Dying of cancer of whatever part of the body is one of the worst ways to part with life, the victim experiences excruciating pains while he or she watches the body wither away slowly. A lot of people just want to end the endless pains, but parting from loved ones is even more painful than the disease itself. I lost a good friend of mine and a 23 years old client recently to uterine cancer and another 20 years old had her uterus removed because of cervical cancer, although the latter is fortunate to have had two kids before the hysterectomy was performed.
Cancer is an abnormal growth or replication of abnormal cells in any organ of the body which can invade other organs or tissues (metastasis) causing malfunctioning of the organs and subsequently resulting in death. When this abnormal growth affects the cells of the cervix, it’s known as cervical cancer. One uncanny thing is that a good number of ladies do not know where their cervix is located and have never heard of cervical cancer. The cervix is a very small part of the body, but is a vital organ in the female reproductive system. It is the lower part of the uterus that opens into the vagina; connecting the uterus to the vagina. If you insert a finger into the vagina, it feels like the bridge of the nose.
In the world today, it is the 4th most common cancer in women, with 2017 estimation of 527,624 new cases and 265,672 deaths yearly. Cervical cancer is the 2ndleading cause of female cancer in women aged 15 – 44 years in Nigeria, with 14,089 new cases and 8,240 deaths annually ( averagely 1 woman dies every hour) .  A 10-year study in Kano by Sule and Ochicha published in 2017 revealed that the mean age of women affected by it is 48.3, in Zaria 44.5, in Sokoto 48 and 42 in Ibadan. This surprisingly is only a fraction of people captured as lack of health insurance coverage, poverty, ignorance and illiteracy militates against health seeking behaviour of many women.
Someone might be wondering how this deadly cancer can develop especially at a very young age. Yes, it is caused majorly by a virus called human papillomavirus (HPV), which is contacted through sexual intercourse. There are about 40 types of HPV that can infect the genitals of men and women, most of which causes no symptoms but type 16 and 18 are responsible for 70% of all cervical cancers. These viruses may infect men without any significant harm, though it has been discovered lately that some throat, anal and penile cancers in men are linked to them. Also, HPV infections are long lasting; a man can be a carrier as a boy and infect a woman many years after. Women who had early exposure to sex before 18 years, multiple sexual partners (or who have sex with men who have had many other partners), second wives of men whose first wives had died from cervical cancer and female sex workers are at a greater risk. Persistent exposure to this viral infection and other factors such as, smoking, high parity, long term ingestion of contraceptive pills and weakened immune system ensures progression from cervical infection to cervical cancer.
When a woman notices abnormal vaginal bleeding in between periods, or after having sex, vaginal bleeding after menopause, increased vaginal discharge tinged with blood, pain during sex or pelvic pain, then she should be aware of the likely presence of cervical cancer, however, many women can have the virus for years (10-15) before it result in these symptoms. So the only remedy is to find precancerous cells and treat it early. Even though deadly, cervical cancer is the most preventable form of cancer if detected early.
In April 2018, the Federal Ministry of Health developed a 4 year National Cancer Control Plan (2018 – 2022) in which prevention remains the first priority area of action. In preventing cervical cancer, vaccination and cervical screening is paramount and it’s unfortunate that presently, about 8 out of 10 women have never screened for cervical cancer. Centres for Disease Control and Prevention recommend that every young girl from 9 -26 years should receive HPV vaccine (Gardasil or Gardasil 9) and every woman must be screened for cervical cancer (PAP SMEAR) every three years from 21 to 65 years. This test is done in the clinic and takes less than 30 minutes. From 30 years and above, one may choose to have HPV TEST along with PAP SMEAR.  Furthermore, precancer cells can be controlled by certain behaviour modification such as delaying first sexual intercourse until the late teens or older, limiting the number of sex partners and avoiding sexual intercourse with people who have had many partners, quitting smoking.  Prevention is better than cure. In resultant cases, it can be treated with chemotherapy, radiation, cryotherapy, radical trachelectomy or hysterectomy to prevent metastasis.
Some nongovernmental organisations that have launched awareness campaigns, making women alert to the prevalence of this marauding disease in the society. Last year, Medical Women Association of Nigeria targeted to screen 8000 women for cervical cancer and was able to screen 6000. Cervical screening awareness week led by Jo’s cervical cancer trust UK will commence on 11th to 17th June, 2018. In Nigeria, general screening weeks are usually in January but women can be screened in major hospitals gynaecological clinics any time of the year. I urge husbands, brothers and boyfriends, to show their wives, sisters and girlfriends love by ensuring they get screened. Please, don’t say, “It’s not in any way my business’. Am sure no one likes to lose mother, wife, daughter, sister or friend to cervical cancer, as it’s the most preventable form of cancer among women today.
Written by Obi Lois Amarachukwu
