The Philippine Online Chronicles

Several years ago, I lost a college friend to cervical cancer. Her death came as a shock because she told me that her cancer treatment had been successful. Little did I know that her second chance in life was short-lived.

Dr. Cecilia A. Ladines-Llave, Chair of the UP-PGH Cancer Institute and Programme Director of the Cervical Cancer Prevention Network Programme (CECAP), says that every eight minutes, a Filipina dies due to cervical cancer in the Philippines.

In year 2000, conservative estimates of cervical cancer cases in the Philippines were reported to be between thirty-five thousand and seventy thousand. Every year, an estimated seven thousand new cases are added to the statistics.

“The tragedy,” says Dr. Llave, “is that fifty-six percent of Filipino women with cervical cancer will die within five years of diagnosis from a disease that is wholly preventable.”

Next to breast cancer, cervical cancer is the second most common cancer among Filipino women. But cervical cancer is deadlier, Dr. Llave says. According to her, for every four women who survive breast cancer, only two will survive cervical cancer.

In a worldwide perspective, a woman dies every two minutes because of cervical cancer while some five hundred new cases arise every year. It is estimated that around eighty percent or an equivalent of four hundred thousand new cases occur in developing countries.  Out of four hundred thousand, fifty percent or about two hundred thousand are reported in Asia.

What is cervical cancer?

Cervical cancer is malignant neoplasm of the cervical area. The cervix is the lower portion of the uterus connecting the upper vagina to the uterus. It may manifest through vaginal bleeding; however, there may be an absence of symptoms until the cancer is in its advanced stages.

As cervical cancer progresses, a woman may experience the following signs and symptoms:

• loss of appetite
• weight loss
• fatigue
• pelvic pain
• back pain
• leg pain or single swollen leg
• abnormal vaginal bleeding, including bleeding after sexual intercourse
• pain during sexual intercourse (this may be common and not always related to cervical cancer)
• leaking of urine or feces from the vagina
• heavy vaginal discharge
• bone fractures

What makes a woman at risk?

The human papillomavirus (HPV) is known as a major factor behind the development of cervical cancer. HPV is a viral infection that is spread through skin-to-skin sexual contact. It accounts for nearly seventy percent of cases of cervical cancer.

Other factors that increase a woman's risk of having cervical cancer include: sexual intercourse at an early age (after start of  menstruation); multiple sexual partners; sexually transmitted disease (STD); exposure to partner with STD; cigarette smoking; regular exposure to second-hand smoke; exposure to hormonal drug diethylstilbestrol (DES) which is used for preventing miscarriage of pregnancy; chlamydia infection; having five or more children; weakened immune system; and family history of cervical cancer.

The common vinegar’s role

Pap smear screening can identify potentially precancerous changes and small tumors that may result to cervical cancer. Dr. Llave said that Pap smear is a good procedure to detect cervical cancer, because it has diminished the incidence of invasive cervical cancer by fifty percent or more in developing countries.

However, the Pap smear also has limitations since it requires a laboratory setup that some hospitals in the Philippines are not properly equipped for.

Single Visit Approach (SVA) is a quicker alternative to the Pap smear.  This procedure detects cervical cancer at its very initial stage. In the Philippines, SVA is championed by Jhpiego (an affiliate of John Hopkins University) and the University of the Philippines-Philippine General Hospital’s Cancer Institute (CI).

The SVA makes use of both screening and treatment in just one session. It utilizes an effective, low-resource screening method called the Visual Inspection using Acetic Acid (VIA) – yes, acetic acid a.k.a vinegar, the lowly suka. Vinegar is dabbed on the cervix, and after one minute, the health professional can make a diagnosis. On-the-spot treatment using cryotherapy is given if the test comes out positive.

In comparison, it takes one to six weeks before Pap smear results come out, while it takes only one minute after dabbing acetic acid to know the outcome of SVA.

There are three types of treatment for patients with cervical cancer: surgery (there are various surgical methods, one being total hysterectomy), radiation therapy, and chemotherapy.

Cervical cancer survivors

Dr.  Jane Adevoso shared her battle with cervical cancer during a forum organized by Bravehearts.  She was a 27-year-old medical intern at a public hospital in Metro Manila in 2006 and, at the same time, pregnant when she found out.  During her prenatal check-up, her doctor did a routine Pap smear (her very first) which revealed premalignant lesions in her cervix.  After several more tests, her condition was confirmed. She had Stage 1-A cervical cancer.

Jane found herself on a perilous crossroad. She weighed her options: give birth before getting treatment, hoping that the cancer would not spread quickly; or sacrifice her pregnancy and start with treatment right away.

She chose to have her baby and gave birth in October of the same year, naming her healthy baby boy Gabriel. After that, Jane went through a hysterectomy to have her uterus removed.

Sahara Villanueva was thirty-nine years old when she was diagnosed with cervical cancer.  She never thought she would become a victim of cancer. She ate organic food and kept a healthy lifestyle.

Sahara is lucky because she survived the disease. She remarked, "Because of my personal experience... I hope that I have enlightened everyone with early detection, early prevention and surviving cervical cancer."

Awareness and early detection

In 2008, the Department of Health (DOH), along with other civic organizations, launched May as the Cervical Cancer Awareness and Prevention Month.

Cervical cancer is best prevented through proper knowledge and understanding of the disease.  Living a healthy lifestyle is the best defense against any cancer.

Women should make it a priority to get regular screening to detect HPV-related diseases once becoming sexually active every two to three years before reaching the age of thirty.  Screening should be done every year after that.

Awareness, early detection, and a dab of vinegar may just save your life.

Photo: “so meta the photograph cried fake tears and even the stuffed bear dressed as a pirate got upset” by Regan Walsh, c/o Flickr. Some Rights Reserved / Cervix from Wikimedia Commons. Public domain. / Cervical Cancer Awareness Ribbon by Rachel Yapchiongco. Some Rights Reserved.

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Rachel Yapchiongco, also known as Rach to her friends, is a Psychology and Marketing Management graduate of De La Salle University.  She took up several units of MBA at the same university.  Rachel is a full-time mom to a charming young boy and married to an entrepreneur with a passion for cooking. She shares parenting experiences and slices of everyday life on her personal blog called Heart of Rachel