Protect to Tell: Cervical Cancer Protection Talk

Do you know what is Cervical Cancer? Do you know how you can protect yourself and your loved ones? 
Thank you OCG for the invitation to this informative session about Cervical Cancer at Lady M. 🙂 The myths and confusions about Cervical Cancer were brought up during this session. Always good to know more to make informed decisions.
Free Pap smear provided at Bishan Clinic

Why is there a need to clear up the confusion?

  • There have been great efforts made over the past few years to increase awareness about cervical cancer and options for preventions.
  • Rates have dropped since the introduction of CervicalScreen, Singapore’s pap smear screening programme.
  • HPV vaccination was made Medisave payable in 2010 for young girls.
  • Dispelling the myths will help all in a better education about cervical cancer and how you can prevent through regular screening and vaccination.
What a pleasant surprise to bump into an ex-colleague, Shandy.  🙂 She was an emcee. 
Before we start three presentation, we were given ample time to enjoy the delicious treat from Lady M.
Thank you Lady M for the yummy brunch! 🙂

Myth 1: Cervical Cancer is not common, it can never happen to me.

  • The number of Cervical Cancer cases in Singapore has been decreasing in the last 20 years because women take part in prevention programs.
  • Without these programs, cervical cancer is the 2nd most common cancer affecting women
Myth 2: I am not at risk of Cervical Cancer as there is no such history in my family.
  • Almost all cases of Cervical Cancer occur in women with no family history of it. It is caused by a common virus – HPV.
  • There are about 130 different types of HPV, but only 15 cause cancer.
Myth 3: Getting Cervical Cancer is linked to being sexually promiscuous.
  • HPV is transmitted through skin-to-skin contactSexual intercourse or contact at the genital area and non-sexual contact (mother to infant during delivery)
  • Women can still be infected from having just one partner
  • Every sexually active women is at risk of being infected by HPV because it is so common and so easily transmitted.
Myth 4: I am feeling well, I do not have HPV infection.
  • Cancer causing HPV infection is silent. Infected individuals do not know that they are infected and may unknowingly spread the virus.
  • Early Cervical Cancer has no signs or symptoms, this is why regular screening and prevention are critical.
  • As the cancer progresses, these symptoms and signs include – vaginal bleeding following intercourse or in between periods or after menopause

Myth 5: If I have a normal Pap smear, it means I will not have cervical cancer

  • A pap smear is a screening test to detect any changes in cervical cells.
  • One normal Pap smear is not enough to protect you from Cervical Cancer.
  • In Singapore, all woman aged between 25 and 69 years-old who ever had sex are advised to have a Pap smear done once every 3 years.
Myth 6: Pap Smear Program is effective, HPV vaccination is unnecessary
  • Pap smears and HPV vaccination play different roles in the holistic prevention of cervical cancer:
  • Pap smear detects changes in the cells of your cervix which may develop into cancer later.
  • Vaccination helps prevent certain HPV infection and reduce the risk of developing cervical pre-cancers and Cervical Cancer.
Professor Anne Goh, President of Singapore Pediatric Society

Myth 7: I am already sexually active, so the vaccine will not work for me

  • The best time to vaccinate is prior to sexual debut.
  • It does not treat or protect against any HPV infection you may already have. But it is very rare that you are infected by both types of cancer causing HPV at the same time.
  • HPV vaccine has been proven to protect thousands of women in the clinical trials who were already sexually active.
Myth 8: My daughter is too young to be vaccinated. She won’t be at risk of cervical cancer at the age of 10.
  • Better immunogenicity – immune response is stronger when vaccinating young
  • Singapore has included HPV vaccination into it’s National Childhood Immunization Programme starting from age 9-26 years. The decision to go for HPV vaccination is based on informed choice.
Professor Tay Sun Kuie, Senior Consultant, Department of Obstetrics & Gynaecology, SGH

Myth 9: Vaccinating adolescents will encourage sexual promiscuity

  • The main purpose of vaccination is to reduce risk of Cervical Cancer.
  • Hence vaccination should not encourage promiscuity.
Dr Chua Yin Nin, Senior Consultant gynaecologist and gynaecologic oncologist, Gleneagles Hospital
Information below from Amber Lim.
Who should have Pap Smear?
  • All women who have had sex should have their first pap smear at the age of 25.
  • Subsequent pap smear should be repeated every 1-3 years.
  • Women who have not had sexual contact need not have to go through pap smear since their hymen will still be intact.
  • One can stop screening at the age of 65 provided that there has been 3 normal consecutive preceding smears BUT if you were to re-marry at the age of 65 and had a change of sexual partner, you are advisable to continue doing the screening.
The percentage of effectiveness in preventing cancer through pap smear, no doubt, is highest when one do the screening yearly but even once every 3 year is already pretty effective.
When Pap Smear is abnormal:
It does not mean that you already have cervical cancer. Your doctor will have to do a colposcopy which is an outpatient scope procedure that magnify your cervix and vagina 40x to further detect for pre-cancer abnormalities. Once detected, pre-cancer changes can be easily removed with surgery laser in outpatient settings and the cure rate is more than 90%. Early treatment saves the womb and saves your life as your cervix will become normal again after the procedure!
It might be too late when Cervical Cancer sets in:
Cervical cancer management may involve surgery, radiotherapy, chemotherapy and palliative care.
While we might think that cancer is easier to cure when detected in the early stages, Dr Chia shared with us that 2 of her patients died when they were diagnosed at Stage 2.
This is why it is better to have detected pre-cancer abnormalities early before signs and symptoms (of cancer) started happening.
After the talk, a Q&A session.
1. How long will the vaccination last for?
Vaccination should work for a lifetime. HPV vaccination has been around for about 10 years and so far, the immunity of those who had been vaccinated were still going strong and thus, there is no reason to believe that the vaccination will be ineffective after 10 or more years.
2. Which vaccine should we choose?
It depends on your intention. Cervarix is more effective in protecting one from cervical cancer causing strain 16 & 18, as well as cross protection against some other cervical cancer inducing strains while Gardasil protects one better from genital warts caused by type 6 and 11, on top of, from cervical cancer causing strain 16 & 18. It is always the best to discuss with your doctor to make a better informed choice for yourself.
3. I am pregnant or breastfeeding, should I be vaccinated? 
HPV vaccines are not recommended for use in pregnant females. If you discover that you are pregnant after receiving 1 or 2 doses of the vaccine, it is recommended that you postpone the remaining dose(s) till after you deliver (there is no need to start from the first dose all over again). However, even if pregnancy is only discovered after completing the 3 doses of the vaccine, it is not necessary to terminate your pregnancy as there had been cases where women were vaccinated when they are not aware that they are pregnant and neither they nor their child suffered from any abnormalities. 
4. Does those who have irregular menses have higher risks?
No. Women who have higher risks; 1. had first sexual intercourse at an early stage (12++), 2. have multiple sexual partners in lifetime, 3. Smokers 4. Suffered from STDs (gonorrhea, chlamydia, syphillis, HIV). BUT, as mentioned multiple times earlier, any woman is susceptible to HPV infection leading to cervical cancer.
Ying Jie
Miyo and Joey
Photos credit to this wonderful woman, JJ Ho 🙂
For any inquiries, contact Singapore Cancer Society:
Singapore Cancer Society Multi-Service Centre
9 Bishan Place
Junction 8 Office Tower
Singapore 579837
Tel: 6499 9133
Fax: 6499 9140
Weekdays 8.30am – 6pm
Singapore Cancer Society
15 Enggor Street
Realty Centre
Singapore 079716
Tel: 6221 9578
Fax: 6221 9575
Weekdays 8.30am – 6pm
Disclaimer: Protect to Tell – Cervical Cancer Awareness” on 12th April 2014 Sat (the “Event”) was held as a lunch session, organised and sponsored by GlaxoSmithKline Pte Ltd. I was not paid for participating in the Event. All personal views expressed here are entirely my own.

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