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January is Cervical Health Awareness Month Jan 07, 2010

Each year, approximately 12,000 women will receive a cervical cancer diagnosis, and an estimated 4,000 will die.  However, this is one disease that is easily treated if caught in the early stages.  With yearly Pap tests and gynecologic screenings, cervical cancer is even easily prevented.  In this video, Michael Numnum, M.D., discusses the importance of preventative care in overall cervical health, as well as the latest on the HPV (human papillomavirus) vaccine.  Dr. Numnum specializes in gynecologic oncology. Click on the video above to watch.

Cervical Health Awareness with Dr. Michael Numnum Transcript

Hello, I'm Michael Numnum and I'm a physician here at Sarah Cannon Research Institute here in Nashville and I'm a GYN oncologist.  So I specialize primarily in cancers of the ovary, cancers of the uterus, cancers of the cervix - specifically cancers of the female genital tract.  Today, I'm here to talk specifically about cervical health, specifically cervical cancer - what is it, how can it be prevented, how can it be treated before it becomes cervical cancer, and what are options once you are diagnosed with cervical cancer.

It is a pretty rare cancer in the U.S. - there are about 12,000/year and about 4,000 deaths from cervical cancer which in reality is about 4,000 too many.  The reason I say that is because it is largely preventable with screening tests and treatments to treat cervical pre-cancers which I will talk a little bit more about in a second.

Cervical cancer is larger preventable with the use of pap smear which has dramatically decreased the rates of cervical cancer over the past 50 years.  As far as when to start screening with pap smears, there has been a lot of controversy recently, a lot of debate on when exactly is a right time to start.  Should it be at the initiation of sexual activity as a teenager or whenever or at the age of 21?  The most recent recommendation, which I agree with, state that you should start pap smear screening at the age of 21.  Clearly the screening with the pap smear is the most effective means to prevent cervical cancer and its pre-cursors such as cervical dysplasia, there are a few things that you need to be aware of as far as what to report to your doctor if you experience these things.  The main one is abnormal vaginal bleeding, any abnormal discharge.  A lot of these things are not caused by cancer, but certainly they need to be evaluated.  Those are the big ones as far as what to report to your doctor other than obviously the annual screening with pap smears.

A lot of women have questions about these new HPV vaccines or the human papillomavirus vaccine.  I think the important thing to remember is that the vaccine is most effective in women who have never been exposed to the HPV virus.  As far as the appropriate age to start vaccination with the HPV vaccine, most experts agree that ages 11-12 is the right time to start.  I think one of the things that is really important to me and important to doctors that do that I do those who specialize in cervical cancer is outreach - get out in the community and put out the message to all areas that this is a preventable cancer, that we can with the pap smear, prevent this type of cancer.

When you see a physician who has an expertise in cervical cancer, one of the first things they do is a full pelvic exam, and that determines your initial stage of cancer.  For those who don't know, cancers are staged 1, 2, 3 and 4 in general.  Stage 1 cancers are the best cancers to have if you are to have cancer unfortunately.  They are largely curable - most cancers and in cervical cancer especially.  Once the cancer has spread beyond the cervix, it becomes a Stage 2, 3, or 4 and those are generally less curable.

If you are considered to have Stage 1 cervical cancer, then most patients who are medically fit to undergo surgery, usually require a radical hysterectomy.  And again, as far as the types of options in regards to which types of radical hysterectomy you need, I would definitely ask about less invasive approaches - laparoscopy, robotics.  In women who have cervical cancer that has spread beyond the cervix, they may be at Stage 2, Stage 3, or Stage 4 cancer, radiation is the primary method of treatment - radiation with chemotherapy or sometimes just radiation depending on the patient's medical condition, but I think once it spreads beyond the cervix, that is the best chance at a cure.

I think it is extremely important that when you first meet with your oncologist that you ask about the availability of clinical trials.  These days they are available in the community, they are available in a lot of places and they should be available for you with cervical cancer or with any cancer for that matter.

Once when it is in its pre-malignant or pre-cancerous stage, there are multiple options such as laser treatments, the leap procedure which some of you may have heard of, and also sometimes observation or just watching it with close follow-up with your gynecologist is the best bet.

If you would like to get more information about cervical cancer, I would start with the research portion minniepearl.org.

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