Screening of cancers in the reproductive organs
Women experience various types of cancers. Among them, the cancer in the reproductive organs has a frequency of 14%. This can be the cancer in the opening of the uterus, cancer in the ovary, cancer in the vaginal path and also in other parts.
It is possible to reduce the frequency of these cancers by improving the living standard, maintaining hygiene of reproductive organs, not getting married or not getting habituated in sexual intercourse at early age, avoiding polygamous tendencies for both male and female, giving up the habit of smoking and taking vaccines.
We need to observe the primary symptoms of cancer in reproductive organs. These can be irregular menstruation, problem in sexual intercourse, foul smelling vaginal discharge, feeling lumps in the body, accumulation of free water in abdomen etc.
It is possible to identify the cancers in reproductive organs at primary stage by regular physical and laboratory check ups. In developed countries, due to regular check ups and public awareness, 25-50% women report to the doctor within three months of the development of primary cancer symptoms, and the rest 20-45% women report within 3 month to one year. The scenario of countries like Bangladesh is different in this aspect.
Cytological test can help us to identify the cancer in reproductive organs at early stage. In this method, some fluid is taken from the reproductive organ and then it is examined whether it has any cancer cell or not.
Cervical cytology/Pap smear: This is considered as the gold standard in primary identification. In this method, some fluid is taken from the opening of uterus. It is said that every woman should take this test at least once within 30 years of age. If the first test reports that there is no cancer cell, then she is advised to take the test again after one year. If the second and third year test also comes negative, then she is advised to take Pap smear every 3 yearly.
Peritoneal cytology: Fluid can accumulate in the abdomen as a symptom of various diseases. The cancer in ovary is one of these. If the fluid is examined and cancer cells are found there, then the presence of cancer can be verified by specialised test afterwards.
VIA: In this method, some medicine is applied and the opening of the uterus is observed under bright light. After applying the medicine, if it is observed that the opening of uterus turns white in colour, then it is considered as VIA positive. If it does not, then it is considered as VIA negative. This white colour does not stay for a long time. If VIA is positive, then the cancer is identified through colposcopy, biopsy. VIA is very easy method. It does not require any dissection.
Colposcopy: In this method, the cells from the exterior of vaginal path and the opening of uterus are examined with a specially made microscope. If Pap smear test reports the presence of cancer cells, or if the presence of cancer is suspected despite the negative Pap smear report, this test is suitable for both the cases.
Cervicography: This method can be applied to the places, where it is difficult to find a skilled person who can provide medical services. In this method, a picture of the opening of uterus is taken with a special camera, and then it is sent to some specialist for opinion.
USG: The cancer in ovary can be primarily identified by transvaginal scan (TVS). For this reason, the women with a family history of cancer in ovary are advised to perform TVS at least once a year. In some cases, Doppler Ultrasonography can be applied.
Tumor marker: It resides in the blood and indicates which part of the body contains tumour. This tumour marker is one of the methods to primarily identify cancer in ovary and Gestational Trophoblastic disease.
The simple and naive women of Bengal don't want to open their mouth regarding any confidential matter concerning her, especially when it comes about menstruation. These financially dependant women are sometimes afraid of going to doctors and prove her suspicion right. Some walk in a wrong path due to ignorance and lack of scientific explanation. Besides that, it is also true that appropriate medical services are yet to reach every doorstep.
Even then we are hopeful. With our combined effort, it is possible to cure and prevent the cancer in reproductive organs.
The writer is a gynaecologist. E-mail: dr.purabi@yahoo.com