‘No woman in Jamaica should die from cervical cancer’
ADVANCES have been made in Jamaica in the fight against cervical cancer, the number two cause of death in women from desiese. According to obstetrician/gynaecologist at the University of the West Indies (UWI), Dr Matthew Taylor, Jamaica had the third highest level of cervical cancer in the world in the 1960s, numbers which have decreased by half today.
But despite the reduction over the years, cervical cancer remains the second most common cancer among Jamaican women, especially those of reproductive age.
Dr Taylor was making his presentation at the third staging of the Dr Joseph St Elmo Hall Lecture Series last Thursday, held at the Terra Nova Hotel, on the topic ‘The treatment of Carcinoma of the Cervix — 50 years on’.
Dr Taylor said advances have been made in neoadjuvant chemotherapy — the administration of therapeutic agents before a main treatment. The use of this therapy can turn the tumour in the cervix from untreatable to treatable by shrinking the volume and allowing it to then be operated on.
“Screening is not just important to prevent the disease but to pick up the early stages of the diseases so it can be treated,” Dr Taylor said.
Another advancement is that of trachelectomy, the surgical removal of the cervix, the lower portion of the uterus that protrudes into the vagina.
Trachelectomy is done in younger women with early cancer of the cervix (with a tumour no larger than two centimetres). In this surgery, the cervix and the upper part of the vagina are removed but the rest of the uterus is left in place. Again this will allow the woman to be able to produce children thereafter.
He said if the disease is detected early the cervix can be removed and the woman can live a normal life. However, late detection means that surgery cannot be done and chemo/radiotherapy would have to be applied.
“The complication of chemo and radiotherapy is quite significant,” Dr Taylor said. He explained that for some women their sex lives will be over as the vagina becomes narrower and shorter, they may suffer from incontinence and diarrhoea, along with the fact that they have to wait six months to be given radiotherapy as a result of the lack of sufficient cobalt machines in the system. Presently there are only two in the public system and one in the private system.
Dr Taylor said quite a few young women are being diagnosed with cervical cancer, but if detected early and the cervix is removed, they would still be able to have children. However, late detection requiring radiotherapy means that the woman can no longer reproduce.
“If you remove the cervix the uterus is left behind so she can still have children,” Dr Taylor said. “Screening will prevent cervical cancer and also pick it up earlier so we can offer them treatment and increase their chances of fertility,” he said.
He said research done by Professor Horace Fletcher, head of the Obstetrics and Gynaecology Department at UWI, found that 90 per cent of women who die from cervical cancer have never been screened. Therefore, women are being encouraged to do regular pap smears.
Dr Tamu Davidson, medical epidemiologist, chronic diseases and injuries prevention officer at the Ministry of Health, said no woman should die from cervical cancer and that women need to get screened more regularly.
She said there has been a 31 per cent reduction in Kingston and St Andrew in terms of women being seen with the disease, but the aim is to have 80 per cent testing being done.
“We need to do better,” she said, explaining that the ministry is looking to partner with UWI to train more technicians for screening.
Meanwhile, Earl Jarrett, chairman of the Jamaica Cancer Society, said there is still the challenge with what happens post-screening and post-testing, as many women don’t do follow-ups.
