From July to August this year, girls aged 9 to 13 in public schools in Region 12 were administered with the first dose of human papillomavirus (HPV) vaccine, according to a news report released by MindaNews.
The second dose of HPV vaccine will be given by next year yet, particularly from February until March, according to Malu Cadelina-Manar, author of the news report.
“We target girls aged 9 to 13 for the vaccine as it is during this stage that their reproductive organs start to develop,” Dr. Edvir Montaner, an official of the regional office of the Department of Health, was quoted as saying. “We all know the life of an adolescent nowadays.”
HPV vaccine has been identified as “one of the best protections” against cervical cancer and other reproductive health problems.
Every day, cervical cancer kills 12 Filipinos, mostly women. Although it does not spared men, cervical cancer is women’s enemy number two. “In the Philippines, cervical cancer is second to breast cancer as the most common malignancy that afflicts and kills women,” reports Dr. Cecilia Ladines-Llave, former chair of the University of the Philippines-Philippine General Hospital Cancer Institute.
Between breast cancer and cervical cancer, the latter is the deadlier. As Rina Jimenez-David, a recognized advocate in reproductive health, puts it: “While breast cancer is the most common form of cancer for women in the country, it is not the most deadly. The death toll from cervical cancer is higher than for breast cancer, and this is mainly because by the time its victims come for treatment, it is already too late.”
Cervical cancer is no respecter. It strikes anyone – even famous women. Among those who died of cervical cancer include Argentinian politician Eva Peron, American senator Mary Lundy, Belgian singer Ann Christy, Australian Olympic silver medalist Sarah Tait, Canadian actress Colleen Dewhurst, and Hong Kong actress Anita Mui.
On September 5, 2003, Anita Mui publicly announced that she had cervical cancer. But she assured her fans that her condition was stable and that she had no fears and would win the fight. “I am not a weak person… I can tell you that I have never had any fears and I will win this fight,” she was quoted as saying.
Four months later, she was admitted to the Hong Kong’s Sanitarium Hospital after slipping into a coma. At the age of 40, she died of respiratory complications leading to lung failure on the early morning of December 30.
The cervix is the lower part of the uterus. It extends into the vagina. Cervical cancer, which results from the uncontrolled growth of severely abnormal cells in the cervix, usually affects women aged 35 to 55, but is can affect women as young as 20.
“The younger a woman was the first time she had sexual intercourse and the more sex partners she has had, the higher her risk of cervical cancer,” points out The Merck Manual of Medical Information.
Usually, it takes about ten years before cancer develops. But it presents some early signs. “In the early stages, cervical cancer usually causes no symptoms. It may cause spotting or heavier bleeding between periods, bleeding after intercourse, or unusually heavy periods. In later stages, such abnormal bleeding is common,” says the Merck manual.
Other symptoms may include a four-smelling discharge from the vagina, pain in the lower abdomen, and swelling of the legs. The urinary tract may be blocked, without treatment, kidney failure and death can result.
Contrary to common beliefs, cervical cancer is not hereditary. It is primarily caused by HPV, which is transmitted during sexual intercourse. HPV takes several forms, which are referred to by number.
“There are about 100 types of HPV that generally infect people in various parts of the body but there are only 13 types that can cause cancer in the cervix,” wrote Dr. Llave in a paper presented at the Global Conference on Low-Resource Setting Cervical Cancer Prevention held at the Johns Hopkins University.
The most common causes of cervical cancer are HPV Types 16 and 18. These two types are responsible for 70 percent of cervical cancer around the world. HPV Type 16 also causes oropharyngeal cancer. Condoms do not fully protect against infection because the virus can exist throughout the genital area and around the anus.
“Exposure to HPV alone is not enough to cause cancer – human bodies are equipped with the mechanisms to naturally reject and fight infections, HPV included,” wrote Elderita C. Rizo in an article which appeared in Health and Lifestyle. “However, in some women, the virus stays and survives for years without manifesting any symptoms, which eventually changes normal cells to pre-cancerous cells.”
Although sexual intercourse is the primary culprit cited for cervical cancer, there are several other factors that may trigger such cancer among women. These factors include early age at first birth, having many births, tobacco use, prolonged use of hormonal contraceptives, and an impaired immune system, particularly related to HIV infection.
“Twenty percent of all cancers are caused by viruses,” Prof. Ian Frazer, a clinical immunologist and currently the chair of the Australian Cancer Research Foundation’s Medical Research Advisory Committee. “If we know that cancer is caused by a virus, then we know how to prevent it.”
The Geneva-based World Health Organization recommends HPV vaccination as early as nine to 13 years old, especially in liberal countries. “But every woman is at risk so women aged 13 to 55 years old can still have the vaccine,” Dr. Llave said.
Clinical trials done by Prof. Frazer and his team showed that the vaccine can last for as long as ten years. However, as these do not protect against all types of cancer-causing HPVs, more vaccines are need to combat the other HPV strains.
If detected early, cervical cancer is curable. “There is no reason for any woman to die of cervical cancer,” deplores Noe Tuason, a research scientist at the University of San Francisco Comprehensive Cancer Center.
Industrialized countries, like the United States, have achieved success in early detection of pre-cancerous conditions in the cervix with the Pap smear. But in developing countries like the Philippines, visual inspection with acetic acid (VIA) is recommended.
In VIA, a swab cotton is immersed in acetic acid, and then placed on the cervix. If an area turns whitish, this is an indicator for health practitioners to suspect for the presence of cancer.
In industrialized countries, screening has saved a lot of lives of women – but not yet in the Philippines. It has been found that most Filipinas are hesitant to undergo screening, according to a study conducted by the health department. “They are either shy or they don’t want to find out that they may be carrying the disease,” the study said.
According to the National Cancer Institute in the United States, treatment options for cervical cancer depend on the following: the stage of the cancer, the size of the tumor, the patient’s desire to have children, and the patient’s age.
“Treatment of cervical cancer during pregnancy depends on the stage of the cancer and the stage of the pregnancy. For cervical cancer found early or for cancer found during the last trimester of pregnancy, treatment may be delayed until after the baby is born,” NCI advises.
Women should have themselves check for cervical cancer before it’s too late. “We have got good treatments for cervical cancer especially if we detect it early, in which state it becomes definitely curable. This is why screening is very important,” Prof. Frazer explained. “The problem arises if a woman waits until she finds she is sick of cervical cancer, wherein by that time, the disease is so advanced that is already becomes incurable.”
