cervicalcancerCervical cancer risk and prevention is a confusing topic that many of even my most proactive female patients have misconceptions about. This article is meant to clear up some of these misconceptions, dispel myths, as well as discuss cervical cancer prevention from a new perspective – a naturopathic perspective.

The basics:
Cervical cancer is diagnosed in about 12,000 women yearly in the United States, and causes 4,000 deaths each year. Cervical cancer is caused by HPV – the human papilloma virus – which is spread through sexual contact. There are several strains of HPV circulating in our population, some of these strains cause genital warts, which are bothersome but not harmful; other strains are completely benign causing no symptoms at all; and still other strains, known as high-risk strains, can cause cervical cancer. Cervical cancer is generally a very slow growing cancer that can be detected early by a pap smear. Death from cervical cancer has reduced by 79%, largely due to the widespread use of pap smears for early detection.

Women who have multiple sexual partners and who do not use barrier protection during sex are at a greater risk of contracting HPV and thus developing cervical cancer. High-risk HPV infections are not always symptomatic, particularly in men. Men and women can be HPV carriers and pass the virus on to their sexual partners.

A Pap smear is a scraping of cells from the cervix. Pap smears are sent to a lab and evaluated by a pathologist for abnormalities. Cells that show abnormalities are graded as to how abnormal they are. The more abnormal the cells are, the more likely they are to progress to cancer.

HPV Vaccine:
In 2006 Merck released a vaccine called Gardasil that protects against 2 high risk strains of HPV and 2 HPV strains associated with genital warts. The CDC now recommends the administration of the vaccine for both boys and girls to prevent cervical cancer and HPV transmission. It is important to keep in mind that Gardasil protects against only 2 of the high-risk strains associated with cervical cancer. Therefore, vaccination does not completely protect women from cervical cancer because there are other high risk strains of HPV associated with cervical cancer, beyond just the two prevented against with the vaccine. Safe sexual practices and screening pap smears are still extremely important for prevention.

Naturopathic Prevention of Cervical Cancer:
As a primary care doctor I feel the most important component of preventing cervical cancer is education. Understanding the connection between HPV and cervical cancer is the first step. Preventing transmission by using barrier methods for safer sex, and getting screened regularly – yearly for women who have more than one sexual partner – is the next step.

For women who do test positive for abnormal cells on their pap smears, naturopathic treatment is a great option for preventing further abnormalities and cervical cancer. While conventional medicine adopts a “watch and wait” approach for low-grade abnormalities, naturopathic medicine adopts a proactive approach. This approach involves strengthening the immune system with dietary and herbal interventions. Cervical cancer is triggered by a virus, so strengthening the immune system to “contain” the human papilloma virus can reverse cell abnormalities and in some cases eliminate HPV infection. Some well-researched behavioral modifications associated with reduction in risk of cervical cancer progression include smoking cessation and increased consumption of green leafy vegetables high in folate and beta-carotene.

Other naturopathic therapies aimed at strengthening the immune response against HPV and the development of cervical cancer include green tea extract for its anti-cancer properties, indole-3 carbinol – an extract from the cabbage family of vegetables – for its hormone balancing effect, and supplementation with nutrients like vitamin C, lycopene, and vitamin A.

Conventional treatment of high-grade abnormalities include laser removal of abnormal cells, cryotherapy to remove abnormal cells, and LEEP procedures which involve surgery with a wire loop to remove abnormal cells. Biopsies and cone biopsies are also common procedures done to provide both diagnostic information as well as treatment.

While conventional treatments are sometimes the best option, Naturopathic treatment of abnormal cells may be a better alternative in certain cases. Conventional treatment, particularly the LEEP procedure, can negatively impact fertility by creating scar tissue and dysfunction of the cervix. Women who are planning on having children may want to consider naturopathic management for an abnormal pap smear to prevent the risk of infertility and preterm labor. Similarly, because conventional treatment is highly effective in removing the abnormal cells, but does not address the cause of the abnormal cells, which is HPV, using conventional and naturopathic therapies together is often the best option in aggressive cases.

Going Forward:
Navigating the health care world with its ever-changing recommendations regarding the frequency of screening exams is understandably confusing. I highly urge women to have discussions with their primary care providers about what the optimal schedule for each screening exam is for them, based on their individual set of risk factors. These screening exams include pap smears, mammograms, blood work for cardiovascular risk, blood pressure, and bone density scans.

For women who have had an abnormal pap smear and are watching and waiting, consider taking a proactive approach to strengthen the immune system and avoid more invasive procedures in the future.

Celebrate Women’s Health Week, May 13th-18th and schedule an appointment for a well-woman exam! In honor of Women’s Health Week, I am offering 50% off well-woman exams for the month of May. Please call the office for more information. 949-529-0577.