Cheryl Martin (Host): Cervical cancer is most frequently diagnosed women between the ages of 35 and 64 with the average age being 50. On this episode, we discuss the symptoms, screening and treatment with Dr. Manolis Tsatas, a gynecologic oncologist with Maimonides Medical Center.

This is my Maimonides Talk, a podcast from Maimonides Health. I'm Cheryl Martin. Doctor, so glad you're here to educate us on cervical cancer.

Manolis Tsatas, MD: Good morning, Cheryl. I'm glad to be here.

Host: First, talk about what cervical cancer is and what are the symptoms.

Manolis Tsatas, MD: Cervical cancer is a disease of the cervix, the bridge between the vagina and the womb. It is a disease that is entirely preventable, and is most commonly diagnosed in the mid-40s, but going up to later ages in life.

Host: You mentioned that it is preventable. How so?

Manolis Tsatas, MD: The majority of cervical cancers are caused by the HPV virus, the HPV virus standing for human papilloma virus. This is sexually acquired typically in the late teens or in your twenties. And the resulting cervical cancer happens about 20 years later. There are no ways to cure the HPV virus, but there is an HPV vaccine, which is recommended by the Academy of Pediatrics for use in the early teen years.

Host: So again, the main way to prevent it is for a person much younger in life to get that HPV vaccine?

Manolis Tsatas, MD: That is correct.

Host: So, talk about then the importance of screening. What are the symptoms that would make someone concerned that maybe they have cervical cancer?

Manolis Tsatas, MD: This is a very interesting question, how do people present? In fact, most women who acquire cervical cancer will do so in their reproductive years. So, the most common symptom, which is abnormal bleeding, may often be missed. There is also a large number of women with cervical cancer who have no symptoms whatsoever, but will often report having some spotting after sexual activity.

The mainstay of diagnosing cervical cancer is through screening, and the most common screening test known to the community is Pap smears. Although over the last 10 to 15 years, HPV testing has also been introduced and is very important.

Host: And again, a person typically will not get screened until they have some of these other symptoms.

Manolis Tsatas, MD: No. Typically, screening strategies involve routine Pap smear starting at the age of 21. And repeating that test every two to three years up until age 30. At which point, Pap smears in HPV testing gets spaced out to every five years. It is very unlikely for a person with negative Pap smears and HPV testing to have cervical cancer. But the majority of patients who do develop cervical cancer either haven't been screened or have not been screened properly.

Host: So, this is really a great commercial for people, women, having regular visits to the gynecologist so they can get that Pap smear.

Manolis Tsatas, MD: Absolutely. If you do your Pap smears and you go to the gynecologist when you're supposed to, I can almost promise you will not get cervical cancers.

Host: That's good news, definitely. So, what are the treatment options if someone has cervical cancer?

Manolis Tsatas, MD: Fortunately, the majority of cervical cancers are caught in an early stage, and surgery remains an option. In really early stages, even removal of the cervix alone is an option. But in more advanced cases, typically, surgery is not available, and chemotherapy and radiation can cure the disease, albeit at a slightly lower rate.

Host: So, what is the survival rate, Doctor, for women who have been diagnosed with cervical cancer, whether it's at the beginning stages or, let's say, the higher stages?

Manolis Tsatas, MD: I would say for stage I cancer, the survival rate is somewhere in the 85-90% range. So, the majority of patients with early stage cervical cancer will be cured. Stage II, stage III have a lower survival rates. Typically, for stage II, we expect a survival rate in the 70% range. And that drops to 45% for stage III and IV cancers. But there have been significant advances in the field, so I'm hoping that these numbers keep getting better.

Host: Anything else you'd like to add about cervical cancer, especially interventions?

Manolis Tsatas, MD: The big take-home message is to prevent cervical cancer. If I don't see another cervical cancer in my career, I will not be unhappy. And the best way to do that is through HPV vaccination. Australia has done universal HPV vaccination. And they have virtually eradicated cervical cancer from their population. And I think we can do the same thing as well.

Host: Dr. Manolis Tsatas, thanks so much for sharing your expertise with us on cervical cancer. Great information. Thank you.

Manolis Tsatas, MD: Thanks for having me.

Host: To make an appointment, call 718-283-8380. Or for more information, visit my maimo.org. You can follow us on social at Maimo Health. And if you found this podcast helpful, please share it on your social media. You can also check out our podcast library for other topics of interest to you. This is Maimo Med Talk, a podcast from Maimonides Health. Thanks for listening.