What Pharmacists Should Know About Cervical Cancer - Pharmacy Times
What Pharmacists Should Know About Cervical Cancer - Pharmacy Times |
| What Pharmacists Should Know About Cervical Cancer - Pharmacy Times Posted: 16 Feb 2021 12:00 AM PST 
When detected early and treated effectively, cervical cancer is one of the most successfully treatable cancers. The WHO predicts that with a "comprehensive approach to prevent, screen and treat, cervical cancer can be eliminated as a public health problem within a generation."1 Cervical Cancer Data Cervical cancer was once a common cause of death from cancer, but the death rate for this cancer type decreased significantly with the Papanicolaou test, which can detect cervical cancer in early stages, when it is easier to treat. The HPV test also screens for cervical cancer. This test looks for infection by types of HPV that are more likely to cause cervical cancer and can be performed at the same time as the Papanicolaou test.2 According to the American Cancer Society (ACS), in 2020, about 13,800 new cases of invasive cervical cancer will be diagnosed, and about 4290 women will die from this disease.2 The average age at diagnosis is 50 years. Although many women do not realize cervical cancer can be detected as they get older, more than 20% of cases are diagnosed in women older than 65 years. However, cervical cancer rarely occurs in women who are regularly tested.2 Survival Rates According to the ACS, survival rates for cervical cancer are as follows3 :
These numbers are based on women who received a diagnosis and were treated at least 5 years prior. Because treatments improve over time, the outlook may be better than these numbers indicate. Other factors, such as age and overall health, also can affect the outlook.3 Prevention and Risk Factors Ways to help prevent cervical cancer include the following4 :
Signs and Symptoms of Cervical Cancer Because cervical cancer may not cause symptoms (especially in the early stages), regular cervical cancer screening should start for patients aged 21 years (or as determined by their physician). Symptoms, which may or may not be present, may include pain/bleeding with sexual intercourse, pelvic pain, unusual discharge, and/or unusual bleeding. Patients who experience any of these symptoms should consult their physician immediately.5 Diagnosis The best way to detect cervical cancer early is with regular screening with the Papanicolaou test and the HPV test. Routine screening can prevent cervical cancer. Early detection improves the chances of successful treatment of precancer and cancer.6 Abnormal results from a Papanicolaou or HPV test will require the patient to undergo further testing, including history and physical examination, and various biopsies and/or procedures. If cancer is present, more testing will be performed, including additional procedures and imaging.7 Types and Staging Cervical cancers start from precancers, but only some women with cervical precancers will develop cancer. Treating cervical precancer prevents most cervical cancers.8 Most (almost 90%) of cervical cancers and precancers are squamous cell carcinomas. Most other cervical cancers are adenocarcinomas. Some cervical cancers are mixed carcinomas.8 Cervical cancer is classified from stage 0 to stage IVB, depending on the location and spread.9 Cervical Cancer Treatment Depending on the type/stage of cervical cancer, patients may need surgery, chemotherapy, radiation, or a combination of treatments. Chemotherapy may be given, often with radiation, depending on the type and stage of cervical cancer.10 Some examples of chemotherapy drugs for cervical cancer include cisplatin (Platinol; Bristol Myers Squibb), carboplatin (Paraplatin; Bristol Myers Squibb), paclitaxel (Taxol; Bristol Myers Squibb) and topotecan (Hycamtin; Novartis), or a combination of drugs.11 Common adverse effects (AEs) of chemotherapy include nausea, vomiting, diarrhea, appetite loss, hair loss, mouth sores, and fatigue. Low blood counts may result in increased chance of infection, bleeding, bruising, shortness of breath, and fatigue. AEs are often worse when chemotherapy is given with radiation.11 Targeted therapy drugs target the changes in cancer cells. The monoclonal antibody bevacizumab (Avastin; Genentech) is a targeted therapy medication that treats advanced cervical cancer. Common AEs include high blood pressure, fatigue, and nausea.11-13 Immunotherapy stimulates the immune system to recognize and destroy cancer cells, and is used to treat cervical cancer that has spread or recurred. Pembrolizumab (Keytruda; Merck) is a monoclonal antibody that targets proteins on T cells to shrink tumors or slow growth.14 The most common AEs of immunotherapy drugs are fatigue, fever, nausea, diarrhea or constipation, headache, rash, appetite loss, and joint or muscle pain.14 The treatment selected for cervical cancer depends on the stage, location, and type of cancer, as well as age, overall health, and whether the patient wants to have children.15 HPV Vaccine HPV causes almost 35,000 cases of cancer in men and women annually in the United States. HPV vaccination can prevent more than 32,000 of these cases.16 HPV can cause cervical cancer or anal cancer in women and penile cancer or anal cancer in men. It can also cause oropharyngeal cancer.17 Since 2016, there has been only 1 HPV vaccine available in the United States. This vaccine is administered to boys and girls, in 2 or 3 doses, depending on age. The vaccine can be administered to children as young as 9 years, but generally is first given to children aged 11 or 12 years. Administration of the vaccine is recommended to continue up to patients aged 26 years. The vaccine also can be administered to patients as old as 45 years. Patients can consult their physician to see whether they need HPV vaccination.16 The most common AEs of the HPV vaccine are injection site reactions, fever, nausea, headache, fatigue, muscle or joint pain, and dizziness or fainting. To prevent fainting and associated injuries, adolescents should sit or lie down during vaccination and remain in position for 15 minutes after receiving the vaccine.16 The Pharmacist's Role As trusted and knowledgeable health care professionals, pharmacists can help prevent cervical cancer cases by educating patients about the risk of cervical cancer and the importance of the HPV vaccine. Pharmacists can vaccinate patients when appropriate, and can remind patients to get regular Papanicolaou and HPV tests. Additionally, pharmacists can refer patients to their health care provider if they mention any symptoms that could indicate cervical cancer. KAREN BERGER, PHARMD, is a pharmacist at an independent pharmacy in northern New Jersey. REFERENCES
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| The impact of COVID on women’s health - Herald-Mail Media Posted: 15 Mar 2021 10:09 AM PDT  "You can't say 'yes' to everything and not say 'yes' to taking care of yourself." — Shonda Rhimes The pandemic has hit everyone hard. Mental health, economic security, physical health have affected everyone. In particular, working mothers have taken on more of the household and child-care responsibility. That can have a negative impact on their health. Women might also not be taking the time to take care of themselves. Do not think of taking care of yourself as taking away from others. Taking care of yourself first gives you the energy and ability to care for others. That's why the flight attendant tells you to put on your mask first. Taking care of yourself includes prevention and early detection. Prevention includes healthy lifestyle behaviors such as eating to nourish your body and moving regularly. Early detection is making sure to see your health care provider regularly and have screenings done as recommended. For nutrition and physical activity guidance, the American Cancer Society issued new diet and physical activity guidelines in 2020. The guidelines recommend that you: • Achieve and maintain a healthy body weight throughout life. • Be physically active. Adults should engage in at least 150 to 300 minutes of moderate-intensity physical activity a week. Children should get at least an hour a day of moderate to vigorous physical activity. You should also limit sedentary activity throughout the day. • Follow a healthy eating pattern. This includes eating a rainbow of fruits, vegetables and whole grains while limiting red and processed meats, sugar sweetened beverages and highly processed foods. • Do not drink alcohol. The other side of taking care of yourself is making sure to get your annual screenings and immunizations. Many chronic illnesses and cancers can be prevented or treated successfully, if detected early. Regular mammograms, pap and HPV tests and HPV vaccination are part of a women's health care routine. When to have these done depends on your age. Breast cancer is the second most common cancer among women, after skin cancer. The United States Preventive Services Task Force (USPSTF) recommends that most women age 50 to 74 have a mammogram every two years. If you have a close relative who has had breast cancer, you might begin screening in your 40s. The Pap test can find precancerous changes on the cervix that can be treated to prevent cervical cancer. A Pap test can also find cervical cancer early, when treatment is most affective. Women should start getting regular Pap tests at age 21. A Pap test does not screen for ovarian, uterine, vaginal or vulvar cancers. Know your body. See your doctor if you notice any changes that are not normal to you. HPV test looks for human papillomavirus or HPV. Almost all cervical cancers and some vaginal and vulvar cancers are caused by HPV. The HPV test may be used with the Pap test to screen for cervical cancer in women 30 years or older. It is recommended to get the HPV test every five years for those 30 to 65 years of age. HPV vaccine can prevent infection with some types of human papillomavirus. HPV infections can cause certain types of cancers. HPV infections are so common that nearly all men and women will get at least one type of HPV at some time in their lives. Most HPV infections go away by themselves within two years. But sometimes HPV infections will last longer and can cause cancers later in life. The HPV vaccine is for girls and boys. It is routinely recommended for adolescents at 11 or 12 years of age to ensure they are protected before they are exposed to the virus. HPV vaccine may be given beginning at age 9 years, and as late as age of 45. Talk with your health care provider on what is recommended for you and your family. Don't let the pandemic get in the way of your regular health care routine. Getting your regular physical checkups will help with your long-term health. Dana M. DeJarnett is the health promotion coordinator of WVU Medicine East and The Wellness Center at Berkeley Medical Center. She can be contacted at 304-264-1287, ext. 31814, or dana.dejarnett@wvumedicine.org.  |
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