�Silencing the silent killer�
Florence Radull | Friday August 22, 2014 16:17
A case in point is the lesser known but more deadly Cervical Cancer which was launched on the last day of July this year and is ‘celebrated’ annually in the month of August.
The Cancer Association of Botswana (CAB) organised weekly events this month to bring much needed awareness to the public about this near silent killer.
Just as Breast Cancer is represented by the colour pink, Teal (a dark green colour) symbolises Cervical Cancer. At an informative session on the deadly disease held at Oasis Motel on Tuesday the National Cervical Cancer Prevention Programme Officer in the Ministry of Health, Tlhomamo Pheto said despite the fact that Cervical Cancer is the leading cause of fatalities in women in Botswana, the disease has not received the awareness it deserves. She stressed the fact that the virus that causes Cervical Cancer is treatable and as such implored women to come forward and test to fight the disease.
“Our campaign message for the disease is let us fight Cervical Cancer to save lives. Silence the silent killer. Test early in order to get treatment in a timely fashion,” she said.
Pheto explained that Cervical Cancer is caused by the Human Papillomavirus (HPV). “HPV has been found to cause Cervical Cancer if left untreated. This virus is spread not only through sexual contact but also through skin to skin contact from other areas not protected by a condom such as the anal or genital area,” she said.
She said that using a condom could assist in stopping the transfer but added that since it is transferable from skin to skin, sexual intercourse does not have to take place for one to get infected. She, however, cautioned that not all HPV types put women at risk of contracting Cervical Cancer and other factors that contribute to the risk of contracting cancer include; being HIV positive, smoking, Chlamydia infection, unhealthy diet and Oral Contraceptives.
“Other risk factors include multiple pregnancies, low socioeconomic status and of course a family history of Cervical Cancer. There are high risk HPV’s no 16 and 18 that are known to be associated with Cervical Cancer and low risk HPV 6 and 8 which cause Genital Warts,” she said.
She urged women especially between the ages of 30 and 49 years of age to go for yearly Pap Smears as that is the only way of detecting the presence of HPV as the virus may remain dormant for years but can be passed from one person to another even when there are no visible warts or other symptoms.
On the other hand she advised men to heed the circumcision call as they can also spread HPV on their foreskin even though they cannot develop Cervical Cancer.
“Uncircumcised men can spread HPV from partner to partner but they do not develop Cervical Cancer. They can however, contract Penile Cancer as a result of this virus,” she said.
Pheto also revealed that the ministry has introduced a new method of testing that will hopefully take over from the dreaded and often uncomfortable Pap Smear, known as Visual Inspection with Acetic Acid or VIA.
“The VIA test is less intrusive and the time it takes to get the results is brief, but it is currently only available at Bontleng Clinic in Gaborone and Nyangabwe Referral Hospital in Francistown. We are in the process of training nurses in other institutions to be able to perform this test,” she said.
On the ministry’s response to the virus Pheto said that they are rolling out a new vaccine to counter the virus, which is known to reduce the high risk HPV by 70 percent. “This vaccine will be made available next year to all girls from the ages of nine and 11,” she said.
On risk factors of contracting HPV Pheto said that certain types of sexual behaviour increase a woman’s risk of getting the infection. These include having sex at an early age, having numerous sexual partners, having a partner who has had or continues to have many sexual partners and having sex with uncircumcised men.
“Being HIV positive also contributes to the contraction of this virus as of course your immune system is compromised, so in such a scenario extra pre-caution should be taken,” she said. Signs and symptoms that may indicate Cervical Cancer include; pain during intercourse, abnormal vaginal bleeding, unusual discharge from the vagina that may include blood spots, longer menstrual cycles or bleeding after intercourse or after a pelvic exam.
Speaking to Mmegi in an exclusive interview last week CAB coordinator Sharon Munyoro pointed out that Cervical Cancer continues to kill scores of women annually because of challenges such as lack of awareness and the time it takes for the results to be received. “Cervical Cancer is not as well known as Breast Cancer, hence our efforts to bring added awareness to it in the month of August. On top of that the government is grappling with the influx of women wanting to test as the service is free and this causes a huge backlog in getting their results back to them in a timely fashion,” she said.
Monyoro added that officially it is supposed to take three months to get the results back but some women say they have waited up to a year to get their results, which is of grave concern seeing the disease can progress rapidly in that period of time. She explained that some of the backlog challenges are caused by shortage of laboratories, a chronic lack of pathologist and few machines to perform the tests,
On the issue of vaccines currently available, Munyoro explained that there are two vaccines in the market manufactured by International Global medical companies Merck and GSK.
“A pilot project was run last year on girls aged between nine and 23-years-old to immunise them against the disease.”
She revealed that the immunisation consists of three injections. After the first vaccine the other two are administered at three month intervals. Despite the fact that medical aids in the country do not cover the cost of the vaccine, the P970 price tag for the three shots may be considered a small price to pay to prevent the disease.
“This immunisation covers a woman for between 10 and 20 years, so if one can afford it, it should be taken,” she emphasised. Munyoro reveals that in countries like Canada immunisation takes place automatically when girls enter Form One, usually between the ages of 10 and 18 years.
CAB is hoping to hold more sessions on Cervical Cancer before the month is up but this depends on obtaining funding for such events. Botswana Insurance Company sponsored the sessions on Tuesday and an impressive number of their employees took part in the proceedings.