Cancer Cervix

2 days back in outpatient, I had this middle aged lady sitting in my clinic. She appeared quite shy to tell her complaint. She complained of a heaviness of her lower abdomen. And then slowly, I could very diffinitely smell a characteristic odour which has been well taught to us.

There was only one diagnosis. Cancer of the Cervix . . . It was death knell for her. I told our RCH nurses to check it out. After checking her, they wondered how she had been living with this for so long. The whole genital region was closed tight because of the mass. Only a small orifice remained through which urine was dribbling out. The ultrasound showed that the mass was extensive. It was only a matter of time before her ureters would become blocked.

Most of us in India are used to seeing such cases.

We’ve had a very high incidence of Cervical Cancers in our surrounding communities. Last year, there were 5 deaths due to Cervical Cancer in the 3 villages which surround our hospitals.

It has been known for quite some time that using acetic acid to diagnose early cervical cancer could be a better primary health option than using PAP NICOLEAU smears. Recently, there were news in the papers about research which was done on this in India.

I’m exploring options on how to start out the program in our regular outpatient department. In addition, at a later stage, I would like to look at transferring the skill to the Sahiyas (ASHA workers) and the Auxiliary Nurses and Midwives.

Could I request the leaders and experts in the area of Gynaecology Cancers to give me the up to date knowledge on this issue and help in exploring ways to start this program in NJH? Of course, some sort of funding to kick start the program would be welcome.

The trainings we could be looking into are –

1. Training of RCH nurses to do this.
2. All lady doctors to receive training to supervise this work.
3. Training for one of the doctors preferably the surgeon to do the follow-up work like punch biopsies etc.
4. Identification of a referral centre for patients diagnosed to have.

The screening program for gynaecological cancers is something that has been on my mind for quite a long time now. I pray that we would have someone who would take up this burden.