As we honor Cervical Cancer awareness month, what do you feel is the most important message to share with patients and their families?
Cervical cancer can affect women of all ages including younger women. Cervical precancers and early cervical cancers are usually asymptomatic. Often, there are no symptoms or warning signs until the cervical cancer is advanced and has spread beyond the cervix. That is one reason that prevention and screening is critically important for saving lives and reducing cervical cancer mortality.
How do you collaborate with the gynecological oncology team at Smilow Cancer Hospital to care for your patients?
Depending on each individual woman’s needs and priorities, the treatment plan may involve fertility sparing approaches and avoiding premature menopause for younger patients. For patients with high-risk or advanced cervical cancer, a multi-modal individualized treatment plan is created to achieve best outcomes. The treatment could include individualized radiation therapy, chemotherapy, or immunotherapy, and often combined treatments. We have a multidisciplinary tumor board which brings together experts in my field (gynecologic oncology/gynecologic cancer surgery), radiation oncology, medical oncology, radiology, and pathology to develop individualized treatment plans. This collaborative approach results in the highest chance of disease control and survival for patients with advanced cervical cancer.
How does innovative scientific research work to advance the field of gynecologic oncology? Any recent advances that you are excited about?
What we have learned recently through well-designed randomized controlled clinical trials (the gold standard for evidence-based medicine) is that immunotherapy benefits many patients with cervical cancer and has a role in first-line treatment as well as treatment of recurrent disease. Immunotherapy is now an FDA-approved standard therapy for selected patients with cervical cancer.
Cancer prevention is one of the key priorities following the NCI’s 50th anniversary of the National Cancer Act. How can we prioritize cancer prevention in our daily lives? Role of screening?
HPV vaccination is a highly effective cancer prevention vaccine. HPV vaccination is part of the routine recommended childhood immunization schedule. In the absence of immunization, almost all adults acquire HPV infection which results in over 30,000 HPV-associated cancers in men and women each year in the United States, including over 10,000 new cases of cervical cancer each year. HPV vaccination prevents over 90% of cancers caused by HPV, which is an effective and proven strategy to protect from cervical cancer and several other cancers which affect men and women. Complementing vaccines, we know that cervical screening using pap tests and HPV tests is a highly effective way to detect precancers, which can then be treated before cervical cancer develops. All women should have cervical screening starting by age 21 years old. In young adults, screening is done with a ‘Pap test’ also known as cervical cytology. Once women reach age 30, routine HPV testing is a useful and highly sensitive screening test, which is often done as a ‘co-test’ at the time of pap (cytology). All women, whether or not they have had the HPV vaccine, should have periodic cervical screening as part of their ‘well-woman’ preventive care.