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Deborah Howell (Host): You know, we humans are made up of a lot of moving parts and we don't always think about checking up on all of them. But this is Cervical Health Awareness Month. And today, we're going to find out why that's so important. My guest is Dr. Samer Schuman, the Medical Director of Gynecologic Oncology at the Women's Cancer Center. Welcome, Dr. Schuman.

Dr Samer Schuman: Hi, Deborah.

Deborah Howell (Host): Great to have you back on the podcast.

Dr Samer Schuman: Thank you.

Deborah Howell (Host): So I guess, we'll begin from the beginning. What is cervical cancer?

Dr Samer Schuman: The cervix is that bottom part of the uterus which meets the vagina. And cancer of the cervix or cervical cancer happens when the normal cells in the cervix change into abnormal cells and grow out of control. Most people whose cervical cancer is found early and treated, they do very well.

Deborah Howell (Host): Okay. And which women are most at risk for cervical cancer?

Dr Samer Schuman: So cervical cancer, mainly the majority of it, I would say about 99.7%, is due to the HPV or human papilloma virus. So the risk factors that are associated with HPV infection are the risk factors for cervical cancer. So these include things like early-onset sexual activity, multiple sexual partners, high-risk sexual partner, history of sexually transmitted diseases, immunosuppression, any of those could increase the risk of developing cervical cancer.

There are also other non-HPV-related risk factors, such as low socioeconomic status, use of birth control pills and cigarette smoking.

Deborah Howell (Host): Okay. And what are some of the common symptoms of cervical cancer?

Dr Samer Schuman: So it depends at the stage or how far along is the cervical cancer. It might not cause any symptoms at first. But when it does cause symptoms, it can cause things like vaginal bleeding that occurs between menstrual cycles, meaning the bleeding happens when you are not having your period. It can also cause bleeding after sex or after menopause. These symptoms can also be caused by conditions that are not cancer, we have to say. But if someone has those abnormal bleeding episodes, as mentioned previously, I highly recommend that they talk to their doctor or nurse practitioner.

Deborah Howell (Host): Yeah. Good advice. How is cervical cancer diagnosed?

Dr Samer Schuman: So the traditional way of diagnosing cervical cancer is through the Pap test or the Pap smear that probably most of our listeners know about, and this was the first way of screening for cervical cancer that was developed in the '70s. Doctors nowadays also can do another test called the human papilloma virus or HPV test that's because HPV itself is the cause of most cervical cancers.

Deborah Howell (Host): Now, for the good part. What are the treatment options for cervical cancer?

Dr Samer Schuman: So cervical cancer can be treated in different ways. And the treatment depends on the stage it's detected in. Surgery can play a major role when cervical cancer is detected in early stages. And this could include something such as removing the cervix, uterus and upper vagina, something called a radical hysterectomy. Sometimes we remove all or part of the cervix leaving the uterus in place. This is only done in special circumstances.

If the cervical cancer is more advanced, then we need things like radiation therapy, which radiation is that type of treatment that kills cancer cells. And very often with radiation therapy, we add a little bit of chemotherapy when the cervical cancer is local. If the cervical cancer is advanced and metastatic throughout the body, then chemotherapy is the treatment of choice.

Deborah Howell (Host): Sure. How can the Women's Cancer Center play a role in preventing cervical cancers?

Dr Samer Schuman: So the Women's Cancer Center helps in preventing cervical cancer by encouraging screening and talking to our colleagues and general OB-GYNs and primary care physicians regarding the importance of screening and prevention of cervical cancer before it develops, detecting those cancer cells when they are precancerous, before they become invasive cancer. What we have been doing, we have been providing education to patients and other providers through different forums. And also, we have been promoting HPV vaccination. We are leading a campaign within our health system to increase the rates of HPV vaccination as this seems to be one of the most proactive and most effective ways to decrease the incidence of cervical cancer.

Deborah Howell (Host): So who should receive this vaccination, Dr. Schuman?

Dr Samer Schuman: Everybody should receive this vaccination if they are eligible. Right now, the vaccine is recommended for both boys and girls when they reach the age of nine. And it can be given until the age of 26 and, in some instances, even beyond that.

Deborah Howell (Host): Okay. And what makes the Women's Cancer Center stand out when it comes to prevention and treatment for women in the community?

Dr Samer Schuman: So the Women's Cancer Center is the only center in this region that has a dedicated team of board-certified gynecologic oncologists and breast cancer specialists. Through this team, we offer the entire spectrum of care for GYN cancers and breast cancer.

Deborah Howell (Host): Is there anything else you'd like to add to our conversation?

Dr Samer Schuman: Yes, one last thing. Again, I'm going to talk about the vaccination against HPV. This is the most proactive way of preventing cervical cancer. I encourage all our listeners that are eligible to consider getting the HPV vaccine and to vaccinate their children, both boys and girls. I also encourage our physicians, primary care physicians and OB-GYNs as well as the pediatricians to educate their patients about cervical cancer and to offer them the HPV vaccine.

Deborah Howell (Host): Well, this is such excellent information, Dr. Schuman. Thank you so much for being with us today to talk about Cervical Health Awareness Month.

Dr Samer Schuman: You're very welcome.

Deborah Howell (Host): This is Deaconess The Women's hospital, a place for all your life. For more information, visit www.deaconess.com and search for cervical health. Please remember to subscribe, rate, and review this podcast and all the other Deaconess Women's Hospital podcasts. For more health tips and updates, follow us on your social channels.

This is Deborah Howell. Thanks for listening and have yourself a great day.