In the realm of women’s health, the importance of early detection and regular screening cannot be overstated, especially when it comes to cervical cancer. Cervical cancer is a silent threat that affects women worldwide, but early detection holds the key to successful treatment and improved outcomes. In Malaysia, it is the 4th most frequent cancer among women and 2nd most frequent cancer affecting women 44 and belowi. This worrying finding shows that it is crucial to shed light on the significance of proactive health measures, breaking taboos, and embracing regular screenings.
Dr Thangesweran Ayakannu, Consultant Gynaecology, Oncology and Robotic Surgeon, Sunway Medical Centre, Sunway City, delves into the importance of cancer screening among women, especially for cervical cancer, while providing advice for Malaysian women to empower them in their journey towards optimal gynaecological health.
Types of gynaecological cancers are rising
Dr Thangesweran Ayakannu highlighted three primary gynaecological cancers: uterine cancer, cervical cancer, and ovarian cancer. Cervical cancer is one of the most common forms of gynaecological cancer, even in Malaysia, where 12.9% of female cancers are caused by cervical cancer.ii
However, uterine cancer is on the rise, correlated with increasing obesity rates. According to the National Cancer Registry of 2011-2016 report, uteri cancer among women has increased from 3.8% in 2007 -2010 to 4.6% in 2011 -2016iii. Dr Thangesweran Ayakannu adds, “As a healthcare professional, we have been seeing a rise in uterine cancer. This could be mainly due to the hormonal imbalance as a result of obesity. This imbalance is one of the contributing factors of cancers affecting organs like the uterus, breast, and ovaries.”
Role of the HPV vaccine
According to the World Health Organisation, human papillomavirus (HPV) is a common sexually transmitted infection affecting the skin, genital area and throativ. Persistent HPV infection of the cervix (the lower part of the uterus or womb, which opens into the vagina – also called the birth canal) if left untreated, causes 95% of cervical cancersv.
Dr Thangesweran Ayakannu adds, “HPV, a widespread infection affecting nearly everyone, both men and women is a leading cause of cervical cancer. One of the most prevalent preventative measures is the HPV vaccination, which can substantially lower the risk by targeting the most dangerous strains of the virus. However, HPV vaccines should not be considered a substitute for pap smears as a proven method of gynecological cancer screening”
Fertility Treatments and Cancer Risk
As one of the main risks of cancer is hormonal imbalance or fluctuations, and the main function of fertility drugs is to overstimulate the ovary, there may be concerns surrounding the increased risks of cancer to women undergoing or who have undergone fertility treatments. Dr Thangesweran Ayakannu acknowledges the concern, citing, “Fertility drugs, especially those that overstimulate the ovaries, pose a risk, especially when it is done frequently. It is important for women who have undergone fertility treatments to monitor their ovarian tissue closely through ultrasounds, and blood tests, especially after strong and frequent IVF or fertility treatment cycles.”
He adds, “Infertility has been found to be an important risk factor for ovarian cancer. However, the association between infertility drugs and ovarian cancer needs to be addressed with consideration of other factors such as age, body mass index, parity, genetic factors (i.e. family history for ovarian cancer), and aetiology of the infertility, along with longer follow-up times.”
Importance of Cancer Screening
Dr Thangesweran Ayakannu also underscores the critical importance of early cancer screening for Malaysian women, stating, “Early detection is paramount in the fight against cervical cancer. Regular screenings empower women to take control of their health, allowing us to identify potential issues in their infancy.
In Malaysia, where cultural nuances sometimes hinder open discussions about women’s health, breaking these taboos and embracing early screening is a pivotal step. It improves treatment outcomes and transforms the narrative around women’s well-being.
Dr Thangesweran Ayakannu adds, “By fostering awareness and encouraging proactive health-seeking behaviours, we can collectively move towards a future where cervical cancer is not just treatable but preventable. Prevention involves detecting cell changes early through HPV vaccines, regular pelvic exams, HPV DNA tests every 4 years and pap smears every three years. Late-stage diagnoses, preventable with these measures, are something we aim to avoid.”
Knowing Your Risks and the Importance of Managing Your Gynaecological Health and Wellbeing
Dr Thangesweran Ayakannu shares valuable insights, breaking down essential steps for women to proactively manage their well-being. This includes:
- Know Your Body, Break the Taboos: Understanding one’s body is the first step towards empowerment. Monitoring your menstrual pattern, being alert of irregularities, and seeking early help can help. Do not ignore these symptoms.
- Clear Communication and Regular Pelvic Examinations: When doing your health checkup, it is important to communicate your medical history during doctor visits. Regular pelvic exams can also help with your overall gynecological health and provide vital information to the healthcare professional
- Risk Assessment and Screening: Risk assessment guides healthcare professionals in determining the right screening tests. The best treatment outcome is when we can catch it early. Dr Thangesweran Ayakannu advises that Robotic surgery, for example, has advanced technologies that can help. Catch it early; the earlier you catch it, the better the outcome.”
- Recognising and Addressing Symptoms and Risk factors: For women who know their bodies best, it’s important not to ignore your symptoms even though you may think it’s normal. For example, bleeding after menopause or postmenopausal bleeding is not normal but it may be an early warning sign for endometrial cancer. Dr Thangesweran Ayakannu adds, “Other conditions like PCOS and endometriosis predispose you to gynecological cancers. Keep an eye on these long-term problems, monitor your periods, and undergo regular checkups, including ultrasound scans.”
Early detection is not just an option but a shared responsibility. Dr Thangesweran Ayakannu’s expert guidance underscores the transformative power of early detection, open communication, and regular screenings. By breaking taboos and fostering a culture of awareness, we pave the way for a future where cervical cancer is not just treatable but preventable.
i. Malaysia: Human Papillomavirus and Related Cancers, Fact Sheet 2023 (hpvcentre.net)
ii. A Review of Cervical Cancer Research in Malaysia (e-mjm.org)
iii. Summary_MNCR_2012-2016_-_06112020.pdf (moh.gov.my) PAGE 2
iv. Cervical cancer (who.int)
v. Cervical cancer (who.int)
Dr Thangesweran Ayakannu
Consultant Gynaecology Oncology and Robotic Surgeon
Sunway Medical Centre, Sunway City
