Cervical cancer is caused by an STI virus

By WATSON GABANA

I WAKED into the Gusap Health centre outpatient department on September 10 2009. It was close to 10 am, the place was beginning to be filled with patients with specific health needs, complaints and infections.  I was the 11th on the line. Behind me were mothers with their kids in slings and bilums hanging from their necks.  We were about 100 of us in total waiting for our turn.

A young nursing officer, maybe  in her early twenties was serving us.  After a brief introduction, I asked her to see a sexually transmitted infections (STI) expert.  When I mentioned, STI, the young nurse got the shock of her life.  She uttered no words.  She fell to her knees giggled and vanished into the building.  I stood there astonished and belittled by her unprofessional response.  After a long 30 minutes wait, a male staff came to the scene, ushered me out of the reception area to the back of the building and tried to interrogate me.  He asked me what my problems were and wanted to help me out. 

I smiled at him and said; "I don't have any problem mate. My problem is your reaction to STI clients."
Actually, I was there for that very purpose.  I wanted to see and learn the immediate reactions and responses of service providers when someone (client) approaches them and wants to discuss and disclose his/her STI or HIV status for that matter.  I wasn't seeking any STI medication.  I wanted to find out how clients and patients were treated during their initial contact. 

This particular episode prompted me to share some common STI facts with all.  Sexually transmitted infection (STI) is a huge problem in the world and here in Papua New Guinea.  According to the World Health Organization (WHO) 1999 STI report, about 340 million new STI cases are reported annually. There are 31 different types of pathogens that use sex as their way of transmission.  Sexual activity is the way these pathogens get from person to person. These 31 include bacteria, virus, protozoa, and parasites. Sexual activity usually means very close contact involving intercourse, although some can be transmitted without sexual intercourse such as scabies and pubic lice which we can catch from sleeping in a bed where the sheets were not washed or changed which the previous person had these infections.  Children also can catch the scabies mite from playing with each other and close physical contact.

STIs are common.  HIV is actually one type of STI. 

According to WHO in their 1999 report, an estimated 340 million new STI cases are recorded each year all over the world. These are only cases on the major known STIs including syphilis, gonorrhea, chlamydia and trichomonasis.  The figure does not include herpes or warts or HIV.  STI mostly affect young people (15 to 30 years) due to the reality that many young people experiment sex with several partners.  STIs often have no signs or symptoms. Symptoms and signs often go unrecognized.
Someone may have more than one STI at the same time. It involves more than one person. Re-infection is common, if sex partners are not treated at the same time. People with STI are just the same as everyone else - in fact they are everyone else as well as you and me.
Service providers' oversight can be detrimental to the lives of many of our mothers in this country.  One particular STI that is becoming very common and is affecting a lot of our mothers and sisters is the human papilloma virus (HPV).  This particular virus causes the genital warts and cervical cancer killing 1 out of 10 pregnant mothers in Papua New Guinea.
Breast and cervical cancers are the most common cancers reported by our national cancer unit in Lae recently.  It is an indication that these two forms of cancers are affecting our female partners and if nothing is done, most of our mothers will succumb to these preventable and avoidable viruses.
As preached and proclaimed all over, prevention is better than cure, I wish to illustrate here how the cervical cancer can be prevented at the first instance.  As I've mentioned above, HPV is an STIs and all are transmitted only through sexual intercourse.  A poor mother should have not contract the cancer if she had not have sex.  Women, mostly child-bearing mothers are falling victim to this cancerous virus and we need to find ways in order to stop unnecessary death.  Maybe in order to do that, we need to know the relationship between HPV and cervical cancer.

Human papilloma virus (HPV) is an STI. There are many HPV viruses but not all can cause cancer.  About 80 per cent of us (male) have this virus.  HPV virus comes in varying forms and categories.  It is activate from our system during our first sexual encounter.  Some cause genital warts and are low-risk and some can lead to cervical cancer and are high-risk.  There is no known cure for HPV in the medical world.

Then what is cervical cancer?
Cervical cancer occurs when abnormal cells on the cervix grow out of control.  The cervix is the lower part of the uterus that opens into the vagina.  Cervical cancer can often be cured when it is found early. It is a usually found at a very early stage through a Paps test.

What causes cervical cancer then?
Most cervical cancer is caused by a virus called HPV.  HPV is contracted by having sexual contact with someone who has it.  There are many types of HPV viruses.  Not all of HPV causes cervical cancer.  Some of them cause genital warts but other types may not cause any symptoms at all.  A woman can have HPV for years and not know it.  It stays in the body and can lead to cervical cancer years after the body was infected.  That is why it is very important for you to have regular Pap tests.  A Pap test can find changes in cervical cells before they turn into cancer.  If you treat these cell changes, you may prevent cervical cancer.

Common symptoms
Abnormal cervical cell changes rarely cause symptoms.  But you may have symptoms if those cells changes grow into cervical cancers.  Symptoms of cervical cancer may include;
- Bleeding from the vagina that is not normal or a change in the menstrual cycle that one can't explain.
- Bleeding when something comes into contact with the cervix, such as during sex or when you put in a diaphragm.
- Pain during sex.
- Vaginal discharge that is tinged with blood.

Diagnosis
As part of your regular pelvic examinations, you should have a Pap test.  During the test, the doctor scrapes a small sample of cells from the surface of the cervix to look for cell changes.  If a Pap test shows abnormal cell changes, your doctor may do other tests to look for precancerous or cancer cells on your cervix.  The doctor may also do a Pap test and take a sample of tissue (biopsy) if you have symptoms of cervical cancer such as bleeding after sex.

Treatment options
Cervical cancer that is caught early can usually be cured.  If the cancer is caught very early, you still may be able to have children after treatment.  The treatment for most stages of cervical cancer can and makes you unable to have children.  These treatments include;
- A hysterectomy and removal of pelvic  lymph nodes with or without removing both ovaries and fallopian tubes - (surgical removal of the uterus)
- Radiation therapy (use of high dose x-ray to remove cells)
- Chemotherapy (use of medication to destroy cancer cells)

Prevention
Yes!  Every sexual active woman must have regular Pap test.  It is the best way to find cervical cell changes that can lead to cervical cancer.  The virus that causes cervical cancer is spread through sexual contact or intercourse.  The best way to avoid getting an STI is to not have sex.  If you do have sex, practice safer sex, such as using condoms and limiting the number of sex partners you have.
There we are.  Husbands and wives need to sit down together and discuss their sexual health needs. Do see doctors and health professionals now. 

Those in the Jiwaka area and Western Highlands can go to Tininga clinic or Kudjip Nazarene Hospital near Banz.  There are facilities also in Gusap at the Ramu Valley, Laiagam and Porgera Hospital, Moro Clinic, Kikori hospital in Gulf, Siroga Clinic in Popondetta and all other major provincial hospitals.
Pass on the message; tell every woman and girl to go for the Pap test.  There is no harm going and seeing a doctor which is far better than to suffer from cervical cancer and die.  If a service provider reacted like my sister in Gusap, don't give up.

Writer's e-mail: wgabana@yahoo.com.