ISLAMABAD: Many experts agree that a large-scale screening programme for cervical cancer could prevent and improve prognosis in a majority of cases.
In Pakistan, there is no national screening programme for cervical cancer, the second most common form of cancer amongst women worldwide, said Dr Ghazala Mehmood, Head of the Gynaecology Department at the Pakistan Institute of Medical Sciences (Pims).
Pap smear screening can detect changes before the cancer develops and the patient can be treated on time.
Dr Mehmood said that 90 per cent of cervical cancer cases could be prevented if there was a mass screening programme in place in the country.
“There are no national statistics available on cervical cancer. Hospitals collect their own data,” she added.
Dr Rasheed Jumma, Director- General, Ministry of Health, agreed that there is no national screening program for cervical cancer and that there is a lack of awareness.
However, the Ministry has been unable to focus on this issue because of a lack of funds, he said. Tests for cervical cancer are very expensive and require that a pathologist be present at all times at the hospital. However, if someone comes to Pims, having a family history of cervical cancer, then a pathologist is called the next day to carry out tests, Dr Jumma explained.
Dr Mehmood said the cancer can be treated and prevented if diagnosed at an early stage, she explained. If diagnosed early, it is treated with surgery and in advanced stages, through chemotherapy and radiation.
There are no awareness programmes about the importance of screening, which is rarely offered at most hospitals in the country because of a shortage of pathologists, she added.
Often there are no symptoms during the early stages of the disease. However, as the cancer advances, symptoms begin to appear, she said.
Symptoms of cervical cancer include vaginal bleeding between regular menstrual periods, after intercourse or after going through menopause.
Those women who experience symptoms of cervical cancer should go for screening immediately, Dr Jumma said.
“Almost everyday, one or two women diagnosed with cervical cancer are referred to me,” she said.
Dr Mehmood said cervical cancer is common among married women from both urban and rural areas and if left untreated, can cause death. “Nowadays, it is mostly found in young women aged 20 to 25,” she added.
However, treatment of cervical cancer is very expensive in Pakistan and is mostly caused by the human papillomavirus (HPV), which is transmitted through intercourse. “There is a vaccine called Gardasil which is being imported from developing countries and one dose costs Rs30,000,” she said.
Dr Jumma said that, in Pakistan, the HPV vaccination is unaffordable for the middle and lower-middle class.
The HPV virus can be caused by mishandling during pregnancy, gallbladder surgery, unhygienic conditions during menstruation, unprotected and frequent sex, smoking, taking medication that weakens the immune system or having a sex partner who is HIV/AIDS positive.
Dr Nadia Mehak, a nutritionist, said that, besides medication and chemotherapy, the disease can also be controlled through diet and exercise.
“A number of cervical cancer patient’s visit my clinic every month and try to control their disease through diet,” she said.
Mostly the disease is common amongst urban women who often eat a lot of junk food and do not exercises.
She said fresh fruit such as oranges and vegetables like spinach, cauliflower and broccoli are all cancer-fighting foods and should be included in our diet.
“I usually refer yoga to cervical cancer patients as it can help during early stages of the disease, along with medication,” she said. However it can be controlled through mass awareness and screening, she said.
Published in the Express Tribune, May 29th, 2010.
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