Posted in Health, news

Cervical Cancer Awareness: Why get a Pap Smear?

Let’s face it… Pap Smears aren’t fun.  The only test to sample tissue for cervical cancer just happens to be one of the most embarrassing and awkward.  But it can be one of the most life saving and simple.  So what is it and how does it work?  Here’s your questions answered.

 

What is the cervix and what is cervical cancer?

The uterus looks similar to a light bulb.  The larger top portion being where the fetus develops, and the bottom, narrower area, the cervix.  The cervix thins and dilates during childbirth, as you’ve heard in the movies “she’s only 7 cm!” and then after childbirth becomes narrow again.  It affects nearly 13,000 and kills 4,100 women each year, rising each year.  It can affect women of any age but is more common between 20 and 50.

 

375x321_cervix

http://www.webmd.com/women

 

What causes cervical cancer?

The most common cause is HPV (Human Papillomavirus), especially HPV-16 and HPV-18.  This is acquired through unprotected sex, so condom use is encouraged. Thus its one of the most preventable causes of cancer.  Additionally, there are 3 vaccines for HPV currently approved by the FDA, Gardasil, Gardasil 9, and Cervarix.

 

What are the symptoms of cervical cancer?

Early cervical cancer may not be symptomatic but as it develops it may cause an odor, pain with urination, pelvic pain and bleeding. This bleeding may occur after sex, a pelvic exam, or intermittent bleeding not associated with a menstrual cycle.

 

Is cervical cancer treatable?

Yes.  Early detection is key and can be done by a Pap Smear, explained below.  Multiple treatments are available including surgery, chemotherapy,  radiation therapy, and targeted therapy such as Bevacizumab (Avastin®which prevents new blood vessel growth that can feed a tumor.

 

Who should get screened for Cervical Cancer?

The USPSTF (United States Preventive Services Task Force) recommends the following:

Screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.

 

What is a Pap Smear?

It is the cytology (cell analysis) of the cervix.  Years ago, a cytobrush would collect the cells and the medical provider would “smear” it onto a slide, place fixative, and then send it to the laboratory for the pathologist to analyze it.  Now ThinPrep® Pap tests are used more commonly as the cells from the brush are placed into a container with fixative, and this vial is sent to the pathologist to spin down and analyze.

 

cervical-smear-test-equipment-97358274-575db1493df78c98dc633c53

TEK IMAGE/SPL / Getty Images

 

In order to obtain the cells from the cervix, the medical provider needs to use a speculum to open the vaginal canal and allow access to the uterus.  A woman may be in the lithotomy position…lying on one’s back on the exam table with her feet in stirrups and knees bent. During the speculum exam, the medical provider may take cultures to test for common vaginal infections such as yeast, bacteria vaginosis, or sexually transmitted illnesses such as gonorrhea and chlamydia.  After the speculum exam, the provider may perform a pelvic exam with her gloved hand to examine the uterus and ovaries, evaluating for tenderness, shape, size and masses.

How is an HPV test done?

An HPV test can be done with the cells obtained during the Pap Smear.  The laboratory evaluates the cells to see if the HPV virus that causes cervical cancer is present.

In summary the thousands of deaths that occur each year to cervical cancer can be prevented with simple testing, such as the Pap Smear.  Discuss with your medical provider when cervical cancer screening is best for you.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

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Posted in Health, news, sex

Male Virgins May Unknowingly Have STD’s

A common misconception is “Virgins are STD free.”  However, what many don’t realize is making it to first, second or third base can still transmit the deadliest of diseases.

A new study published in the Journal of Infectious Disease found cancer-causing strains of Human Papilloma Virus (HPV) to be prevalent in many male virgins. Although these results were not a surprise as female virgins were found to acquire HPV through non-penetrating sexual contact, this was the first study to look at male virgins.

Researchers from the University of Texas Health Science Center in Houston looked at 87 self-proclaimed virgins ranging in age from 18-70 living in the US, Mexico and Brazil and performed follow-up check-ups every 6 months between the years 2005 and 2009.  25% carried HPV with 20% having contracted the strains that cause cancer.  Once any of these men had full sexual intercourse, their risk of acquiring HPV jumped 28.7 % the first year and 45.5% within two years.

HPV can cause cancer of the cervix and vagina, but in men may cause cancer of the penis and in both men and women cause cancer of the throat, anus and rectum.  It may also cause genital warts.

genital-wart-removal.jpg

Genital Warts: Image from Urological Consultants of Florida

 

However most people infected with HPV are asymptomatic and in many, the virus may be self-limited, not causing any disease.

HPV is the most common sexually transmitted infection but may not be the most reported.  Per the CDC, the prevalence of genital infection with any HPV type was 42.5% among United States adults aged 18–59 years during 2013–2014.

HPV can be contracted not only through penetrating sexual intercourse but also oral sex and “heavy petting.”  Many teens are at risk if they assume open-mouth kissing is STD-free.

Since HPV is acquired through unprotected sex, condom use is encouraged. For those naive as to its transmission, education and vaccination are paramount.  There are 3 vaccines for HPV currently approved by the FDA, GardasilGardasil 9, and Cervarix.  Vaccination is recommended for all boys and girls starting at the age of 11 up to age 26.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

Posted in Health, news

IUDs May Cut Cervical Cancer by 30%

A new study suggests intrauterine contraceptive devices (IUDs) may fight off the virus that causes cervical cancer.

Researchers from the University of Southern California’s Keck School of Medicine found the small T-shaped device may stimulate an immune response against the sexually transmitted Human Papilloma Virus (HPV) virus which causes cervical cancer.

 

iud.jpg

T-shaped IUD sitting within the uterus

 

IUDs are a favorite among women as they do not involve taking a daily hormone pill and can provide contraceptive protection for years.  There are two main types:

The ParaGard IUD is a non hormonal implant made of copper. The copper wards of sperm allowing contraception up to 12 years.

Hormonal IUDs, such as Mirena, release progestin, a hormone similar to progesterone, to the local environment, thickening the cervical mucous to prevent sperm from reaching the egg.  Hormonal IUDs may also prevent ovulation.  Additionally, IUDs can alter the lining of the uterus such that if a fertilized egg does occur, it may not be able to nest in the uterus without proper lining.

But both IUDs can stimulate an immune response that is both a deterrent to sperm and now suggested to viruses such as HPV.

Vaccines against the HPV virus exist and are given to 11-12 year old girls with the maximum age at which one could receive the vaccine, 26 years old.

If more research confirms this is the case, then those women who have not been vaccinated or are too old to receive the vaccine against cervical cancer may benefit from using an IUD.

What is the cervix and what is cervical cancer?

The uterus looks similar to a light bulb.  The larger top portion being where the fetus develops, and the bottom, narrower area, the cervix.  The cervix thins and dilates during childbirth, as you’ve heard in the movies “she’s only 7 cm!” and then after childbirth becomes narrow again.  It affects nearly 12,000 and kills 4,000 women each year.  It can affect women of any age but is more common between 20 and 50.

375x321_cervix

HTTP://WWW.WEBMD.COM/WOMEN

 

What causes cervical cancer?

The most common cause is HPV (Human Papillomavirus), especially HPV-16 and HPV-18.  This is acquired through unprotected sex, so condom use is encouraged. Thus its one of the most preventable causes of cancer.  Additionally, there are 3 vaccines for HPV currently approved by the FDA, GardasilGardasil 9, and Cervarix.

 

What are the symptoms of cervical cancer?

Early cervical cancer may not be symptomatic but as it develops it may cause an odor, pain with urination, pelvic pain and bleeding. This bleeding may occur after sex, a pelvic exam, or intermittent bleeding not associated with a menstrual cycle.

 

Is cervical cancer treatable?

Yes.  Early detection is key and can be done by a Pap Smear, explained below.  Multiple treatments are available including surgery, chemotherapy,  radiation therapy, and targeted therapy such as Bevacizumab (Avastin®which prevents new blood vessel growth that can feed a tumor.

 

Who should get screened for Cervical Cancer?

The USPSTF (United States Preventive Services Task Force) recommends the following:

Screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.

What is a Pap Smear?

It is the cytology (cell analysis) of the cervix.  Years ago, a cytobrush would collect the cells and the medical provider would “smear” it onto a slide, place fixative, and then send it to the laboratory for the pathologist to analyze it.  Now ThinPrep® Pap tests are used more commonly as the cells from the brush are placed into a container with fixative, and this vial is sent to the pathologist to spin down and analyze.

cervical-smear-test-equipment-97358274-575db1493df78c98dc633c53

TEK IMAGE/SPL / GETTY IMAGES

In order to obtain the cells from the cervix, the medical provider needs to use a speculum to open the vaginal canal and allow access to the uterus.  A woman may be in the lithotomy position…lying on one’s back on the exam table with her feet in stirrups and knees bent. During the speculum exam, the medical provider may take cultures to test for common vaginal infections such as yeast, bacteria vaginosis, or sexually transmitted illnesses such as gonorrhea and chlamydia.  After the speculum exam, the provider may perform a pelvic exam with her gloved hand to examine the uterus and ovaries, evaluating for tenderness, shape, size and masses.

How is an HPV test done?

An HPV test can be done with the cells obtained during the Pap Smear.  The laboratory evaluates the cells to see if the HPV virus that causes cervical cancer is present.

In summary the thousands of deaths that occur each year to cervical cancer can be prevented with simple testing, such as the Pap Smear.  Discuss with your medical provider when cervical cancer screening is best for you.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician