A campaign by the Cancer Society to encourage vaccination against the human papillomavirus (the Cancer Society)
A busy clinic day as usual, outside the clinic the queues pile up, conversations between the women, stress due to delays.
Einat (pseudonym), a 38-year-old mother of 3 children, the youngest of whom is 3 years old, enters the clinic.
Einat came because of irregular vaginal bleeding for about 4 months and bleeding during sexual intercourse.
Recently the bleeding increased and pains in the lower abdomen were added.
Einat looks scared, a little pale.
I try to calm her down and find out if she has had a recent gynecological examination.
It turns out that she has not been tested since birth.
Have you had a pap smear from the cervix before, I ask.
No, Einat answers, I don't think so.
We do the gynecological examination.
As I inserted the speculum, that plastic device we use to see the vagina and cervix, my heart dropped.
In the cervix I saw a lump about 5 cm in size protruding, bleeding and looking really ugly. It is absolutely clear to me that Einat has a cancerous tumor in the cervix.
A preventable disease.
A woman in a clinic (Photo: ShutterStock)
The thoughts are now swirling in my head: how will I tell this young woman with small children that this is what is causing the bleeding.
A lot of sadness attacked me: could it have been possible to detect the beginning of the process at an earlier stage by periodic examination?
Could the situation that Einat reached be prevented by vaccination against the papilloma virus?
I explain to Aina what I see, explain to her that a biopsy should be done from the cervix and additional tests to assess the condition of the tumor.
Indeed cervical cancer, I have already metastasized to the lymph nodes and pelvis.
She needs radiation treatment and chemotherapy, and now only time will tell if she will recover from her illness and get to raise her children.
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"There is no reason that in the 21st century in which we live, women will still be diagnosed with cervical cancer in an advanced stage or die from their disease."
Prof. Talia Levy (Photo: B.H. Wolfson)
Cervical cancer is a malignancy caused by infection with the human papillomavirus (HPV).
This virus is considered the most common contaminant transmitted by sexual contact in the world, and the main cause of precancerous changes, cervical cancer and conical viral warts (condylomas) in the genitals.
The main infection is through sexual intercourse of any kind.
HPV has over 150 known strains.
About 20 of them are related to the development of pre-malignant changes and cervical cancer, as well as malignancy in the mouth and pharynx area, when infection is through oral sex.
There are two main HPV strains, 16 and 18, which together are responsible for about 70 percent of the number of cervical cancer patients.
Strains 6 and 11 cause about 90 percent of warts (condylomas) in the genitals, as well as low-grade premalignant lesions.
A virus that causes a disease that can be vaccinated against.
Papilloma vaccine (Photo: ShutterStock)
Most women and men become infected with HPV in the first few years of having sex.
It is important to know that the high infection rates in women and men are the same.
HPV infection has no symptoms and the body's natural defense system overcomes it naturally, usually within a year or two.
Since the virus is very common in the population, the cumulative chance of a woman contracting the virus during her lifetime is about 80 percent.
In a very small proportion of infected women, the virus does not disappear from the body and remains permanently in the cells of the cervix.
Constant infection with HPV happens especially if you get infected with HPV strains that can cause the development of precancerous changes and cervical cancer and not with strains that cause warts.
Additional risk factors for the development of malignancy in the cervix in the presence of constant virus infection are smoking and taking birth control pills.
About 90 percent of all infections are latent.
Even when pre-cancerous changes have already developed, most of the time, there will be no symptoms at all.
That is why it is very important to perform screening tests for cervical cancer that include a test for diagnosis.
Don't give up on a Pap test - and a vaccine
The Pap test and the HPV test allow early detection of pre-malignant changes and thereby significantly reduce the development of cervical cancer and mortality from it.
The global recommendations are to start performing these tests from the age of 25, once every 3 years.
The cessation of screening tests for cervical cancer is recommended at the age of 65-70, if three previous consecutive tests were normal.
Cervical cancer is a cancer that can be detected early and prevented, and therefore the great importance in raising awareness of the screening tests and the therapeutic options in the pre-malignant stages.
Against the HPV virus there is an effective vaccine against 9 types of papilloma: 6 and 11 which cause about 90 percent of viral warts in the genital tract, 16 and 18 which cause about 70 percent of cervical cancer cases, and against another 5 more violent strains.
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About cervical cancer:
the virus that causes this cancer can be stopped.
So why do women still get it?
"There is no other way to tell you this - you have cancer"
Ideally, girls should be vaccinated before first sexual contact, since most people become infected with the HPV virus within the first 3 years of having sex.
Global studies show that among girls and young women who have been vaccinated there is a significant reduction in the development of pre-cancerous and even cancerous changes in the cervix.
The vaccine against the papilloma virus is given in eighth grade schools for girls and boys and is approved for women and men up to the age of 45.
The health organizations emphasize that it is important that women who have been vaccinated continue to undergo screening tests for the early detection of precancerous changes in the cervix in order to prevent the development of cervical cancer.
Cervical cancer is a preventable cancer.
Vaccinate your child and get checked regularly.
There is no reason that in the 21st century we live in, women will still be diagnosed with advanced stage cervical cancer or die from their disease.
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