A Preventable Cancer

Vaccination and regular screening provide the best protection from cervical cancer

Vaccination and regular screening provide the best protection from cervical cancer.

Like many women, you might worry about breast cancer, but cervical cancer should also be on your radar. In 2016, the most recent year for which statistics are available, there were nearly 13,000 cases of cervical cancer, and 4,188 women died from the disease, according to the Centers for Disease Control and Prevention (CDC). Fortunately, the disease can be prevented.

A lifesaving vaccine

Cervical cancer occurs in the cells of the cervix—the lower part of the uterus, which allows a baby to enter the birth canal. It’s almost always caused by the human papillomavirus (HPV), the most common sexually transmitted infection in the U.S., says Ruth Stephenson, DO, FACOG, a gynecologic oncologist at Robert Wood Johnson University Hospital (RWJUH) Hamilton and Rutgers Cancer Institute of New Jersey. About 70 percent of women are exposed to HPV, but the immune system eliminates the virus 80 to 90 percent of the time, according to the National Cervical Cancer Coalition. However, certain high-risk types of HPV can be dangerous. “HPV can cause changes in the cells of the cervix that, over time, can turn into cancer,” says Dr. Stephenson.

Gardasil®, the HPV vaccine, protects against the most common high-risk strains of the virus. The vaccine was originally intended for children and young adults, but the U.S. Food & Drug Administration recently approved it for adults up to age 45. The CDC recommends giving children two doses of the HPV vaccine at ages 11 and 12. Three shots must be given to people who are vaccinated between the ages of 15 and 45.

Smart screening

Regular screening with a Pap test can also help women avoid cervical cancer. During this procedure, a physician collects cells from the cervix during a pelvic exam. The cells are examined under a microscope for signs of cancer and precancerous changes. If abnormalities are found, a biopsy may be necessary. The physician will remove any precancers, which helps to prevent cervical cancer more than 95 percent of the time. Before you have a Pap test, ask your physician if you should have HPV testing—which checks for the presence of the virus—at the same time. Having regular Pap tests (see “Screening Guidelines”) and keeping any follow-up appointments with your gynecologist are key. “Many women stop seeing their gynecologist after they’re done having babies or have gone through menopause,” says Dr. Stephenson. “If a woman has precancerous cells and isn’t treated, she’s at risk for cancer.”

The most advanced treatment

Early cervical cancer doesn’t usually cause any symptoms. When the disease is more advanced, signs include abnormal vaginal bleeding (between periods or after menopause, for instance); pain during sex; discharge, which may contain blood; changes in your bladder or bowel function; weight loss and fatigue. Patients who are treated at RWJUH Hamilton benefit from the hospital’s partnership with the Rutgers Cancer Institute of New Jersey, the state’s only National Cancer Institute-Designated Comprehensive Cancer Center.

“We’re fortunate to have a multidisciplinary tumor board,” says Dr. Stephenson. “Every cancer case is presented to a panel of interdisciplinary specialists—including a radiation oncologist, medical oncologist and other surgeons—to determine the best treatment.” Patients also have access to clinical trials. “We offer promising new therapies, such as immunotherapy [in which the body’s immune system is harnessed to fight cancer cells] and targeted agents for cancer,” says Dr. Stephenson.

Screening guidelines

Getting a regular Pap test enables your physician to identify any abnormal cell changes in your cervix. Women should begin annual testing at age 21. If the results are normal over time, a woman can have less frequent Pap smears (every three to five years).

“If you’ve never had any abnormal Pap tests, you can stop having them at age 65,” says Ruth Stephenson, DO, FACOG, a gynecologic oncologist at Robert Wood Johnson University Hospital (RWJUH) Hamilton and Rutgers Cancer Institute of New Jersey. “But I still recommend having an annual pelvic exam to check the cervix, vagina and vulva for abnormal growths."

Reducing your risk

Simple lifestyle changes can help lower your risk for cervical cancer. If you smoke, quit. Smoking weakens the immune system, making you more vulnerable to long-term HPV infection. In addition, use a condom to help reduce your risk of contracting HPV.

Take care of yourself! Learn more about the RWJ Center for Women’s Health and request an appointment.