The World Health Organization (WHO) today launched a worldwide campaign to get rid of cervical cancer. The disease is caused by a long-term infection with HPV. The aim of the campaign is that by 2030:
- 90 percent of people in all countries have been vaccinated against HPV.
- 70 percent of women are screened at least twice in their life with a Pap smear.
- 90 percent of women have access to treatment for cervical cancer or its precursor. This is still a challenge, especially in poor countries.
Olijf, a patient organization for women with gynecological cancer, is pleased with the WHO’s campaign. Every year in the Netherlands about 800 women are diagnosed with cervical cancer, most often between the ages of 30 and 40. About 200 women die from its effects every year. “And that while it is largely preventable,” said a spokesman.
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Blood loss
Kim (now 47) was 39 when she made an appointment with her doctor because she suffered from bleeding between her periods. Since it wasn’t a lot of blood, she wasn’t worried. Not even when she got the Pap 3b result after a smear, which means that abnormal cells were found in the cervix.
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She was sent to hospital for further examination. The gynecologist was also not concerned. “She said that most likely treatment was needed for the abnormal cells, but that she did not think about cervical cancer,” Kim tells RTL Nieuws.
When she came back two weeks later for the results, it turned out to be completely wrong. “I was sitting there alone in the hospital because I thought I would be told a treatment plan for the abnormal cells. Suddenly I turned out to have cervical cancer. I fell into a black hole. If I wanted to call someone, she asked. But everyone was at work. “
Metastases
The doctors decided that it was best for Kim to undergo Wertheim surgery. The uterus, cervix, support tissue, upper part of the vagina and regional lymph nodes are removed. During the operation, however, the doctors discovered that she had metastases in her lymph nodes.
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“Then it could not continue. The metastases meant that I would also receive radiation and chemo. It was too intense for my body to also undergo an operation.” The treatment afterwards was also very tough: for six weeks she received daily radiation treatment, chemotherapy once a week and finally brachytherapy, in which you received internal radiation.
Still complaints
After that, the cancer was gone, but Kim is still struggling with the consequences of the treatment more than seven years later. She suffers from complaints that occur more often after cancer, such as memory and concentration problems and fatigue. She also regularly has pain in her leg, bladder complaints and stomach and intestinal problems.
She is happy that the WHO is now starting a campaign. “Getting vaccinated at a young age or participating in the population screening can prevent a lot of misery. Women around 30 often think they are too young to have cancer. Then I think: yes indeed, try to prevent that with the population screening. “
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Population screening
The population screening for cervical cancer is done with a smear test. This involves taking cells from the mucous membrane at the border of your cervix and cervix.
Women between the ages of 30 and 60 are asked to have a Pap smear every five years. In the Netherlands, only 6 in 10 of the women called up does this. Especially women between the ages of 35 and 50 have a smear test performed less often.
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Nathalie (32) also knows how important it is to get vaccinated and to have a smear test. When she received a call for the cervical cancer screening program in September 2018, she initially put the envelope away. “I didn’t feel like it. That will come later, I thought.”
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She eventually went in December anyway. She already had stomach pains at the time, but was looking for nothing. The result of the smear test turned out to be incorrect: Pap 4, which means that seriously abnormal cells can be seen. “My doctor said there was no immediate cause for panic. I was referred to a gynecologist. She also said: ‘In the worst case, they are troubled cells that need to be burned away’.”
But it turned out to be wrong. “When she did further research, she suddenly said: ‘Oh, I see a tumor’. There you lie. She said it very directly and didn’t give a damn about it. I can appreciate that to this day, but I really didn’t see it coming at all. The tumor turned out to be quite large, about 4 centimeters. “
Children
Because Nathalie had no metastases, she was able to undergo the Wertheim operation. That also means that she can no longer have children now. “I already had two children, but when the results came, I had just started a new relationship. We were not that far yet. On the one hand, I am very happy that I have two healthy children, on the other. it’s very difficult when something like that is taken from you. “
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Just like Kim, Nathalie still suffers from complaints. “Something went wrong during the operation, causing a nerve damage in my leg. I can’t feel anything from my groin to my knee, but I can do everything with it. But now that it is getting colder, I have a lot more difficulty controlling my leg.” She also suffers from bladder spasms.
She understands that women don’t like the screening program. “Nobody feels like it. But I know from my own experience how important it is to go. You don’t have to have any complaints at all. And once you have complaints, it is often already at an advanced stage, like mine.”
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Vaccination
An HPV vaccination protects against two types of HPV, which together are responsible for about 70 percent of cervical cancer cases. Getting vaccinated does not guarantee that you will never develop cervical cancer, but you are much better protected.
In order for the vaccination to work optimally, it is important that you get it if you have not yet had sex. That is why girls are offered the vaccine in the year they turn 13.
In June of this year, the National Institute for Public Health and the Environment published the definitive vaccination figures for 2019. It became clear that the vaccination rate of girls against HPV has increased to 53 percent after a period of decline. That is an increase of 7.5 percent compared to 2018.
From 2021, HPV vaccination in the Netherlands will no longer only be for girls, but also for boys. The vaccination will be included in the National Immunization Program and the age limit will be lowered to 9 years.
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