Being told that you have a gynaecological cancer can come as a total shock - especially as many women in the UK are not even aware that there are in fact five forms of gynaecological cancer - Womb, Ovarian, Cervical, Vulval and Vaginal.
This new knowledge that you've been diagnosed with a cancer you hadn't even heard of before today's consultation with your gynaecological oncologist no doubt leaves you with many questions and perhaps anxieties and uncertainties about what the future may hold.
Unfortunately, that is the case for over 3,000 women who are sadly diagnosed every year, with just shy of 1,000 women tragically dying from a potentially eradicable disease. That's 9 women being diagnosed every day, and 3 women losing their lives.
These are brutal statistics which women's cancer charity The Eve Appeal, along with the Women's Cancer Department at University College London are determined to change - through imploring women to 'know their bodies'.
Cervical cancer? What, how, why
The cervix - the 'neck' of the womb - connects the womb cavity (where babies develop) with the vagina, however, the area where the womb lining meets with the 'skin' of the cervix is susceptible to cancer if it is infected with Human Papilloma Virus (HPV) - a virus commonly associated with cervical cancer.
Fortunately in the UK, we have a very successful and efficient screening test which enables us to pick-up any abnormal cells during a woman's smear test, which if left untreated, could potentially turn cancerous. But it seems that women are still delaying in having their smear tests when called for a number of reasons, whether it is through embarrassment or fear that it may hurt and be uncomfortable. Worse still, is that women in their early 40s and 50s are not attending due to nearing the end of their "smear journey" - and don't feel it necessary.
In reality, it is a simple process which could potentially save your life. A nurse or doctor collects cells from your cervix using a specially designed brush - a speculum. The brush is then placed into a preservative liquid and the cells are shaken off into the liquid so they can be analysed under the microscope. If the cells are abnormal, then depending on how abnormal they look, and whether they contain the HPV virus, the woman may be referred to a gynaecologist. The gynaecologist then examines the cervix closely to identify and, if necessary, treat any precancerous cells.
So what does the future hold?
There are plans to change how cervical smears are taken, so that the sample taken with the speculum is analysed for HPV first, and the cells looked at only if the HPV test is positive - which could have a huge impact going forward. However, around 15% of women aged 25-35 years are infected with HPV, so this test will identify a very large number of women who are HPV positive, but in reality, their immune system will usually clear the infection, preventing development of cervical cancer.
Research paving the way for preventative measures
So whilst there may be changes in the future, looking to the present day, and you'll find researchers both in the UK and across Europe aiming to develop a test which can predict which women with a HPV infection go on to develop cervical cancer. A potential game-changer in terms of risk-prediction.
This new test is based on analysis of the so called 'epigenome'. Each cell of the human body has exactly the same set of genetic information or 'genome', which can be considered the hardware of a cell. The epigenome, which is essentially the software of a cell, is just as important as the genome, because it determines which genes are switched on and which are switched off. For example, a gene might instruct a cell to develop into a skin cell, or a brain cell. If the process goes wrong, a gene might tell a cell to revert to an 'undifferentiated' state, such as that seen in 'stem' cells or the cells of a developing baby. Proliferation of undifferentiated cells as a result of an accumulation of genetic and epigenetic errors is typically associated with cancer.
The research team at University College London (UCL) will test whether and how the cancer-causing types of HPV affect the epigenome of cervical cells and how this leads to cancer development. The expectation is that the more impact HPV has on a cervical cell's epigenome, the higher the risk of the cell becoming malignant. Such a test, which is actually not measuring the virus itself, but rather the 'epigenetic traces', leaves behind great potential to predict the future risk of cervical cancer development - in particular in young women.
So whilst cervical screening has been one of the great success stories of modern medicine, saving thousands of lives a year in the UK alone, it does identify many women as being 'at risk' even though the majority won't go on to get cancer. That is why we're imploring women to attend regular screening when called and know their bodies; whether you're a parent taking responsibility for your daughter's health or a woman in her early 50s and 60s, because at The Eve Appeal we know that regular screening protects women against developing cervical cancer and could ultimately save your life.