When Dr. See Hui Ti recommends one thing for gynecological cancers caused by human papillomavirus (HPV) infection is to talk to your doctor about regular checkups and vaccinations.
The senior consultant to the medical oncologist at the Parkway Cancer Center says cervical, vaginal, and vulvar cancers are largely preventable with regular screening and HPV vaccination.
“As long as there is no HPV exposure, no HPV infection, or good immunity to HPV, the risk of developing these HPV-related cancers is low, but not zero,” says Dr. Lake.
Cervical cancer is one of the top 10 cancers in women in Singapore and the second leading cause of death here for women aged 15 to 44.
The incidence of vaginal and vulvar cancers is much rarer in women, with an incidence rate of about 0.3 to 0.9 percent.
Many of the patients she sees are in their late 30s and already in the late stages of cervical, vaginal, or vulvar cancer with damaged organs. Until then, according to Dr. See too late, so she urges an early examination and vaccination. “
Here are four important things you need to know about HPV-related cancers:
1. How HPV leads to infection and cancer
HPV is transmitted when it is exposed to the surface of the lining of the vagina, vulva, cervix, rectum, anus, or mouth. This means that even without penetrative sex through skin-to-skin contact such as B. strong stroking can be transmitted.
However, not all HPV strains lead to cancer.
According to the World Health Organization, there are over 100 types of HPV strains, at least 14 of which can lead to cancer. Of these, HPV types 16 and 18 are responsible for 70 percent of cervical cancers worldwide.
There is currently no treatment for HPV infection. Some strains of the virus cause low-level infections that can usually go away on their own, while others cause high-level inflammation, infections, and mutations. In women with normal immune systems, it takes 15 to 20 years for cervical cancer to develop. In women with weakened immune systems, such as B. in the case of an untreated infection with the human immunodeficiency virus (HIV), it can only take five to ten years. These infections can be detected and treated with regular checkups before they develop into cancer cells.
However, it’s also harder for women over 30 to get rid of HPV infections, says Dr. Lake.
“A woman under the age of 30 can be infected with HPV and she is usually able to clear this infection. For HPV infection in a woman over the age of 30, this means that the infection is unlikely to have cleared and that the infection is more likely to develop cervical cancer, ”she says.
2. Men can also get cancer from HPV
In addition to being able to pass HPV on to women, men can also pass HPV on to their male partners through oral sex. If HPV is transmitted through anal sex, it can also develop into anal cancer.
Men should speak to their doctors to find out how they can protect themselves against HPV.
3. There are no symptoms in the early stages of cancer
Cervical, vaginal, and vulvar cancers have no symptoms in their early stages. Only early screening can detect the presence of cancer-causing HPV.
If the cancer is discovered at an early stage, a patient can have surgery to remove the cervix. Depending on the results, a patient may need chemotherapy or radiation.
“In the end, we will do a scan in the next few years. If the cancer doesn’t come back after five years, it’s unlikely to come back. However, we recommend that they return for follow-up care if other organs such as the vagina and vulva are affected, ”says Dr. Lake.
She shares that she sometimes receives patients who have gone for screening but not regularly, which can keep HPV infection undetected and cause cancer.
Others may have got a Pap smear but didn’t take the HPV test and the infection wasn’t detected.
The procedure for a Pap smear and an HPV test is the same – the cells in the cervix are gently scraped off. Pap smear samples are then examined for abnormal cells under a microscope, while the HPV tests are done for DNA from cancer-causing strains of HPV.
In addition to regular check-ups, Dr. See the vaccination. In Singapore, vaccination can start as early as the age of nine as it is generally recommended for people who are not yet sexually active.
“The younger we do the vaccination, the stronger our reaction and the longer our body remembers such a vaccination. Therefore, the HPV vaccine should ideally be given in early adolescence, as the vaccine is most effective before it is exposed to HPV through sexual activity, ”says Dr. Lake.
4. Treatments are potentially more difficult when symptoms of cervical, vaginal, and vulvar cancers become apparent
If symptoms such as vaginal bleeding and abdominal pain occur in cervical cancer, the cancer has progressed to at least stage 2, when the cancer has grown beyond the cervix. This means that treatment may not be as simple as removing it with surgery.
Symptoms of vaginal cancer also include bleeding or discharge, pain during intercourse, in the pelvic area, or when urinating.
“The earlier the cancer is, the easier it is to treat it; The later the cancer is, the more complex it is. If it reaches stage 4, the chance of recovery is slim and patients will have to receive chemotherapy for the rest of their lives, ”she says.
Her advice: “For those who have been vaccinated, get screening – HPV tests if you can. If you can’t get access to the HPV test, continue with Pap smears every year until it’s normal for three years. Then do it every three years until you are no longer sexually active. ”
Talk to your doctor to learn more about how to protect yourself from HPV.