Month: August 2015

Prevention of Cervical Cancer (HPV Vaccine)

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What is HPV ?

HPV (Human Papilloma Virus) is a common virus that is passed from one person to another through direct skin-to-skin contact during sexual activity. Most sexually active people will get HPV at some time in their lives, though most will never even know it. HPV infection is most common in late teens and early 20s.

There are many strains (types) of HPV that can infect the genital areas of men and women. Most HPV types cause no symptoms and go away on their own. But some types can cause cervical cancer in women and other less common cancers – like cancers of the anus, penis, vagina, and vulva (area around the opening of the vagina) and oropharynx (back of throat including base of tongue and tonsils). Other types of HPV can cause warts in the genital areas of men and women. These genital warts are not life-threatening. However, they can cause emotional stress and the treatment can be very uncomfortable.

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Pic courtesy:  http://www.virology.wisc.edu/virusworld/viruslist.php?virus=hpv

Why are HPV vaccines important ?

The vaccines target the HPV types that most commonly cause cervical cancer. One of the two currently available vaccines also protects against genital warts caused by HPV. Both vaccines are highly effective in preventing specific HPV types.

What is the vaccination schedule ?

The schedule is three doses of intramuscular injections, administered over a period of six months.

Who needs to get vaccinated ?

HPV vaccination is recommended for girls and women (9 to 45 years of age).

Can pregnant women take the vaccine ?

The vaccines are not recommended for pregnant women. Although studies show that HPV vaccines do not cause problems for babies born to women who received HPV vaccination when pregnant, more research is still needed. If the patient becomes pregnant in the middle of the vaccine series, then the doses should be completed after delivery. Vaccination can be given during breastfeeding.

Should girls and women be screened for cervical cancer before getting vaccinated?

Girls and women do not need to get an HPV test or Pap test to find out if they should get the vaccine. However it is important that women continue to be screened for cervical cancer, even after getting all three shots of the HPV vaccine.

How effective is the vaccination ?

It is a prophylactic vaccine. As with any vaccine, a protective immune response may not be elicited in all cases. The vaccines are less effective in preventing HPV-related disease in young women who have already been exposed to one or more HPV types. That is because the vaccines can prevent HPV only before a person is exposed to it. HPV vaccines do not treat existing HPV infections or HPV-associated diseases.

How long does the vaccine protection last ?

Research suggests that the vaccine protection is long-lasting. Current studies (with up to about seven years of follow-up data) indicate that the vaccines are effective long term, with no evidence of decreasing immunity.

Do the vaccines protect against all HPV types ?

The vaccines do not protect against all HPV types. They are ineffective in about 30% of cervical cancers. It is important, therefore, for women to continue regular screening (Pap tests) for cervical cancer.

How safe is the vaccine ?

Both vaccines have been licensed by the Food and Drug Administration (FDA) and approved by Centre for Disease Control (CDC) as safe and effective. Common mild adverse events reported during these studies include pain at the injection site, fever, dizziness and nausea.

In what other ways can women prevent cervical cancer ?

Regular cervical cancer screening and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early treatable stage. There are HPV tests, which may be used with the Pap test in certain cases, to help determine the next step in cervical cancer screening. Use of condoms and limiting the number of sexual partners may lower the chances of getting HPV.

Regular cervical cancer screening and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early treatable stage. There are HPV tests, which may be used with the Pap test in certain cases, to help determine the next step in cervical cancer screening. Use of condoms and limiting the number of sexual partners may lower the chances of getting HPV.

Breast Cancer – Early Detection And Prevention

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Breast cancer is now becoming the most common cancer in women in India. For the year 2015, there will be an estimated 1,55,000 new cases of breast cancer and about 76,000 women in India are expected to die of the disease. The gap only seems to be widening, which means, we need to work aggressively on early detection. (Statistics of Breast Cancer in India: Global Comparison)

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Pic Courtesy: http://www.discussingbreastcancer.com/breast-cancer-prevention-and-early-detection-tips/


Tips for prevention and early diagnosis

Exercise :

Women who exercise about 30 minutes, three to four times a week, can decrease the risk of breast cancer by 26%.

Breastfeeding Your Child :

Women who breastfeed their children will have reduced risk of breast cancer.

Maintaining Weight :

Women who gained 25 kgs above what they weighed after the age of 18 have 45% risk of developing breast cancer compared to women who maintained their weight.

Weight Loss After Menopause :

Women who reduced 10 kgs after menopause compared to pre-menopause weight also reduce their risk of developing breast cancer by 45%.

Avoid Alcohol :

Women who have 1 or 2 alcohol drinks a day increase their risk of breast cancer by 10%. Even moderate alcohol intake increases endogenous estrogen levels and provide a potential mechanism for breast cancer development.

Regular Screening After Age 40 :

Breast cancer, if detected early, can be cured completely. Monthly breast self-examination, yearly medical check and mammogram will detect cancer in its early stage. Monthly breast self-examination should start as early as in teens.

Eating Right :

A plant-based diet of at least two cups of a variety of vegetables or fruits is beneficial. There is evidence that minerals, vitamins, and phytochemicals in plant foods interact in different ways to boost an individual’s anticancer effects.

The top picks for cancer prevention include beans, berries, cruciferous vegetables (broccoli, cauliflower, cabbage, brussels sprouts), dark leafy green vegetables (spinach, mustard greens etc), flaxseed, garlic, grapes/grape juice, green tea, soy, tomatoes and whole grains.

Central Obesity :

Excess belly fat seems to be particularly harmful, most likely because of its effects on inflammation and its association with elevated insulin levels. So if you tend to be more “apple shaped” and carry extra weight in your belly, it is especially important to lose weight. Exercise regularly, and limit refined grains, sugar sweetened beverages, and added sugar in your diet.

How To Do Breast Self-Examination

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Why Do  Breast Self-Examination

There are many good reasons for doing breast self-examination each month. It is easy to do. When you get to know how your breasts normally feel, you may be able to feel any changes. With practice, it should take about 15 minutes each month. Early detection of likely cancerous lumps is the key to successful treatment and cure.

Look for Changes

Look for changes in front of a mirror. View the front and each side in three positions. Relax arms at your sides. Look for changes in shape, colour, or any puckering, dimpling, skin changes or nipple discharge.

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Raise hands above your head. Check again for puckering, dimpling and skin changes.

Place hands on hips, press down, and bend forward. Check nipple direction and general appearance.

Palpation Technique

Use the pads of the middle three fingers of each hand to examine the breast on the opposite side. Do not use fingertips. Keep fingers together.

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Move fingers in small circles, using the three levels of pressure in each spot. Keep fingers, knuckles, and wrists straight. “Walk and slide” finger pads along so no breast tissue is missed.

Feel for Changes Lying Down

Pressure : Lumps can occur at any depth. Use three levels of pressure to examine each spot thoroughly.

Light : Use very light pressure on the first circle. The pressure should be just enough to move the skin without disturbing the tissue underneath. Pressing too hard at first could cause the lump to move out of the way.

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Medium : On the second circle, use medium pressure to feel for changes below the surface up to the mid-level of the breast tissue.

Deep : On the third circle, check for lumps deep in the breast tissue.

Pattern :  Use a vertical strip pattern to check the entire breast area. Imagine mowing a lawn with straight, vertical, overlapping rows. When you reach the end of each row, move over about one finger width and start the next row.

Once you start, do not lift fingers from the breast area. Be sure to examine the nipple with the same palpation technique you use to examine the rest of the breast tissue. The area to be examined includes sides, top and bottom of the breast. Sides include the line from the middle of the armpit (axilla), the area beyond the breast fullness, down to the bottom bra line and over to the middle of the breast bone.

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The top starts after a two finger gap above the collar bone. Two finger-widths below the bra line indicate the bottom of the breast.

Check the Lymph Nodes

Lymph nodes drain the breast tissue. The lymph nodes that drain the breast tissue are located in three spots :

  • Above your collar bone—
  • Below your collar bone
  • In the armpit you will want to know if any nodes are enlarged, movable or unmovable

Position for Examination

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Position 1 :  Spread the breast tissue evenly over the rib cage. Turn on your side with the knee bent. Lean the shoulder back towards the outside (away from your hip) and put your hand on your forehead. Place a pillow under your lower back to make it more comfortable. You are in the right position when your nipple seems to “float” at the top of the mound of your breast tissue.

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Position 2 :  When the search pattern reaches the nipple, hold fingers in place on the nipple and roll back into a position. Lie flat on your back. The arm on the side being examined should now be extended directly away from the body (at a right angle).

When to Do Breast Self-Examination?

The best time to do breast self-examination is right after your periods, when the breasts are not tender or swollen. If you do not have regular periods or sometimes skip a month, choose a day and do it the same time every month.

Remember the ABCs of Breast Health

  • A Screening mammogram
  • Breast self-examination
  • Clinical breast examination

Breast self-examination can save your life. Most breast lumps are found by women themselves or their partner. Most lumps in the breast are not cancerous. Any lump or change should be checked by a doctor.

Early detection is your best protection!