Cervical Cancer: Prevention, Detection and Treatment

January marks Cervical Cancer Awareness Month, which draws attention to this highly preventable disease. Michael Pearl, MD, FACOG, FACS, Professor of Obstetrics, Gynecology and Reproductive Medicine and Director of the Division of Gynecologic Oncology, wants women to stay informed on how they can protect their cervical health, as well as what options are now available for treatment.

What is cervical cancer and is it preventable?

This type of cancer forms in the tissue of the cervix, the organ connecting the uterus and vagina. It is usually a slow-growing cancer and is almost always caused by human papillomavirus (HPV).

Cervical cancer is a highly preventable disease. That wasn’t always the case. Cervical cancer was once the most common cause of cancer death in women. With the introduction of the Pap test, a screening test that detects changes in the cervix before cancer develops, cervical cancer deaths dropped nearly 70 percent between 1955 and 1992 — and this rate continues to drop by 3 percent each year. Preventing it involves a three-pronged approach: receive regular Pap tests; vaccinate against HPV early; and take an HPV test when recommended

Is the Pap test the single best tool for reducing the risk of cervical cancer?

Yes. This simple test, done in your doctor’s office, detects abnormal cells that can lead to cancer. The cells can then be treated before they develop into cancer. When the Pap test is performed, your doctor can also ask that the sample be tested for HPV. The key is to follow the guidelines for test frequency.

What are the guidelines?

The American Cancer Society (ACS) recommends that women ages 30 to 65 have screenings with Pap testing and HPV testing every five years, or Pap testing alone every three years. For women ages 21 to 29, the ACS recommends screening with Pap testing alone, every three years. This is something you should discuss with your doctor to ensure there are no other factors that may require more frequent screenings. Because HPV is linked to cervical cancer, another useful tool is the new HPV vaccine; current guidelines recommend giving the vaccine to teens before they become sexually active.

What additional steps can be taken to reduce the risk?

In addition to following the Pap and HPV screening test guidelines and the recommendations of your physician based on your individual health, you can consider incorporating these steps into your lifestyle:

• Reduce your risk for HPV, which often is symptomless, by following safe sex practices, including using barrier contraception.
• Don’t smoke, as smoking cigarettes slightly increases the risk.
• Get vaccinated against HPV.
• Strengthen your immune system.

If I am diagnosed with cervical cancer, what are my options?

As with most cancers, treatment options include surgery, radiation therapy and chemotherapy — all of which are available at Stony Brook Cancer Center. The Center’s Gynecologic Oncology Management Team is the only academic subspecialty practice in Suffolk County. In addition to providing comprehensive multidisciplinary care for women with known or suspected gynecologic cancers, we also conduct research into the development and treatment of these cancers.

What new treatments are available at Stony Brook?

Stony Brook offers robotic-assisted minimally invasive surgery using the da Vinci® Surgical System for staging and treatment of cervical cancers. The system offers doctors increased depth perception, magnification, and the ability to use different instrumentation than in laparoscopic minimally invasive surgery. It also offers women significant benefits over traditional open surgery, including faster recovery,  fewer wound complications and less postoperative pain.