Are you a Young? Cervical cancer still poses a threat

By Ruchi Kumar

'I am a healthy 20-something woman. Can I get cervical cancer?' The unfortunate answer is yes -- you can.

Jade Goody, the outspoken 27-year-old reality TV personality lost her battle against cervical cancer two weeks ago. It was only seven short months prior that she had been diagnosed with Stage III cervical cancer. She lived out her illness on TV, bringing attention to a disease that is easily treated if caught early enough -- unfortunately, in her case that was not to be.

Here are a couple of questions for all young women out there:

1. Do you know what causes cervical cancer? Is it one's genes or is it the lifestyle choices that one makes?

2. How relevant is the occurence of cervical cancer to young women in India?

The answer to both questions is that all young women are at risk, but some more so than others. Cervical cancer is not inherited, but rather a result of exposure to the HPV (human papilloma virus) and lifestyle choices.

Ignorance about the need for early and regular screening, lack of access to routine health care and poverty have led to the high incidence of cervical cancer.

What is cervical cancer?
In a nutshell, cervical cancer is an abnormal change and growth in the tissues of the cervix, a tube that joins the vagina to the uterus.

While it can take up to 20 years for the cancer to show itself, changes in the cervix wall related to HPV can begin to occur within the first couple of years of getting infected. A pap smear can detect these changes right away and steps can be taken to pre-empt the disease if detected at this stage.

Which factors increase the risk of developing cervical cancer?
- Exposure to the sexually transmitted human papilla viruses (HPV)
- Poor genital hygiene
- A weak immune system
- Malnutrition
- Sexual activity at an early age
- Having multiple partners -- this greatly increases exposure to infections.
- Persistent and frequent infections make cells prone to cancerous changes.
- Having a monogamous relationship with a male who has had multiple physical relationships increases the risk of his partner getting HPV
- Smoking
- Being overweight

Symptoms
Early cervical cancer is usually asymptomatic. Dr Elizabeth Vallikad, Head of the Division of Gynecological Oncology at St John's Medical College, Bangalore says,"A white vaginal discharge must always be investigated further, as it may be a sign of infection and if left untreated, can lead to cancer later."

You need to watch out for the following:

- Bleeding after sexual intercourse -- it warrants urgent investigation.
- Spotting or bleeding between menstrual periods.
- Unusually prolonged or heavy bleeding during menstruation.
- Bleeding in a post-menopausal woman.
- Pain in the lower back.
- Pain during sex.
- Preventive steps

Dr Vallikad advises all young women to take the following precautionary steps to prevent cervical cancer:

Pap smear testing: "Screening should start within the first year of becoming sexually active and should be done annually thereafter," she says. In her practice, she has seen patients as young as 18 years of age with cervical cancer.
Pap smears can detect the condition early enough that a patient might be treated with minimal surgery of the cervix, where only the affected portion and the immediate tissue around it are removed surgically. The patient can go on to lead a normal life and even bear children.

Genital hygiene: It is important to wash well and wipe from front to back when cleaning the vaginal area.

Use of condoms: They offer some protection against HPV infections.

A well-balanced diet: The micronutrients, Vitamin A, E, C, folic acid and selenium are known to increase the body's defense against cancers. Vitamin E and selenium are natural antioxidants. Together, they can boost the body's antibody production by almost 30 percent. Vitamin E is present in nuts, seeds, olive oil, wholegrain cereals and wheat germ. Selenium-rich foods are garlic, mushrooms, sesame, asparagus, and cashew nuts. Vitamin A and beta-carotene that are present in green leafy vegetables and bright-coloured fruits and vegetables must be a part of the regular diet. Fresh fruit and green leafy vegetables are rich sources of Vitamin C and folic acid. Eat 5-7 servings of fruits and vegetables daily. The same positive effect on cancer is not seen with nutritional supplements

Choose whole grains such as whole-wheat flour, lentils, beans and whole grain oats and limit intake of processed foods.

Choose a low fat diet with minimal saturated fat and more of omega 3 fatty acids.

Limit your consumption of alcohol and avoid tobacco use -- smoking is strongly associated with an increased risk of cervical cancer.

Maintain a healthy weight and be physically active. All you young ladies out there, schedule a pap smear today and ask your gynaecologist a few simple questions. Remember, cervical cancer is the most preventable of all cancers.