active.
- No upper age limit for screening exists, because the incidence
of cancer of the cervix increases with age. Most of these
cancers are diagnosed after age 50 years. Even after menopause,
a woman should continue to have regular Pap tests.
- If you have had your uterus removed, yearly screening should
be performed if there is a history of abnormal Pap tests or
other lower genital tract cancer.
- Same sex partners (Lesbians) also need regular PAP smears.
The best time to have a Pap test is when you are not menstruating.
If you feel more comfortable with a female doctor, you can
ask for one.
For 2 days before the test, avoid the following because these
might hide any abnormal cells.
- Intercourse
- Douches
- Vaginal medications (except as directed by your doctor)
- Vaginal contraceptives such as birth control foams, creams,
or jellies.
Pap smear should be done as part of a pelvic exam and should
be accompanied by a breast exam performed by your doctor.
It should only take a few minutes to perform a Pap smear.
PAP smears are available with me at my Kuta Poleng practice,
or you may prefer to go directly to the Prodia laboratory.
Although the Pap test is the best method of preventing cancer
or detecting it early, it is not prefect. Because even the
best labs can miss some cell changes, you should have the
test preformed yearly. If your Pap test is normal, you will
continue routine screening.
Early cervical pre-cancers or cancer often have no signs or
symptoms usually appear when the cancer is further along.
Report any of the following to your doctor right away :
- Unusual vaginal discharge
- Blood spots or light bleeding other than your normal
period
- Bleeding or pain during sex
These symptoms do not mean that you have cancer. They can
also be caused by other conditions, but a check-up with the
doctor is a must to find out. And don’t forget, while
this information is now common in developed countries, many
even well aducated local women are unaware of the dangers
of cervical cancer. So why don’t you do someone a favor
and book a local friend in for a smear as well?
“Kim Patra is a qualified Registered Nurse and Midwife
that has been living and working in Bali for almost twenty
years. She now runs her own private practice and medical referral
service from her Kuta office. Kim is happy to discuss any
health concerns with you and she may be contacted via e-mail
at info@chcbali.com or Hp. 081 2366 0000”.
