Cervical Cancer: Prevention, Detection and Treatment

BurkeWilliam M. Burke, MD
Gynecologic Oncologist
Associate Professor, Department of Obstetrics, Gynecology and Reproductive Medicine, Division of Gynecological Oncology
GossnerGabrielle Gossner, MD
Gynecologic Oncologist
Assistant Professor, Department of Obstetrics, Gynecology and Reproductive Medicine, Division of Gynecological Oncology

January marks Cervical Cancer Awareness Month, which draws attention to this highly preventable disease. Drs. William Burke and Gabrielle Gossner, in the Division of Gynecologic Oncology at Stony Brook Cancer Center, want women to stay informed on how they can protect their cervical health, as well as what options are now available for screening and treatment.

What is cervical cancer and is it preventable?
This type of cancer forms in the tissue of the cervix, the organ connecting the uterus and vagina. It is usually a slow-growing cancer and is almost always caused by human papillomavirus (HPV). Cervical cancer was once the most common cause of cancer death in women. With the introduction of the Pap test and widespread screening practices initiated in the 1950s, the number of cervical cancer deaths in the United States have declined dramatically. Preventing it involves a three-pronged approach: community education, screening and vaccination against HPV.

What’s the best method for reducing the risk of cervical cancer?
The best method for cervical cancer screening has changed over the past few years. With a greater understanding of cervical cancer, the causal role of infection with high-risk HPV types, and advancing technology, providers and patients have multiple options for screening. Currently, there are three effective screening strategies. Choosing the best approach may be done on an individual basis. Please speak to your provider about which approach would be best for you.

What are the guidelines?
The American Cancer Society currently recommends no screening for women under 25 years of age. Women ages 25 to 65 should undergo primary HPV testing alone every 5 years (preferred) with an FDA-approved HPV test for primary screening. Co-testing with a Pap smear and HPV test every five years, or a Pap smear alone every three years, are also acceptable options for women in this age group. You should discuss the best option for you with your doctor. Women over 65 may discontinue screening if they have had negative testing for the previous ten years. Women over 65 without proof of negative screening should continue screening until they meet criteria to stop testing.

What additional steps can be taken to reduce my risk of developing this cancer?
In addition to following current screening guidelines and the recommendations of your physician based on your individual health, you can consider incorporating these steps into your lifestyle:

• Get the HPV vaccine. Because HPV is linked to cervical cancer, this vaccine is an important part of reducing your risk.

   – Guidelines recommend giving the vaccine to boys and girls between the ages of 11 and 12 years, but can be given as early as age 9 and as late as 13 to 26 years.

   – Unvaccinated patients ages 27 to 45 may also benefit from HPV vaccination and should speak to their provider about the potential benefits of HPV vaccination.

• Follow safe sex practices, including using barrier contraception, since HPV is often symptomless.

• Don’t smoke, as smoking cigarettes slightly increases the risk.

• Strengthen your immune system.

If I am diagnosed with cervical cancer, what are my options?
As with most cancers, treatment options include surgery, radiation therapy and chemotherapy — all of which are available at Stony Brook Cancer Center. The Center’s Gynecologic Oncology Management Team is the only academic subspecialty practice in Suffolk County. In addition to providing comprehensive multidisciplinary care for women with known or suspected gynecologic cancers, we also conduct research into the development and treatment of these cancers.

What new treatments are available at Stony Brook?
We offer robotic-assisted minimally invasive surgery using the da Vinci® Surgical System for staging and treatment. It offers doctors increased depth perception, magnification, and the ability to use different instrumentation than in laparoscopic minimally invasive surgery. There are also significant benefits over traditional surgery, including faster recovery, fewer wound complications and less postoperative pain.

For more information about cervical cancer, call (631) SB-CANCER (722-2623) or visit cancer.stonybrookmedicine.edu.