Breaking the taboo

We are all in debt to our mother, so let's take part to raise awareness against cervical cancer. With this motto in mind, the month of January is observed as the cervical cancer awareness month. 

The group of women who are affected by this cancer, usually comes from the most neglected part of the society. They often feel shy which hinders detection, diagnosis and treatment. Low socioeconomic condition is another massive barrier to treatment. 

Cervical cancer awareness campaign should continue at equal pace as Breast cancer awareness campaign. Since 2018, second Saturday of January is observed as the cervical cancer awareness day in Bangladesh. Rotary International District 3281 extended hand to support March for Mother, a platform of voluntary organizations working in this field.

According to International Agency for Research on Cancer -IARC, every year 5,69, 847 women develops cervical cancer while 3,11,365 patients die in the world. 

Also according to IARC, cervix cancer is the second most common cancer in Bangladesh next to breast cancer. Every year 8068 women in Bangladesh develops cervical cancer while 5214 dies. 

According to a 2014 report published by National Institute of Cancer Research and Hospital, Cervix cancer is the second most common cancer in women in Bangladesh amounting to 17.9% of all female cancer and 8% of all cancers in both gender and all age groups. In simple terms, every one in five female cancer patients is suffering from cervical cancer.

What is Cervical Cancer?

The womb in which all of us were conceived is called the uterus. Uterus ends as a bottle neck and forms the organ called Cervix. Cancer of the cervix is known as cervical cancer. Cervical cancer is not as same as the cancer of the uterus.

Why does a woman develop cervical cancer?

Several socioeconomic and personal factors are linked to the development of Cervical cancer.
Child marriage is one such factor prevalent in lower income countries. Early marriage and frequent child birth are also linked to the development of cervical cancer. Lack of personal hygiene, especially following menstruation also contributes to this disease. Poor nutrition, unsafe sex and multiple sexual partners can also lead to cancer of the cervix. Human Papilloma Virus, HPV is the main culprit. Frequent infection by HPV is proven to cause Cervical Cancer.

How  HPV infects cervix?

HPV mainly spreads through sexual contact. Multiple sexual partner or a spouse with multiple sexual partner, significantly increases the risk of contracting this disease. HPV can infect other parts of the body as well.

Symptoms of Cervical Cancer

Excessive, foul smelling whitish vaginal discharge, excessive and abnormal per vaginal bleeding can indicate cervical cancer. Sudden increase in amount, frequency and duration of menstrual bleeding are alarming signs. Bleeding after menopause, and following sexual intercourse are strong indications. As the cancer spreads, other symptoms begin to appear. For example, lower abdominal pain. Later, the urinary tract may adhere to the rectum or urinary bladder resulting in embarrassing and painful disability called fistula. 

Early Diagnosis

Early diagnosis following the onset of symptoms and prompt intervention can result in excellent outcome. The good thing about cervical cancer is that, it can take 20-25 years for the cells of the cervix to turn cancerous, this gives the patients and doctors enough time to intervene.  Two tests are available for the early diagnosis of cervical cancer. PAP smear test is considered to be the gold standard. The other one is called VIA. These tests are done for screening.

What is cancer screening

Testing apparently healthy individuals having no symptoms, but who are at risk of developing particular cancer, to detect cases of hidden cancer is called cancer screening. There is nothing scary about these  screening tests. They don't involve any invasive methods and are not painful, just like normal gynecological checkup.

PAPS test

A small stick, called spatula is inserted to extract sample from the cervix. The sample is then smeared on to a glass slide and is then observed under microscope to look for suspicious cells. It doesn't involve any cuts or needles! 

VIA test

This test is easier and cheaper. A large type of cotton bud is soaked in 5% acetic acid and is then gently pressed against the walls of the cervix.  After one minute, visual observation with naked eye is made to detect for any white spot.  This test is also pain less and swift. 

Treatment 

Treatment option depends on a number of factors. Possibilities varies between chemotherapy, surgery or radiotherapy. Sometimes combination of two or more methods can be used. Generally cervical cancer is divided into 4 stages depending on the spread of the tumor These are again subdivided into category A & B. If the disease is within Stag 2A, Surgery is pressed forward. At this stage, outcome and recovery rates are excellent. Advanced stages require interventions with chemo and radiotherapy followed by surgery, if feasible. Earlier the treatment starts, better the prognosis.

Breaking the taboo 

Many women decide to hide symptoms fearing cultural and social constrains, thus endangering their lives. They often do not share their condition even with their most intimate family members and friends. Eventually when they do decide to get treatment, its often too late. Women must understand that cervix is nothing to be ashamed of, it just like another organs such as brain and liver. Disusing about cervix and reproductive health should not be considered as a taboo. Uterus a vital organ, cervix is a part of it.  It's the birthplace of all humans.

March for Mother 

Our life started in our mother's womb. We spend so much time at so many different activities. Is it too much to ask to spare an afternoon for the safety of our mother? 
Since 2016, Cancer Epidemiology, Prevention and Research, Bangladesh (CCEPRB) has been organizing the annual event, March for Mother. This daylong activity involves rally, seminars, etc designed to spread awareness regarding cervical cancer. 

So join us this year. Take part in this noble initiative to raise awareness against cervical cancer. Let's spend a day for our mothers. 

The writer is Chief Coordinator of March for Mother