Did you know that every two sexually active adults, one of them will be exposed to Human Papillomavirus (HPV)? In this episode of AskMeDoctor, Dr. Tan Cheng, Obstetrician and Gynaecologist from Tung Shin Hospital shared questions and answers regarding Cervical and Ovarian Cancer.
Research stated that cervical cancer and ovarian cancer are among the top 10 most common cancers in women. Thus, it is very important to educate ourselves so that we can detect cancer early to improve the chance of recovery before it worsens!
Q1: Does ovarian cancer only affect married women?
Dr Tan Cheng: This statement is NOT TRUE. There are different types of ovarian cancers and can affect both young and elderly women. It can affect virgins and those who have been sexually active.
- 5–10% of all cancers are inherited.
- 10–15% of cancers can have multifactorial interaction.
BRCA (Breast Cancer gene) is associated with breast, ovarian and Fallopian tube cancer.
Q2: Do those with a family history of cancer have an increased risk of getting ovarian cancer and cervical cancer?
Dr Tan Cheng: A woman is defined as being at high risk of ovarian cancer if she has a first-degree relative (mother, father, sister, brother, daughter or son) who is affected by cancer within her family.
Cancer that can most likely to be diagnosed based on two generations family are ovarian cancer, breast cancer, colon cancer, stomach, endometrial, urinary tract, and small bowel cancer.
Q3: Can a woman be pregnant if she is diagnosed with an ovarian cyst?
Dr Tan Cheng: Yes, you will be able to get pregnant. A lady has two ovaries. If you previously removed one and had an operation for ovarian cyst, it can either be cystectomy, which is the removal of the cyst or oophorectomy, which is the removal of the entire ovary.
Cystectomy itself means the ovary of the affected site still remains and will still have its function. Even if it is oophorectomy, the other side of the ovary is still intact and will still be able to produce oocytes/eggs.
Q4: How does ovarian cancer be checked?
Dr Tan Cheng: Screening tests are used to detect a disease in people without any symptom. There has been a lot of research done to develop a screening test for ovarian cancer. However, until now, there is not a single reliable screening test as of yet.
You can use ultrasound, such as trans-abdominal or trans-vaginal ultrasound to assess the ovary. This method can identify any growth, cyst or mass around the ovaries. Further investigation can be carried out if the ultrasound image contains suspicious findings on cancer.
There are also blood tests available in combination with ultrasound in order to assess the risks of cancer. Tumour markers, such as CA125, are commonly used when ovarian cancer is suspected.
Q5: What do we know about HPV-associated cancer?
Dr Tan Cheng: The current data suggests that 5% of the newly diagnosed cancer cases worldwide are caused by Human Papillomavirus (HPV). Human Papillomavirus (HPV) causes:
- 99% of cervical cancers
- 85%–91% of anal cancers
- 70%–78% of vaginal cancers
- 30% of vulva cancers
Q6: Is Human Papillomavirus (HPV) common?
Dr Tan Cheng: Human Papillomavirus (HPV) is a sexually transmitted infection that the majority of the population is exposed to. For every two sexually active adults, one of them will be exposed to Human Papillomavirus (HPV).
Q7: Are there any symptoms for HPV infection?
Dr Tan Cheng: During the initial phase, the majority will not have any symptoms. In fact, a healthy body immune system may clear up the infection naturally.
In the cases of persistent infections, genital warts may be developed by a low-risk Human Papillomavirus (HPV) infection, while cancer may develop years later by a high-risk Human Papillomavirus (HPV) infection.
Q8: How does Human Papillomavirus (HPV) infection be detected?
Dr Tan Cheng: The current cervical screening (liquid cytology) can provide Human Papillomavirus (HPV) genotyping. It can determine the type of Human Papillomavirus (HPV) before there are any changes to the cervical cells.
Q9: Are there any symptoms of cervical cancer?
Dr Tan Cheng: Cervical cancer at its early stage normally does not have any symptoms. When the disease is more advanced, commonly reported symptoms are:
- abnormal vaginal bleeding
- post-coital bleeding
- inter-menstrual bleeding
- post-menopausal bleeding
- abnormal vaginal discharges
- pelvic pain
- painful sexual intercourse
Q10: How can cervical cancer be prevented?
Dr Tan Cheng: Currently, there are two ways to prevent cervical cancer. Prior to the availability of vaccination, the main method of prevention is by cervical cancer screening. It can detect pre-cancerous changes and allow early treatment to be initiated.
Human Papillomavirus (HPV) vaccination, on the other hand, can prevent Human Papillomavirus (HPV) infection. The latest vaccine is able to provide protection for nine types of Human Papillomavirus (HPV) – namely HPV6, 11, 16, 18, 31, 33, 45, 52 and 58.
Important Facts, Take Note Ladies!
- HPV vaccination is FREE to all Malaysian citizens or permanent residents (PR), females who are between 23 and 26 years old, single, not yet married or currently not pregnant.
- It is important to know that vaccination at an older age is less effective in lowering the risks of cancer.
- Well, cervical screening should be initiated among those who are 25 years old and above when you are sexually active. If you are between the age of 25 and 49 years old, my advice would be to do so at least once in every 3 years.
- If you are between the age of 50 and 65 years old, at least once in every 5 years. After the age of 65, there is no need for further cervical screening; provided that your earlier screenings are normal.
Ultimately, it is very important for women to take this matter seriously because the risk of having HPV cancer is high. Remember, don’t forget to get yourself checked! Your health is your number one priority.
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