Doc Alan
25th October 2012, 21:11
Breast cancer is the commonest type in women both for UK and Philippines, and can’t usually be prevented, as a cause is often not apparent. Cervical cancer is much less common but affects relatively far more women in Philippines than UK.
• In the UK all women aged between 50 – 70 ( soon to be 47 – 73 ) are invited every 3 years for breast screening by mammography ( X ray ). This NHS programme is not perfect although benefits outweigh disadvantages and it saves lives. At least 4 / 5 women with this cancer now survive 5 years from diagnosis - early detection gives the best chance of cure.
• In the Philippines survival rate is more like 2 / 5. There is less awareness. Screening is not well developed, and less likely to be free, although there may be free medical services in government hospitals and through schemes such as Phil Health.
• There is effective treatment for breast cancer – usually surgical with or without radiotherapy and possible “ reconstruction “ in the first instance. New drugs are available which “ target “ specific types of this cancer. All of these are costly, which is tantalising when cure is increasingly possible.
• Cervical screening is also well established in the UK. Women are invited for smears every 3 – 5 years between 20 - 64 ( varying slightly between countries ). The aim is to detect PRE-cancerous changes which can readily be treated. Death rates have declined markedly in the decades screening has been available – although about 1/ 5 “ eligible “ women have not had a recent “ smear test “. This type of screening is also not perfect.
• Cervical screening is not so well developed in the Philippines. The government has, however, recently offered free screening for Filipinas between 30 -45 in its accredited hospitals nationwide. Unfortunately about 2 / 3 cases of cervical cancer are diagnosed at an advanced stage. Probably less than 1 / 5 “ eligible “ Filipinas have had a smear test.
• A cheaper technique is available – Visual Inspection with Acetic acid ( VIA ) – yes, very dilute “ vinegar “ ( ! ) highlights changes which can be treated by “ cryotherapy “ ( freezing with carbon dioxide ). This is better than nothing, where resources / expertise are just not available.
• Unprotected sexual intercourse, starting at an early age, and with multiple partners, increase the risk of cervical cancer. This is NOT to judge all women with abnormal smears who may have – or be at risk from – cancer. Infection with certain types of Human Papilloma Virus ( HPV ) may cause cancer – and CAN be prevented by vaccination. Two types of vaccine ( “ quadrivalent “ = Gardasil ; “ bivalent “ = Cervarix ) are approved in UK and Philippines. Gardasil is now recommended for 12 – 13 year old girls in UK ( with “ catch-up “ for unvaccinated older females ). The three doses are free in UK – possibly P 12,000 in Philippines.
• Screening - and HPV vaccination - makes sense, both on health grounds ( chance of cure ) and economically ( treatment of advanced cancer is very expensive, whether paid directly or indirectly ).
• In the UK all women aged between 50 – 70 ( soon to be 47 – 73 ) are invited every 3 years for breast screening by mammography ( X ray ). This NHS programme is not perfect although benefits outweigh disadvantages and it saves lives. At least 4 / 5 women with this cancer now survive 5 years from diagnosis - early detection gives the best chance of cure.
• In the Philippines survival rate is more like 2 / 5. There is less awareness. Screening is not well developed, and less likely to be free, although there may be free medical services in government hospitals and through schemes such as Phil Health.
• There is effective treatment for breast cancer – usually surgical with or without radiotherapy and possible “ reconstruction “ in the first instance. New drugs are available which “ target “ specific types of this cancer. All of these are costly, which is tantalising when cure is increasingly possible.
• Cervical screening is also well established in the UK. Women are invited for smears every 3 – 5 years between 20 - 64 ( varying slightly between countries ). The aim is to detect PRE-cancerous changes which can readily be treated. Death rates have declined markedly in the decades screening has been available – although about 1/ 5 “ eligible “ women have not had a recent “ smear test “. This type of screening is also not perfect.
• Cervical screening is not so well developed in the Philippines. The government has, however, recently offered free screening for Filipinas between 30 -45 in its accredited hospitals nationwide. Unfortunately about 2 / 3 cases of cervical cancer are diagnosed at an advanced stage. Probably less than 1 / 5 “ eligible “ Filipinas have had a smear test.
• A cheaper technique is available – Visual Inspection with Acetic acid ( VIA ) – yes, very dilute “ vinegar “ ( ! ) highlights changes which can be treated by “ cryotherapy “ ( freezing with carbon dioxide ). This is better than nothing, where resources / expertise are just not available.
• Unprotected sexual intercourse, starting at an early age, and with multiple partners, increase the risk of cervical cancer. This is NOT to judge all women with abnormal smears who may have – or be at risk from – cancer. Infection with certain types of Human Papilloma Virus ( HPV ) may cause cancer – and CAN be prevented by vaccination. Two types of vaccine ( “ quadrivalent “ = Gardasil ; “ bivalent “ = Cervarix ) are approved in UK and Philippines. Gardasil is now recommended for 12 – 13 year old girls in UK ( with “ catch-up “ for unvaccinated older females ). The three doses are free in UK – possibly P 12,000 in Philippines.
• Screening - and HPV vaccination - makes sense, both on health grounds ( chance of cure ) and economically ( treatment of advanced cancer is very expensive, whether paid directly or indirectly ).