Cancer in Gynaecology

Prevention is better than cure. This saying is true to it's last word. How do you prevent cancer in women? The key word would be Detection. Statistics apart, practically speaking, the incidence of cancer of cervix (mouth of uterus) tops the list in the Indian subcontinent.

Before we venture onto the methods of detection, let's consider some of the factors that have been proposed to lead to the formation of growth on the cervix.

• Age: Though less common before the age of 35, it has it's occurence between 35 to 50 years, and is again less common after the age of 60. The beginning of cancer is seen much earlier, and this is where screening of a woman is mandatory.
• Marriage: Early marriage, more children and hence early sexual activity has a direct bearing on the incidence of the disease.
• Low socio-economic conditions.
• Early age of first coitus. Women sex workers (prostitutes) have a higher incidence.

Keeping the causative factors in mind, detection is directed towards screening of women who are pre-disposed to the condition. The methods of detection are:-

PAP smear: This is an OPD (out patient) procedure, where the woman is examined and a smear is taken from the cervix on a glass slide. The slide is stained to detect cancer cells. This procedure is painless and does not require anesthesia, though there may be some discomfort.

Colposcopy: Another OPD procedure where there is little or no discomfort experienced. The cervix (mouth of uterus) is visualized with a specially designed magnifying scope. Suspicious areas are mapped and a biopsy is taken. This is more specific than a routine PAP smear.

Cervical Biopsy: Though this procedure can be performed without anesthesia, it is advocated in women with low threshold of pain. A small bit of tissue from a suspicious area is punched out with a special instrument and sent for laboaratory examination.
Cone Biopsy: The entire suspicious area is cordoned of. The additional advantage of this procedure is the help it gives in assessing the severity and probable outcome of the disease.

The other non-invasive procedures like Pelvic sonography, CT scan, MRI will help to assess the grade of the disease and subsequent outcome, but as far as detection is concerned, OPD procedures are good enough, effective and less expensive.