Cervical Cancer: Causes, Symptoms, Treatment, and HPV Prevention | Mass General Brigham

Summary

Dr. Rachel Clark Sassodia discusses cervical cancer, primarily caused by HPV. She emphasizes the importance of regular screenings like Pap smears and HPV tests, and the availability of treatments ranging from simple procedures for pre-cancers to aggressive surgeries and chemotherapy for advanced stages. The doctor highlights the effectiveness of the HPV vaccine in preventing cervical cancer and stresses the need for vaccination regardless of sex, as well as routine checks for women aged 21 and older.

Takeaways

• 🚩 Over 95% of cervical cancer cases are caused by HPV.
• 👩‍⚕️ Dr. Rachel Clark Sassodia is a gynecologic oncologist and associate professor at Harvard Medical School.
• 🌟 Cervical cancer begins in the cervix, which is at the bottom of the uterus.
• 🔍 HPV is so common that almost everyone who has been sexually active has been exposed to it.
• 🌈 Most women can clear HPV on their own, but some remain HPV positive and may develop cervical cancer.
• 👀 Regular PAP smears are recommended to check for HPV and pre-cancerous cells.
• 🚫 HPV can affect anyone with a cervix, including those who have not been sexually active.
• 🚭 Factors increasing the risk of cervical cancer include being immunocompromised or a smoker.
• 🤕 Symptoms of cervical cancer can include bleeding after intercourse, pelvic pain, and increased vaginal discharge.
• 🛠 Treatment for cervical cancer ranges from in-office procedures for pre-cancers to aggressive surgery and chemotherapy for advanced stages.
• 💉 The HPV vaccine is 99% effective in preventing cervical cancer and should be administered to both males and females.

Q & A

What is cervical cancer?

Cervical cancer is a type of cancer that begins in the cervix, which is located at the bottom of the uterus and acts as a gatekeeper during pregnancy to hold the baby inside.

What is the primary cause of cervical cancer?

The primary cause of cervical cancer is the human papillomavirus (HPV).

Is there any stigma or shame associated with HPV?

No, there is no stigma or shame in contracting HPV as almost everyone who has been sexually active has been exposed to it.

What happens when a woman contracts HPV?

Most women will clear HPV on their own over time, but some may remain HPV positive, leading to abnormal cell changes in the cervix.

Why are Pap smears recommended for women?

Pap smears are recommended to allow doctors to check for HPV positivity and the presence of pre-cancerous cells in the cervix.

Are there any rare causes of cervical cancer not caused by HPV?

Yes, there are rare causes of cervical cancer not caused by HPV, but the majority of cases are linked to HPV.

Who is at risk for cervical cancer?

Anyone with a cervix is at risk for cervical cancer.

Can young girls and teenagers contract HPV without being sexually active?

Yes, young girls and teenagers can contract HPV without being sexually active, including through sexual assault or unwanted sexual interactions.

What are some factors that increase the likelihood of cervical cancer?

Factors that increase the likelihood of cervical cancer include being immunocompromised or being a smoker.

Why is cervical cancer difficult to detect?

Cervical cancer is difficult to detect because it is often asymptomatic, and the cervix is not easily visible or palpable.

What are the common symptoms of cervical cancer?

Common symptoms include bleeding after intercourse, painful intercourse, pelvic pressure or pain, and increased vaginal discharge.

How is cervical cancer treated?

Treatment for cervical cancer is divided into three categories: pre-cancers, early-stage cancers, and advanced cancers, with treatments ranging from in-office procedures to aggressive surgery and a combination of chemotherapy and radiation.

Can fertility be retained after cervical cancer treatment?

Yes, there are new techniques that allow women to retain fertility even after being treated for cervical cancer.

How can cervical cancer be prevented?

Cervical cancer can be prevented through vaccination against HPV, which is 99% effective, and through routine Pap smears and HPV tests for women or patients with a cervix aged 21 or older.

Why is the HPV vaccine recommended for both boys and girls?

The HPV vaccine is recommended for both sexes because boys can be carriers and can infect later partners, and they are also susceptible to penile cancer caused by HPV.

Outlines

00:00

🌟 Understanding Cervical Cancer

Dr. Rachel Clark Sassodia, a gynecologic oncologist at Massachusetts General Hospital and associate professor at Harvard Medical School, discusses cervical cancer. She explains that over 95% of cases are caused by the human papillomavirus (HPV). Dr. Sassodia clarifies that HPV is common and not stigmatizing, and most women can clear the virus naturally. However, some women remain HPV positive, leading to abnormal cell changes and potentially cancer. Routine PAP smears are recommended for early detection. She also addresses the unfortunate reality of sexual assault as a route of HPV transmission. Other risk factors include being immunocompromised or a smoker. Cervical cancer often has no symptoms, emphasizing the importance of regular medical check-ups. Symptoms, when present, can include post-coital bleeding, painful intercourse, pelvic pressure or pain, and increased vaginal discharge. Treatment strategies vary from in-office procedures for pre-cancers to more aggressive surgeries and chemotherapy/radiation for advanced stages. Advances in fertility preservation during treatment are also highlighted.

05:02

💉 Preventing Cervical Cancer

The second paragraph focuses on prevention strategies for cervical cancer. Dr. Sassodia emphasizes the effectiveness of the HPV vaccine, which is 99% effective in preventing cervical cancer. She urges vaccination for all eligible children, regardless of sex, as boys can also develop HPV-related cancers and can transmit the virus. For women and individuals with a cervix aged 21 or older, routine PAP smears and HPV tests are recommended. The doctor concludes with a strong statement that with the availability of vaccines, cervical cancer should be preventable. She invites viewers to watch more videos on women's health and to subscribe for updates.

Keywords

💡Cervical Cancer

Cervical cancer is a type of cancer that starts in the cervix, which is the lower part of the uterus that connects to the vagina. In the video, Dr. Rachel Clark Sassodia emphasizes that cervical cancer is primarily caused by the Human Papillomavirus (HPV). The video discusses the importance of early detection through routine checks like Pap smears and HPV tests, and the fact that it is often asymptomatic until it has progressed, which is why regular screenings are crucial.

💡Human Papillomavirus (HPV)

HPV is a group of more than 200 related viruses, some of which are sexually transmitted and can lead to cervical cancer. The video script mentions that over 95% of cervical cancer cases are due to HPV. Dr. Clark Sassodia clarifies that almost everyone who has been sexually active has been exposed to HPV, but most people clear the virus on their own over time without developing cancer.

💡Pap Smear

A Pap smear is a screening test to detect cervical cancer and its precursors. It involves examining cells from the cervix for abnormalities. In the video, Dr. Clark Sassodia recommends getting Pap smears to allow doctors to continually check for HPV positivity and pre-cancerous cells, which is crucial for early detection and treatment.

💡Pre-cancerous Cells

Pre-cancerous cells are abnormal cells that may develop into cancer if not treated. In the context of cervical cancer, the video explains that HPV can cause these cells to become more and more abnormal, potentially leading to cancer. Early detection through Pap smears and HPV tests can identify these cells, allowing for treatment before they become cancerous.

💡Immunocompromised

Immunocompromised refers to a state where the immune system is weakened, making it harder for the body to fight off infections and diseases, including HPV. The video mentions that being immunocompromised increases the risk of developing cervical cancer because the body may not be able to clear the HPV virus as effectively.

💡Smoking

Smoking is a risk factor for various types of cancer, including cervical cancer. In the video, Dr. Clark Sassodia includes smoking as one of the factors that can increase a person's likelihood of developing cervical cancer, although the exact mechanisms are not detailed in the script.

💡Asymptomatic

Asymptomatic means showing no symptoms of disease. The video highlights that most cervical cancer is asymptomatic, which is why routine medical checks are essential. Without symptoms, it's difficult for individuals to know they have the disease, making early detection through screening tests like Pap smears vital.

💡Treatment

Treatment in the context of the video refers to the medical interventions used to address cervical cancer, ranging from in-office procedures for pre-cancers to more aggressive surgeries and combinations of chemotherapy and radiation for advanced stages. The video emphasizes the importance of early detection to increase the chances of successful treatment.

💡Fertility

Fertility in the video refers to the ability to conceive children. Dr. Clark Sassodia mentions advances in medical techniques that allow women with cervical cancer to retain their fertility, even after treatment. This is significant as it provides hope and options for women who wish to have children after being treated for cervical cancer.

💡Vaccine

The HPV vaccine is discussed in the video as a preventative measure against cervical cancer. Dr. Clark Sassodia states that the vaccine is 99% effective in preventing cervical cancer caused by HPV. The video underscores the importance of vaccination, especially for children before they become sexually active, as a key strategy in preventing cervical cancer.

💡Screening

Screening in the video pertains to routine medical tests like Pap smears and HPV tests that are used to detect cervical cancer or pre-cancerous conditions early. Regular screening is highlighted as a critical component in the prevention and early detection of cervical cancer, allowing for more effective treatment.

Highlights

95% of cervical cancer is caused by HPV.

Dr. Rachel Clark Sassodia is a gynecologic oncologist at Massachusetts General Hospital.

Almost everyone who has been sexually active has been exposed to HPV.

Most women will clear HPV on their own over time.

Pap smears are recommended to check for HPV and pre-cancerous cells.

Rare causes of cervical cancer exist that are not caused by HPV.

Anyone with a cervix is at risk for cervical cancer.

Children and teenagers can get HPV even without being sexually active.

One out of four young girls and women are victims of unwanted sexual interactions.

Being immunocompromised or a smoker increases the likelihood of cervical cancer.

Cervical cancer is often asymptomatic, making routine checks crucial.

Symptoms of cervical cancer include bleeding after intercourse and pelvic pain.

Pre-cancers of the cervix can often be treated with a simple in-office procedure.

Early stage cervical cancers can be cured with aggressive surgery.

Advanced cervical cancers are treated with chemotherapy and radiation.

Techniques exist to allow women with cervical cancer to retain fertility.

Vaccines are 99% effective in preventing cervical cancer.

Routine Pap smears and HPV tests are crucial for women over 21.

Dr. Rachel Clark Sassodia believes no patient should get cervical cancer in the U.S. due to vaccine availability.

Transcripts

more than 95 percent of cervical cancer

is due to human papillomavirus also

known as hpv

hi i'm dr rachel clark sassodia i'm a

gynecologic oncologist on staff at the

massachusetts general hospital i'm an

associate professor at harvard medical

school and the senior medical director

for mass general brigham and this is

understanding cervical cancer

so what is cervical cancer well cervical

cancer is a cancer that begins in the

cervix which is at the bottom of the

uterus the cervix sort of behaves as a

gatekeeper for when a woman is pregnant

and helps hold the baby inside cervical

cancer is primarily caused by human

papilloma virus one of the first things

i always tell my patients is

almost everyone who has ever been

sexually active has been exposed to hpv

there's no stigma in it there's no shame

in it full stop

once a woman contracts hpv most women

will clear it on their own over time

some women for reasons that we don't

understand will continue to be hpv

positive and slowly that makes the cells

in the cervix become more and more

abnormal and in a small fraction of

women this will ultimately make a cancer

and that's why we recommend getting pap

smears so that your doctor can

continually check you to see if you're

hpv positive and if so if you've made

pre-cancerous cells

it is important to note that some more

rare causes of cervical cancer are not

caused by hpv but overwhelmingly the

majority are

anyone with a cervix is at risk for

cervical cancer

and one of the most important things

that i highlight particularly to the

parents of young girls and children is

that your child doesn't have to be

sexually active your teenager doesn't

have to be sexually active to get hpv

which causes cervical cancer an

unfortunate reality is that one out of

four young girls and women in this

country are sexually assaulted or the

victim of an unwanted sexual interaction

and they could contract hpv then

other reasons that someone could get

cervical cancer or that increase your

likelihood of cervical cancer is if

you're immunocompromised or if you're a

smoker

cervical cancer is dangerous because

it's sneaky right you can't see your

cervix it's really hard to actually even

feel your cervix so you could be

developing pre-cancerous cells or even a

cancer and not know it's there so

unfortunately the majority of cervical

cancer is asymptomatic which is what

makes it hard to detect if you're not

coming in for routine checks so all of

this highlights how important it is to

see your physician your care provider or

your ob gyn for care

but if a patient is going to have

symptoms they would be the following

bleeding after intercourse

painful intercourse especially if it's

new and painful

a sensation of pelvic pressure or

fullness or pain

or increased vaginal discharge

when thinking about the treatment for

cervical cancer i often think of it in

three broad buckets

first pre-cancers then early stage

cancers and then more advanced cancers

so for a pre-cancer of the cervix the

good news is that a woman or patient

with a pre-cancer of this cervix or

dysplasia can come into the office and

generally we can fix it with an easy

in-office procedure that's quick and

relatively pain-free for early stage

cancers generally we can still cure

those but it's important to know that

surgery gets pretty aggressive pretty

quickly and that's what's required to

cure your cancer for more advanced

cancers those tend to be harder to cure

and these women are almost always

treated with a combination of

chemotherapy and

radiation the final thing that i would

highlight is that we've made amazing

advances in the ability to retain

fertility even if you have cervical

cancer

there's many new techniques that we can

employ to allow a woman or a patient

who's had cervical cancer to be able to

retain fertility be treated for their

cervical cancer and still complete a

family if that's what they want so how

do we prevent cervical cancer well there

are two great ways to prevent cervical

cancer and the good news is is we

actually cured cervical cancer with a

vaccine vaccines are 99 effective in

preventing cervical cancer the problem

is we've just done a bad job of getting

them into all the people who are

eligible

reasons people still get cervical cancer

are number one that they weren't

vaccinated or number two

that they weren't able to get routine

pap smears and hpv tests

as a gynecologic cancer doctor i

recommend that you get all your children

vaccinated for hpv regardless of sex

oftentimes parents will say to me well i

have a boy should i get my boy

vaccinated absolutely you should boys

should be vaccinated because not only

are boys carriers of hpv which can

infect later partners but boys are also

susceptible to penile cancer which is

also caused by hpv

in addition to vaccines women or

patients with a cervix age 21 or older

should get routine pap smears and hpv

tests

so it's worth repeating that the best

news about cervical cancer is that we've

already cured it vaccines are 99

effective and in a country like the

united states where there's widespread

availability of vaccines i truly believe

that no patient ever needs to get

cervical cancer again

thanks for watching i'm dr rachel

clarksonia for more videos on women's

health check out here and don't forget

to subscribe right here