มะเร็งปากมดลูก…ภัยจุดซ่อนเร้นของผู้หญิงทุกคน

<h2>Do you know enough about cervical cancer? 
</h2>
Abnormal division or growth of muscle cells in the cervix may turn into malignant cells in the cervix, or “cervical cancer”, which can also spread through the bloodstream and lymphatic system, invading nearby organs.
Dr. Thanomsiri Satitthit, a gynecologic oncology specialist at Phyathai 2 Hospital explains the nature of the cervix, which is located at the lowest part of the uterus and serves as the opening into the uterus. The cervix connects the vagina and the uterus, which is an organ located in the female pelvic cavity. The cause of cervical cancer cells is infection by a virus in the cervix area called Human Papilloma Virus (HPV). This virus causes changes in cervical cells, turning them into precancerous cells and eventually cancer cells over a period of about 10 – 15 years after infection.
<h2>Women at risk for cervical cancer 
</h2>
Dr. Thanomsiri Satitthit, a gynecologic oncology specialist at Phyathai 2 Hospital also points out the risk factors for cervical cancer. Based on her experience caring for gynecologic cancer patients, she classifies women at risk into 7 groups as follows:
<ul>
<li>Women who have sexual intercourse at a young age, a period when they are more susceptible to HPV infection</li>
<li>Women who have sexual intercourse with men who are promiscuous, increasing the risk of HPV infection</li>
<li>Women who have sexual intercourse with men whose wives or partners have cervical cancer</li>
<li>Women who have sexual intercourse with multiple men, increasing the chance of HPV infection</li>
<li>Women or men who are partners with sexually transmitted infections such as herpes, gonorrhea, warts, etc.</li>
<li>Women with diseases that lower immunity, such as AIDS (HIV)</li>
<li>Smoking reduces the body&#8217;s immunity, making it easier to get HPV infection</li>
</ul>
<h2>Important warning symptoms, physical signs of cervical cancer 
</h2>
It is unfortunate that most women do not realize they have cervical cancer until the body sends frightening warning signs. However, information from the Women&#8217;s Health Center, Phyathai 2 Hospital states that if cervical cancer is detected early, it can be treated. The most common symptom is abnormal vaginal bleeding, which is a key symptom that prompts women to see a doctor. Additionally, women should watch for these important warning signs:
<ul>
<li>Bleeding during sexual intercourse</li>
<li>Bleeding after menopause</li>
<li>Discharge mixed with blood from the vagina</li>
<li>Lower abdominal pain</li>
<li>Pain during sexual intercourse</li>
</ul>
Signs that cervical cancer has spread to other organs include swollen legs, blood in urine, and blood in stool. 
Dr. Thanomsiri Satitthit, a gynecologic oncology specialist at Phyathai 2 Hospital, recommends screening for cervical cancer by a gynecologic specialist
<ul>
<li>With a pelvic exam to look for abnormal lumps or lesions. If suspicious lumps or lesions are found, a biopsy will be performed for pathological examination.</li>
<li>Pap smear test (Pap Smear) is a pelvic exam and collection of cervical cells for laboratory testing.</li>
<li>HPV DNA test to detect HPV virus DNA which has a sensitivity of 99-100% in detecting early-stage cervical cancer. The HPV test checks for HPV infection with nearly 100% accuracy in detecting abnormalities.</li>
<li>Colposcopy and biopsy of suspicious areas for pathological examination in cases where the Pap smear shows abnormal cervical cells or when the Pap smear is normal but symptoms such as abnormal vaginal bleeding are present.</li>
</ul>
<h2>Treatment of cervical cancer 
</h2>
Treatment methods depend on several factors such as the stage of cancer, other underlying diseases, the patient’s age, and the patient’s desire for future fertility.
<h2>Treatment in the precancerous stage 
</h2>
At this stage, patients have no symptoms but can be detected through screening with a &#8220;Pap smear.&#8221; Treatment involves minor surgery with several methods such as cryosurgery (freezing the cervix), laser ablation, conization (removal of a cone-shaped section of the cervix) which can be done with a scalpel or electrosurgical loop, along with regular follow-up. Treatment at this stage has nearly 100% cure rate.
<h2>Treatment of cervical cancer</h2>
<ul>
<li>Early-stage cancer is treated by hysterectomy along with pelvic lymph node dissection. The cure rate for this stage is more than 80%.</li>
<li>Advanced-stage cancer is treated with radiation therapy or combined with chemotherapy.</li>
</ul>
<h2>Side effects of treatment</h2>
<ul>
<li>Surgery may have side effects such as infection and bleeding.</li>
<li>Radiation therapy side effects include dry, irritated skin, fatigue, blood in urine, and blood in stool.</li>
<li>Chemotherapy side effects include fatigue, nausea, vomiting, loss of appetite, hair loss. Symptoms depend on the type of chemotherapy drugs used.</li>
</ul>
<h2>Self-care when diagnosed with cervical cancer</h2>
<ul>
<li>Nutrition should include all 5 food groups at every meal, emphasizing fruits and vegetables. Avoid tea, coffee, and energy drinks. Drink at least 6 – 8 glasses of water daily. If experiencing loss of appetite, nausea, or vomiting during radiation or chemotherapy, eat soft, easily digestible foods in small, frequent meals.</li>
<li>Exercise regularly but not excessively and manage stress.</li>
<li>Be cautious of infections during periods of weakness from radiation and chemotherapy. Avoid crowded places.</li>
<li>Maintain cleanliness and dryness of external genitalia. If there is discharge or bleeding, wear sanitary pads and change frequently. Monitor for abnormal heavy bleeding, soaking pads, or discharge resembling pus, and see a doctor before the scheduled appointment.</li>
<li>Take medications as prescribed by the doctor.</li>
<li>Attend follow-up appointments for ongoing monitoring and treatment.</li>
</ul>
<h2>Pap smear: a globally accepted method to prevent cervical cancer 
</h2>
Pap smear screening detects changes in cervical epithelial cells before they become cancerous. Cervical cancer has a high incidence and mortality rate among Thai women because it is a silent disease with no early warning symptoms until it reaches an advanced stage. However, since the progression from cervical epithelial cell changes to cancer takes many years, cervical cancer can be prevented by screening with Pap smear and treating precancerous lesions before they develop into cervical cancer.
<h2>Who should get screened with Pap smear? 
</h2>
Women who have ever had sexual intercourse at any age and women who have never had sexual intercourse but are over 30 years old should have a Pap smear at least once a year.
<h2>Preparation for Pap smear screening</h2>
<ul>
<li>Avoid sexual intercourse 24-48 hours before the test</li>
<li>Do not insert any medication into the vagina 24-48 hours before the test</li>
<li>Do not douche 24-48 hours before the test</li>
<li>Do not have the test during menstruation</li>
<li>Do not have a pelvic exam within 24 hours before the Pap smear</li>
</ul>
<h2>Prevention of cervical cancer 
</h2>
Since HPV infection causes changes in cervical epithelial cells and is mostly transmitted sexually, it is important to be cautious about early sexual activity and to emphasize condom use to prevent sexually transmitted infections. Annual Pap smear screening is also important. Currently, there is a vaccine to prevent cervical cancer that helps the body build immunity against HPV. The vaccine is highly effective and safe, with side effects similar to other vaccines, such as swelling, redness, and pain at the injection site, which subside shortly after. The vaccine is recommended for everyone aged 9 and above, especially those who have not yet had sexual intercourse but plan to in the near future. Additionally, maintaining good health through proper nutrition, exercise, rest, and avoiding smoking helps strengthen immunity against infections.
&nbsp;
Dr. Thanomsiri Satitthit 
Gynecologic Oncology Specialist 
Women&#8217;s Health Center, Phyathai 2 Hospital

HPV virus causes changes in the cervical epithelial cells. This type of virus is mostly transmitted through sexual contact. Vaccination is another way to help reduce the occurrence of the disease.

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Cervical cancer… the hidden danger for every woman

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