Mrs B recently celebrated her 60th birthday, an event she had planned over a four month period. Due to the excitement of her party, she had ignored the spotting of blood through her vagina which she saw occasionally after sexual intercourse. ‘It is just minor bleeding,’ she mused repeatedly.
She however spoke with a friend who alarmed her that it could be a serious problem. Mrs B sought medical evaluation. Following thorough questioning and physical examination, her doctor suspected she might have cervical cancer for which Pap Smear was requested which revealed cervical changes in keeping with early stage of cancer. She had Total abdominal Hysterectomy with bilateral salpingo-oophorectomy (removal of the womb and cervix, fallopian tubes and ovaries). She has been fine.
Cervical cancer may give mild symptoms which the individual may ignore as being not significant. Common symptoms which women should look out for include any or a combination of these- abnormal bleeding through the vagina (bleeding which is not typical of one’s menstrual experience), painful intercourse, vaginal bleeding after intercourse, abnormal vaginal discharge, unexplained malaise, and unexplained weight loss. Some women have cervical cancer, commonly in the early stages, without having any complaint whatsoever.
If detected early, removal of the diseased cervix, as in the case of Mrs B, is curative. Radiotherapy and chemotherapy may be added treatment modalities following histological examination of the removed cervix. Many gynecologists advise removal of the ovaries especially among women who have attained menopause. This helps to prevent the risk of having ovarian cancer.
The importance of screening cannot be over-emphasized. Simple clinical examination with Pap smear tests can identify women who have cervices at risk of cancer, and those with early or advanced stages of cancer. Inconclusive Pap Smear tests can be followed up with a biopsy-removal of a small sample of the cervix which is examined by a specialist doctor-pathologist-for evidence of cancer. This approach is to ensure that no patient is given the wrong diagnosis. The psychological trauma of having one’s organ removed is much; hence, a gentle yet comprehensive approach is used in identifying women with diseased cervix. Depending on the finding, an annual check can be advised. For those with very healthy cervix, a less frequent Pap smear testing is recommended.
Pap smear test saves lives…………
Dr Ademola Orolu is a Consultant Family Physician. He holds the Fellowship of The West African College of Physicians. He is also an Associate Fellow of The National Postgraduate Medical College of Nigeria. He is in active clinical practice. He is a writer, a patient advocate, and has a passion for health education. He is the Medical Director/Chief Executive Officer of Nathaniel Health Consulting (a family hospital), Matogun, Ogun State. He is the editor-in-chief of The Family Doctors. He can be contacted via firstname.lastname@example.org