Cervical cancer is preventable with vaccines that can hinder infection by the human papillomavirus (HPV), which causes the cancer.
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Immunotherapy – the holy grail
now a major new wave and the fourth pillar of cancer treatment after surgery, radiation and chemotherapy
. It’s already been shown to work better than chemotherapy in selected types of lung, kidney and skin cancers, said Dr John Chia Whay Kuang, Visiting Consultant,
Department of Medical Oncology
National Cancer Centre Singapore
“There are about 800 immunotherapy clinical trials ongoing worldwide, exploring immunotherapy as a single agent or in combination with other drugs, for every imaginable tumour type. It’s become the holy grail of cancer therapy. The immune system is selective, and it’s always with you. We need to learn how to use it optimally with other cancer therapies, and how to make immunotherapy more potent and work better.”
Cervical cancer is the second most common cancer in Singapore women, with about 200 new cases diagnosed a year. Stage 1 can be managed with surgery or radiation therapy, with about 70 to 80 per cent of women being cured (defined as remaining cancer-free for at least 10 years).
Stage 2B and above are treated with chemoradiotherapy, but survival rates in the advanced stages are more limited, unfortunately.
“Standard treatment paradigms for the disease haven’t changed for the past 20 years. We’re excited to be pushing and developing the field. One thing’s for sure – we need to do better,” Dr Chia said.
Vaccines can prevent it
Vaccines that can prevent infection by the human papillomavirus (HPV), which causes cervical cancer, have been available locally for several years. “The vaccines are more than 90 per cent effective, but need to be given before an individual becomes sexually active. Parents can and should do more to bring their children for vaccination.
It’s a preventable disease,” said Dr Chia.
The HPV infection is spread by sexual contact. In most cases, an infection is cleared by the immune system, but it sometimes persists and causes genital warts or cervical cancer.
Cervical cancer is also relatively unique among cancers because it
can be picked up by a PAP smear while still in a “pre-cancerous” stage. Simple intervention or surgery can then get rid of the lesions, and prevent the cancer from developing.
Symptoms include abnormal bleeding (between periods, after sex or after menopause), pain during sex, or abnormal vaginal discharge. Women with symptoms should have regular PAP smears and consult a doctor to catch the cancer in its early stages.
“Vaccination and screening are highly effective. Every new patient diagnosed represents a failure – of our profession, our knowledge systems, our will and our culture. It is a huge disappointment, because the disease is so preventable,” said Dr Chia.