EXPERTS ADVOCATE SCREENING and SYMPTOM AWARENESS FOR BETTER CERVICAL CANCER OUTCOMES

SOME women with cervical cancer experience a delay in diagnosis because they thought their symptoms, such as heavy bleeding and breakthrough bleeding, are a normal part of perimenopause.

Cancer survivors, Eden Lucero and analy asignacion, shared that they were unaware their heavy menstrual bleeding, bleeding between periods, and pelvic pain were symptoms of cervical cancer. Lucero only sought medical attention when her pain became unbearable, while asignacion visited a clinic only after her abnormal bleeding persisted for some time.

Unaware of the symptoms and the disease itself, they urge for better cervical cancer education and awareness.

The two cancer survivors were among the panelists at a recent forum organized by the Pharmaceutical and Healthcare association of the Philippines (PHAP) and healthcare company MSD. The forum titled “Together for Health: Making a United Stand against Cervical Cancer” also featured Toots Magsino, cancer survivor and member of the Carewell Community; Horace Cruda, Committee Secretary of Senator Bong Go; Kara Magsanocalikpala, icanserve Founder and Cancer Coalition of the Philippines, Vice President; Dr. Jean Toral, President, Society of Gynecologic Oncologists of the Philippines (SGOP); Dr. Erwin De Mesa, Chair of the Standing Committee on Immunization for Women, Philippine Obstetrical and Gynecological Society (POGS); Dr. Ingrid Magnata, Country Program Manager, JHPIEGO; Romeo Marcaida, Project Director for Patient navigation Program, Philippine Cancer Society, and Dr. Zoraida Guevarra, Committee Chair, Women’s Health Connected Care Circles, Healthway Medical network.

“Cervical cancer is not a death sentence; it is preventable and, if detected early, highly treatable. We need to continue promoting research-based information, prioritizing health education, and providing access to quality and affordable cancer care,” said andreas Riedel, President, and Managing Director of MSD in the Philippines, indicating that women are then empowered to make the best choice about their health needs.

“Our focus should be on placing women at the center, amplifying the voices of cervical cancer patients and ensuring that we deliver best-inclass vaccines and the latest innovations in cancer care products and services within their reach,” said Riedel.

Prevention through vaccination

CERVICAL cancer can be prevented through vaccination against Hpv—human papillomavirus, which causes about 99 percent of all cervical cancers— and regular screening. When diagnosed early and managed effectively, cervical cancer is one of the most successfully treatable forms of cancer.

yet every year, out of the 8,549 Filipino women diagnosed with cervical cancer, 4,380 or more than half of them lose their lives. The high mortality rate from cervical cancer can be attributed to the late diagnosis of most patients.

Cervical cancer is the second most common cancer among women, and among women between 15 and 44 years old in the Philippines. It often has no early symptoms. However, as it grows, it may cause signs and symptoms such as vaginal bleeding after intercourse, between periods, or after menopause; heavy menstrual bleeding that lasts longer than usual; watery, bloody vaginal discharge; and pelvic pain or pain during intercourse.

“The challenge that we are having with cervical cancer is the stigma because it’s sexually acquired. That is why it is not discussed but the mode of transmission is very common. It’s a virus, it’s an infection that can eventually lead to cancer. We also have other cancers that are being caused by HPV like for women, vaginal cancer and for both sexes, anal cancer and oral cancer. I think we should really stress on education regarding what HPV is,” said Dr. De Mesa.

“The number one form of primary prevention is education. We should really be aware and we should be able to discuss this with our children.

Then number two, vaccination, because the mode of transmission is very common so all of us should be protected,” added Dr. De Mesa.

The cancer survivors echoed this sentiment, stressing the importance of vaccination and encouraging young girls to get the HPV vaccine. according to the World Health Organization (WHO), the primary target group in most of the countries recommending HPV vaccination is young adolescent girls, aged nine to 14. The Department of Health is currently implementing a vaccination and information campaign against HPV infection targeting girls aged 9 to 13 in select areas of the Philippines.

Dr. De Mesa shared that the average cost in private practice per shot is P5,000 to P10,000 depending on the type of vaccine.

“There is a certain population that will receive only two doses while those 15 years old and above will receive three doses,” said Dr. De Mesa. all health experts however agreed that preventing HPV with a vaccine is much cheaper than needing diagnostic tests and potential treatment later.

Screening as secondary prevention

WHILE most high-risk HPV infections clear up naturally within a few years, some persist and can lead to cancer.

“The secondary prevention is screening. We do screening for asymptomatic individuals and that is a form of early detection so that everything that will not be prevented perhaps by the vaccine, you can identify it early through screening,” said Dr. De Mesa.

Dr. Toral pointed out that cervical cancer has a very good screening tool.

“WHO now recommends HPV Dna testing every five years and pap smears every three years for average-risk women. For HPV testing, if you get a negative result, you can repeat it after five years, starting at age 30,” said Toral.

Intensifying efforts to eliminate cervical cancer

THE Philippine government adheres to WHO’S Global Strategy to accelerate the Elimination of Cervical Cancer, which aims to achieve the following targets by 2030: 90 percent of girls fully vaccinated with HPV vaccine by the age of 15; 70 percent of women screened with a high-performance test by the age of 35, and again, by the age of 45; and 90 percent of women identified with cervical disease receive treatment (90 percent of women with pre cancer treated and 90 percent of women with invasive cancer managed).

Through the national Integrated Cancer Control Program (NICCP) Strategic Framework by the Department of Health (DOH) and its action priorities under the DOH Health Sector Strategy (2023-2028), the government has committed to intensify its efforts and interventions directed towards prevention and early detection services to harness the impact of reducing the burden of cancer.

Existing programs include providing free HPV vaccination (coupled with awareness campaigns increasing cancer literacy and dispelling the misconceptions that lead to vaccine hesitancy) and capacity building for primary care and specialist care providers throughout the country to improve delivery of cancer care services, including cervical cancer screening for women.

Eliminating cervical cancer requires a united front. This includes collaboration between the biopharmaceutical industry, patient organizations, government health agencies, and even donors dedicated to health promotion.

“Collaboration and innovation to address the barriers and inequalities in cancer prevention and care is critical. Hopefully, with various sectors working together, we can develop and implement an integrated and holistic approach to cancer elimination, helping achieve our national targets for immunization, screening, and treatment,” said Teodoro Padilla, Executive Director of the Pharmaceutical and Healthcare association of the Philippines (PHAP). “We in the biopharmaceutical industry consider ourselves as partners in nation-building, because a healthy citizenry is the backbone of a strong and inclusive economy.”