We then proceed to apply Lugol ’ s iodine and got a similar picture of yellow patches against the background of deep brown normal tissue and biopsies were taken from the abnormal parts .
The specimen was sent to the lab and again after a week the results were out and fortunately it was a precancerous lesion .
Guidelines recommend that in women between 30-65 years of age , the pap smear should be done at least once in three years and where feasible in conjunction with the HPV test . Screen positive women should undergo treatment and this is what will prevent progression to cancer .
Treatment can be : Expectant : There is no active treatment but the patient has to undergo regular follow up with papsmears about every 6 months ; Ablative therapy : Destructive eradication of abnormal epithelium to prevent its progression to cancer in patients with no suspicion of cancer which include : Laser CO2 , Cryotherapy ( this involves freezing the cervix ), Thermal Ablation ( the use of heat to destroy abnormal cells ), and Electrocautery ( using an electric energy ).
Excision which involves removal of the abnormal parts is another option and can entail : Loop electro-excision procedure ( LEEP ) that involves removal of tissue with electrical knife in shape of a loop ; or Cold knife cone biopsy that use of traditional scalpel to remove the abnormal parts of the cervix .
At the time we opted to treat Bettina with the Loop electro-excision procedure ( LEEP ) and to date her pap-smears remain normal , the small successes that make it worthwhile waking up every morning .
Avoiding risk factors for cervical cancer would also help in preventing the disease . Risk factors include : early onset of sexual activity ( debut ); having multiple sexual partners ; having a sexual partner with multiple sexual partners ; co-infection with other STIs , such as Chlamydia Trachomatis and Herpes Simplex Virus type ; having many children ; immunosuppression due to HIV / AIDS infection ; and tobacco use .
This article however would not be complete without discussing one of the most useful prevention strategies , which is vaccination . I think everyone is aware about vaccines now , especially those who
Guidelines recommend that in women between 30-65 years of age , the pap smear should be done at least once in three years and where feasible in conjunction with the HPV test . Screen positive women should undergo treatment and this is what will prevent progression to cancer .
want to go back to normal following the coronavirus pandemic . I would like to disappoint the president of our neighboring country His Excellency Dr . John Pombe Magufuli and tell him there are actually vaccines against certain types of cancer and cervical cancer happens to be one of them .
As we know the cause is the Human Papilloma Virus ( HPV ) there is a vaccine against this particular virus . HPV is responsible for 99.7 % of cases of cervical cancer . The Human Papilloma Virus is spread primarily via sexual contact but unlike other Sexually Transmitted Infections ( STI ’ s ) condoms do not prevent the spread of the human papilloma virus . Even close non-penetrative contact can result in the spread of HPV which is why up to 80 % of sexually active people will have HPV at some point in their lives . It is asymptomatic in majority of people and that is why they do not know they have it .
There are very many strains of the Human Papilloma Virus . The ones that cause majority of cases of cancer are called oncogenic types of HPV and this is primarily type 16 and 18 which are responsible for approximately 70 % of cases and other head and neck cancers . Other strains can cause other diseases such as perineal or vaginal warts such as HPV type 6 and 11 . Warts are not cancerous but are very uncomfortable and may cause severe distress to the patient .
Currently there are 3 types of vaccines : Bivalent Vaccine : this protects the user against two types of HPV i . e . 16 and 18 ; Quadrivalent Vaccine : this is protective against HPV type 6 , 11 , 16 and 18 meaning it also prevents development of vulvo-vaginal warts ; and Nonavalent Vaccine : which covers against nine types of HPV types 6 , 11 , 16 , 18 , 31 , 33 , 45 , 52 and 58 .
The Nonavalent Vaccine gives protection close to 100 % against cervical cancer , however the cost is quite prohibitive to use especially in what are considered resource constrained or “ third world ” countries .
Getting the vaccine does not mean the client will stop routine screening , however the frequency of screening is less in people who have been vaccinated . Currently the recommendation is once in 3 years in people without HIV and annually in HIV positive population . The vaccine would reduce the frequency to once in 5 years ( without HIV ) and 3 years ( HIV + ve ).
From my tone I would advise everyone to get the vaccine and the recommendation is in people both men and women ages 9-45 years . It is most effective in girls and boys aged between 11-12 years . Our government settled on age 10 as the age of vaccination and target the girls as the primary potential sufferers of this debilitating disease .
I seriously don ’ t understand the people who are against vaccines ( antivaxers ) but in life everyone has a right to their opinion . My role would be to explain and convince users of the benefits . I have the unfortunate advantage of having been involved in the treatment of cervical cancer and lead a team who manage these women with their various complications and inevitable demise . In as much as noone is leaving this earth alive why should a person die of a disease we know how to prevent .
Take action protect yourself and your loved ones get tested and get the vaccine for those who are eligible .
Dr . Maureen Owiti is a practicing Obstetrician Gynaecologist and fertility consultant based in Nairobi . You can commune with her on this or related matters via email at : Drmaureenowiti @ gmail . com .