Cervical Cancer

Last October I went to New York City to visit a dear friend.  She lives in the center of Manhattan and we went to see a couple of Broadway shows.  One of the shows was the musical, “EVITA”.  It is an amazing story of Eva Duarte de Peron.  It takes place in Argentina and roughly follows her rise from rags to riches by marrying a very powerful man.  This man became the president of Argentina and she became the First Lady in 1946 until her death in 1952.

The show starts with the curtains slowly opening and the stage is set with hundreds of white flowers and a beautiful white ballroom gown that had been worn by the First Lady affectionately known as “Evita”. This was a mournful tribute to Eva Peron Duarte, the First Lady of Argentina.  Beloved by the people of Argentina who died at the age of 33….FROM CERVICAL CANCER.

I am happy to say that we have come very far since then and cervical cancer in the developed world is no longer the death sentence it was for women in the middle of the 20th century.

What have we learned? 

We have learned that a VIRUS is responsible for the majority of (70%) of all cervical cancers. The theory that a virus could cause cancer at all was a revolutionary concept in the 1970’s.  Then, in 1983 a German researcher, Dr. H. Zur Hausen and his team isolated the DNA of the Human Papilloma Virus (HPV) from cervical cancer tumor biopsies. This discovery was also made possible by the unwitting* contribution of Ms. Henrietta Lacks. Ms. Lacks was an African American woman whose unique cervical cancer cells had a special quality of being able to survive and be used in research.  Although she died in 1951 of cervical cancer in Baltimore Maryland at the age of 31 her cells live on and provide the tissue for biomedical and cosmetic research.

What you should know:

There is a vaccine, Gardasil  to reduce the risk of cervical cancer.  You are eligible for the vaccine starting at age 9 through 45.

Human Papilloma virus is sexually transmitted.  1 out of 3 adults in the USA has been exposed to this virus.  Once you have the virus it will be with you for the rest of your life.  It may, however, be undetectable at times with the pap smear. 

Pap smears which evaluate the health of the cervix should be done starting at age 21 through 65. The pap smear is done every 3 years so long as you have no history of cervical changes associated w HPV exposure.  These changes are categorized as dysplasia and will change the surveillance usually to every year depending on the category of cervical change.  

We start screening for HPV with the Pap smear starting at age 30.  If you have been exposed to the HPV sometime in your lifetime it does not mean that you will get cancer of the cervix.   It does however change the evaluation of your cervix to sometimes include a colposcopy. 

The flat wart that sometimes is on the vulva or any other part of the skin is also HPV.  However, this type of HPV virus is benign and is not associated with cervical cancer.  

How to avoid risk of HPV, DON’T HAVE SEX.  Just kidding.   In our society sexual intercourse is a significant part of human relationships.  I recommend use of condoms which is not an absolute protective method, but it does reduce exposure.   Get the vaccine.  Again, this will protect you from the more common high-risk types of HPV, notably the HPV type 16 and 18.  These 2 are the ones in developed countries that are closely associated w cervical cancer.  However, in poor resource communities or developing worlds, there are other types to be considered like type 45 or 51.  

On this note, I would like to state that in this country Latinas and African American women continue to have the higher rate of cervical cancer and death from this disease.  This is due to access to quality care.  In areas of poor resource, the risk is higher of death from this preventable cancer and the issues are multifactorial.  I work with an organization Grounds for Health, in Vermont, that has been organizing coffee growing communities to address this health issue.  It is such a solvable problem.  Please join me in disseminating their information and their work.  Please visit groundsforhealth.org for additional information.

Thanks, and I hope you have learned a little bit in this blog.  

*History of Henriette Lacks cells is important for women to understand especially women of color. Her cells were taken for research without her consent as this was not a practice at the time. If obtaining consent had been the practice it is unlikely that it would have been offered to Ms. Lacks.  As an African American woman in the 1950’s, her care reflected the poor access and the poor quality associated with  marginalized racial groups in the United States.  

Since the start of the HeLa cell line, millions of dollars have been made in research and product creation by the use of her cell lines.  She has received very little recognition and her family has never been compensated.  For more information please read the book The Life of Henrietta Lacks by Rebecca Skloot.  Also available on audio.