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Doc Alan
25th October 2012, 21:11
Breast cancer is the commonest type in women both for UK and Philippines, and can’t usually be prevented, as a cause is often not apparent. Cervical cancer is much less common but affects relatively far more women in Philippines than UK.

• In the UK all women aged between 50 – 70 ( soon to be 47 – 73 ) are invited every 3 years for breast screening by mammography ( X ray ). This NHS programme is not perfect although benefits outweigh disadvantages and it saves lives. At least 4 / 5 women with this cancer now survive 5 years from diagnosis - early detection gives the best chance of cure.

• In the Philippines survival rate is more like 2 / 5. There is less awareness. Screening is not well developed, and less likely to be free, although there may be free medical services in government hospitals and through schemes such as Phil Health.


• There is effective treatment for breast cancer – usually surgical with or without radiotherapy and possible “ reconstruction “ in the first instance. New drugs are available which “ target “ specific types of this cancer. All of these are costly, which is tantalising when cure is increasingly possible.


• Cervical screening is also well established in the UK. Women are invited for smears every 3 – 5 years between 20 - 64 ( varying slightly between countries ). The aim is to detect PRE-cancerous changes which can readily be treated. Death rates have declined markedly in the decades screening has been available – although about 1/ 5 “ eligible “ women have not had a recent “ smear test “. This type of screening is also not perfect.


• Cervical screening is not so well developed in the Philippines. The government has, however, recently offered free screening for Filipinas between 30 -45 in its accredited hospitals nationwide. Unfortunately about 2 / 3 cases of cervical cancer are diagnosed at an advanced stage. Probably less than 1 / 5 “ eligible “ Filipinas have had a smear test.


• A cheaper technique is available – Visual Inspection with Acetic acid ( VIA ) – yes, very dilute “ vinegar “ ( ! ) highlights changes which can be treated by “ cryotherapy “ ( freezing with carbon dioxide ). This is better than nothing, where resources / expertise are just not available.


• Unprotected sexual intercourse, starting at an early age, and with multiple partners, increase the risk of cervical cancer. This is NOT to judge all women with abnormal smears who may have – or be at risk from – cancer. Infection with certain types of Human Papilloma Virus ( HPV ) may cause cancer – and CAN be prevented by vaccination. Two types of vaccine ( “ quadrivalent “ = Gardasil ; “ bivalent “ = Cervarix ) are approved in UK and Philippines. Gardasil is now recommended for 12 – 13 year old girls in UK ( with “ catch-up “ for unvaccinated older females ). The three doses are free in UK – possibly P 12,000 in Philippines.


• Screening - and HPV vaccination - makes sense, both on health grounds ( chance of cure ) and economically ( treatment of advanced cancer is very expensive, whether paid directly or indirectly ).

raynaputi
25th October 2012, 22:01
Thanks for the info Doc! :xxgrinning--00xx3:

sars_notd_virus
25th October 2012, 22:14
thanks for the info doc...got the van parked for breast screening in the surgery but was noted that it was there for special appointments only..no walk-in patients.

Ive had my cervical screening done here about a couple of years ago and it was uncomfortable , although the NHS is free here i'd still prefer my OB Gyne in the PH:xxgrinning--00xx3:

Rosie1958
25th October 2012, 22:28
An excellent and informative post, well done Doc Alan. I certainly wouldn't miss any of the screening that is available here in the UK :xxgrinning--00xx3:

raynaputi
25th October 2012, 22:47
Ive had my cervical screening done here about a couple of years ago and it was uncomfortable , although the NHS is free here i'd still prefer my OB Gyne in the PH:xxgrinning--00xx3:

Me too, I did it this year for the first time..and I can say it's very awkward :cwm24:

Doc Alan
26th October 2012, 22:29
In the UK women in “ eligible “ age groups for screening should automatically be contacted. If you’re worried, contact your doctor. In the Philippines you – or your loved ones – might also need to be pro-active, and prepared to pay.


• There are good reasons – unrelated to cost – for NOT routinely screening under the ages of early 20’s ( cervical ) and late 40’s ( breast ).


• Most ( not all ) breast cancers occur over 50, and cervical cancers under 50 ( but over 25 ).


• It’s hard in any case to detect and interpret abnormalities in women younger than the recommended ages. Breast tissue is firmer and more fibrous. Cervical cells in young women often show changes which usually return to normal. Even in older women, it can be hard to interpret changes ( or abnormal cells may be missing from the sample ). In the Philippines, the cheap VIA screening method results in destruction of areas which appear abnormal, without even taking and examining a smear.


• Overtreatment - and the worry caused to the individual ( who has become labelled a “ patient “ ) - can’t always be avoided. A criticism of breast screening is diagnosis of very slowly growing cancers, which would never have been diagnosed without screening and might never have caused trouble during that person’s lifetime.


• It’s important to remember - early detection does save lives :smile:. Most women who have breast screening have a true normal result – cancers are rarely missed. Most women DON’T ever get breast cancer. Even breast lumps, especially in young women, are usually not cancer. ( Men rarely get breast lumps, and even more rarely these may be cancerous ). Many cervical smears are truly negative - regular screening should detect most pre-cancerous changes.


• Women found to have abnormalities on screening are entitled to be fully informed about their significance and options for further treatment.
ALL patients with breast abnormalities – whether detected by screening, or with symptoms such as a lump – are, in the UK, discussed in confidence by " multidisciplinary team meetings " ( doctors and breast care nurses ). The wishes of the patient are rightly taken very seriously before any treatment.

Marie
26th October 2012, 23:35
Thanks Doc for the informative posts...when I was in the Philippines I have this annual tests for all of those since I have health insurance card...