The importance of prevention and screening for cervical cancer

Worldwide, cervical cancer is the second most common type of gynaecological cancer. In North America, it is the eighth most common cancer. The incidence of cervical cancer has decreased in the developed world because of regular Pap screening. Pap tests detect abnormal cells before they become cancer and further treatments can prevent them from ever becoming cancer. 

“Sadly, not all women go for regular testing and so we continue to see this lethal disease,” said Dr. Georgina Wilcock, an Obstetrician/Gynecologist at The Scarborough Hospital. “Each year in Canada, it’s estimated there are 1,300 new cases of cervical cancer diagnosed and 390 women will die of the disease. “

For these reasons, Dr. Wilcock reminds women about the importance of regular Pap test screening, which has been shown to decrease the incidence of cervical cancer by 50 per cent.

The Pap test is a quick, simple and usually painless procedure where a doctor scrapes and removes cells from the surface of the cervix with a small brush or spatula.  The cells are then examined in a laboratory. In the event that a Pap test shows  changes or abnormalities in the cervical cells, follow-up tests or procedures may be done.

Currently in Canada, it is recommended that women between the ages of 18 and 69 (or women under 18 who are sexually active) undergo cervical screening.

“Although the cause of cancer in general remains somewhat of a mystery, the cause of cervical cancer is not. The culprit is almost always the human papilloma virus (HPV) infection, one of the most common sexually transmitted infections (STIs),” points out Dr. Wilcock.

While some types of HPV cause genital warts, other strains of the virus can infect the cervix and then cause abnormal changes within the cells that may slowly progress to cancer.

There are several other important steps women can take to minimize their risk of developing cervical cancer:

• Get the HPV vaccine – The world’s first vaccination against HPV was approved in Canada and the U.S. in 2006. The vaccination provides protection from four different types of HPV – two of which cause 70 per cent of cervical cancer. In Ontario, this vaccine is given free to girls in grade eight. It is given at this young age because it has been shown that this is the best age for young women to develop a strong immunity to the virus.
• Practice safe sex – The HPV virus is most commonly transmitted via sexual contact and intercourse. Refraining from genital contact with an infected person or using a condom will reduce the risk of HPV infection.  However, condoms are not 100 per cent effective as they only protect the covered area.
• Stop smoking – Both tobacco smoking and exposure to second hand smoke have been associated with the development of cervical cancer. Quitting smoking can reduce the chance of developing the disease.

And, of course, ensure that you are receiving regular Pap testing.

Know the risk factors and symptoms of ovarian cancer

Ovarian cancer has been called ‘the cancer that whispers’ because of its vague symptoms and lack of effective screening. But more and more women and health care providers are speaking out about this ‘silent killer’.

“Unfortunately, only about 19 per cent of ovarian cancer cases are diagnosed before the cancer has spread outside the ovaries,” says Dr. Orit Freedman, a Medical Oncologist at The Scarborough Hospital. “However, when ovarian cancer is found after it has spread, while it’s sometimes not curable, it is treatable.”

One of the most important parts of the treatment is the patient’s initial surgery. The Scarborough Hospital has partnered with Sunnybrook Health Sciences Centre to have their surgical oncologists participate in ovarian cancer surgeries at TSH so that patients have the best outcomes possible.

Risk factors for ovarian cancer can include:

• Having a personal or family history of breast, ovarian or colon cancer
• Being post-menopausal
• Being obese
• Infertility and using fertility drugs.

Dr. Freedman encourages women to be aware of the following common symptoms that persist almost daily for two weeks or more:

• Bloating
• Pelvic or abdominal pain
• Trouble eating or feeling full quickly
• Urinary urgency or frequency.

In addition, other symptoms of ovarian cancer may include:

• Upset stomach
• Back pain
• Pain during sex
• Constipation
• Menstrual changes
• Unexplained changes in bowel habits
• Unexplained changes weight gain or loss
• Ongoing unusual fatigue.

“Talk to your family doctor about any concerns you may have about ovarian cancer and ways you can reduce your risk,” says Dr. Freedman.  “General information about ovarian cancer can also be found on the Ovarian Cancer Canada website at http://www.ovariancanada.org/.”

Ten reasons to quit smoking today

Although smoking rates have decreased significantly over the last two decades, lung cancer – most commonly caused by smoking – is the leading cause of cancer deaths in Canada. Each year, over 24,000 people in Canada are diagnosed with lung cancer and 20,000 Canadians die of the disease.

“For those who do smoke, quitting can have a significant and positive impact on your health,” says Dr. Henry Krieger, a medical oncologist at The Scarborough Hospital. “Lung cancer is the most preventable cancer and the deadliest. Quitting smoking can reduce your risk of developing the disease.”

Dr. Krieger shares some good reasons to quit smoking today:

1. Cigarettes contain 70 chemical compounds known to cause cancer.
2. Smoking is the leading cause of lung cancer and kills more than 20,000 Canadians annually.
3. Smoking can also lead to other cancers including oral, esophageal and larynx cancers.
4. Exposing others to second-hand smoke puts them at risk of developing health problems.
5. Quitting smoking saves money.
6. By butting out permanently, you will improve your sense of smell and taste.
7. Smoking can cause complications with other diseases like diabetes.
8. Smoking contributes to heart disease, emphysema, stroke and several other life-threatening conditions.
9. Stopping smoking can give you fresher breath and cleaner teeth as well as a fresher smelling home, car and clothes.
10. Quitting smoking can improve breathing.

Six tips for testicular self-exams

Toronto Public Health recently launched the “Check Your Package” ad campaign aimed at creating awareness about testicular cancer and the importance of monthly self exams. Ads for the campaign, which include a photo of a man’s midsection, were denied by Facebook and deemed distasteful and threatening.

“Testicular cancer is the most common type of cancer among men 15 to 35,” says Dr. Henry Krieger, a medical oncologist with The Scarborough Hospital for 35 years. “In most cases, the cancer is curable if detected early. It is important to bring awareness to the significance of self exams.”

When conducting a self exam, check for swelling or enlargement of a testicle; a hard lump on the front or sides of your testicles; an increase in firmness; and pain, discomfort or a heavy feeling in the scrotum or lower abdomen. If you have any of these symptoms you should consult a doctor.

Here are the steps to conducting a monthly self exam:

1. Look at your testicles in the mirror and get familiar with their size, shape and feel.
2. After a bath or shower, hold the scrotal skin in the palms of your hands.
3. Check one testicle at a time.
4. Using both hands, gently roll each testicle between your fingers.
5. Gently roll your thumb over the top of the testicle. You should be able to feel the epididymis, the tube that carries sperm. This is a normal lump at the back of each testicle.
6. Repeat monthly.