 Hi everyone, I am Pallavi. I am an IT consultant and also a lifestyle influencer and most important role I play is I am a mom blogger as well. So today I have the privilege to have Dr. Prathimanaj with us. She is the gynaecologist at Manipal Hospital, Old Airport Road, Bangalore. And today doctor I want to discuss with you the most trending topic that's going on I think in every layman and women's heart that is about cervical cancer. I think this is the very necessary topic that has to be discussed. So I'd like to take the opportunity doctor to discuss about it with you. Sure, sure Pallavi. You can go ahead with any questions you have. So who are the people who are more prone to this cervical cancer? Is it because of a lifestyle choice, a food ing habit or what are the reasons why people might get infected by this? Okay, so first of all we know that according to the global fat sheet just now you said that there are more than 3 lakh cases being diagnosed throughout the world wide and then more than 50% succumb to death. So why this mortality rate is high? It's because there's lack of awareness among women. So when they come to us or when they present to us in the OPD they usually come in an advanced stage. So cervical cancer we all know it's cancer of the uterine cervix that is the mouth of the uterus and also we know that cervical cancer that is 90% of the cervical cancer are caused by HPV that is human papillomavirus infections. So this is again a sexually transmitted infection but it is not that everyone who comes with this who gets infected this virus will have cancer, will develop cancer is at least 70 to 80% of them will clear this virus from their body due to their own immune system. But there are some certain instances like where the virus persists in the body, when the virus persists in the body then there are changes in the cervical cells abnormalities and then that can lead to a cervical cancer later on. So approximately it takes around 10 to 15 years or maybe 20 years for a cancer to develop from the infection stage. So that's what I was telling that not everybody who gets infected this virus will develop cancer but due to certain risk factors. So talking about the risk factors coming to the lifestyle thing what we say is so since we know it's a sexually transmitted infection. So if somebody is having multiple sexual partners they can acquire multiple sub types of HPV infections as well. So they are at risk of developing cancer later on early child marriage, early child marriage and then multiple pregnancies. And also if somebody is having a habit of smoking and alcohol addictions and with obesity. So we know obesity is also one of the leading factors for most of the cancers and even cervical cancers like obesity can make this virus persists and then they can have cancer later on. And also if somebody is having excessive exposure to oral contraceptive pills and also with a low immune system body. So because if a good immune system the infection usually gets cleared up from the body. But sometimes due to our own body immune system is poor or if somebody with a who are on immunosuppressants or with a chronic kidney failure or who has on dialysis or on immunosuppressant drugs or who are having other immunosuppressive diseases like HIV and other chronic illness or in such patients this virus tends to retain for a long time. And also if a patient or a woman with other sexually transmitted infections not only HPV they are having some HDLV or HIV syphilis. So with other sexually transmitted infections also they can tend to have this persistence of these infections. So as I understand what you mentioned about early marriage could be one of the reasons. So do you think there is an age group which is more prone to this or how is it? So what we see is like there is a bimodal age group where we see the cervical cancer disease. That is first is like around 30 to 45 years one of the age group we see and the other group is 60 to 70 years. This is because what happens is if we say early child marriage because if the girl is very young I mean she is young and she is a child and she gets married and that again could be due to a lot of trauma to her and also her immunity would not have been developed. And also it is like a lot of exposure to the sexual activity and even these kind of early child marriages and these will happen in most of the rural areas where there would not be any hygiene, malnutrition. So there are many other associated factors also. So due to this like you know they can have persistence of this infection for a long time. You think somebody is getting sexually active at the age of 12 years and then exposure of that infection at the age of 12 years. So she has that long time of being infected with virus. So maybe by the age of 30 years or 35 years if that virus is persistent she will develop cancer at a very young age. And what are the symptoms that like of course symptoms will appear I think quite later to the stage like it will not be very early but what are the most constant? So symptoms what we say is most of the cancer not only cervical cancer most of the cancer early I mean they are usually asymptomatic most of the time. And cervical cancer also it is asymptomatic in early phases but has the phase I mean the stage or the phase changes then the symptom starts appearing. But the most common symptoms which usually people generally tend to ignore is one of the most important thing is post-coital bleeding. Post-coital bleeding is something a bleeding that happens after a sexual intercourse. So that one I mean it is a very highlighted symptom and somebody is having abnormal vaginal discharge or it could be a false smelling discharge associated with spotting or bleeding. Some discharge and it is chronically getting heavier but the discharge is not getting away with the treatment or conservative management whatever they are taking even after the medications it is not getting solved. And then abnormal bleeding abnormal uterine bleeding that is bleeding between interminstrel cycles or sometimes a prolonged bleeding it could happen. And also like in a post menopausal bleeding most of the women especially who have are like in a 10 menopause and sometimes they say that they started seeing some pinkish discharge. I think it is just a common factor and people think that maybe you know it is just it is very normal that is what I mean. They say it is because of heat or you know they just tend to ignore. They have heard that so many times from older women they feel like maybe they just again menopause so it is very normal to repeat again. It is a very significant if any woman has a slight amount of spotting or a post menopausal bleeding they should not ignore. It could be any signs of a cancer from a genital tract. There are other infections as well but still this has to be given very importance and significance and cancer has to be ruled out. These are in the early stages but has these stage advances like you know they can start having other manifestations like you know they can have abdominal distention pain in the lower abdomen or they could have a swelling in the limbs legs and they can start having back pain or if the cancer metastasis to the lungs then they can have breathlessness. If the cancer metastasis to the brain they can have other issues like strokes and other things. So this is how like you know cancer it depends upon the stage and also in very advanced stages they can again have a recto vaginal fistula or urethra vaginal fistula. It means that they can pass motions from the vagina itself or they can start passing urine because the tract gets connected the motion tract and the bladder tract with the vagina. So these all are the later signs of the disease. And what are the different treatments already you have mentioned doctors already mentioned the treatments if you just have to summarize them like what will you do. So that's what if again the treatment all depends upon the stage and the extent of the disease and the type of a tumor. So if it is feasible for surgery that is early stage disease and it's always like you know surgery is the best. If it's early then we'll definitely do a good surgeries we have all the technologies of surgeries fertility preserving surgeries. So if a person wants to preserve a fertility we can go for a fertility preserving surgeries. If she has completed fertility then again we can go for a completion surgery in case radical surgeries we have. And if she has come in an advanced stage as well we still have a good like you know chemotherapy drugs immunotherapists target the therapist. Based on these like you know even her disease can be controlled and sometimes it can be cured also. And we have a good radiation technology also that is with cancer service advanced stage we give radiation as well that is external radiation internal radiation. And these days these radiation therapies are also like targeted earlier whenever it was a radiation therapy it used to be extensive and they would have a lot of side effects and they would not be tolerable. So these days we have a targeted radiation which will only target the site which we have to focus. So based on these advancements we have good treatment for us like you know the disease can be controlled and still can be cured as well. I think we all almost got a rough idea and I was also aware of government has passed a bill for women getting free HPV vaccine. Can you just say about that? Yes so like you know recently our Honorable Minister Finance Minister Sir Nirmala Sitaram has announced that like you know HPV vaccination should be made free for all the girls of age 9 to 12 years. So this has been announced. So yes it is a good initiative if government is taking on this. So these vaccines doctor is just for the girls age 9 to 15 or can be given to women as well. Yes yes vaccination it is not only for girls it also can be extended to boys because HPV infection it not only causes cancer in women. So HPV in women it causes cervical cancer, vaginal cancer, vulval cancer, anal genital warts. But same in men it causes penile cancer, anal genital cancer, cancer. Yes it is a sexual transmitted infection it can be transmitted either ways right. So penile cancers and also in both of them they can have oropharyngeal cancers. So head and neck cancers. So it is not only we are preventing cervical cancer. We are preventing all HPV related cancers. I think thank you so much doctor for giving us so much of information about this cervical cancer which is round the topic. But I think people were not understanding even I had so many doubts which you cleared like this can be transferred to men and they will have something respectively more or similarly dangerous. And it can be prevented by you know giving vaccination to kids at the age of 9 to 15 before their sexual debut that what you are mentioning. So I think overall the takeaway will be that everybody should take the vaccine the awareness should be high. Government is introducing vaccines everybody should opt for it. And women should have good lifestyle choices like taking care of their weight of course like you said obesity is one of the leading reasons and smoking and drinking everything should be reduced and I think overall we have to take care of our health. And screening is I think number one necessary thing because we have to be aware of it and I think prevention is always better. Thank you so much doctor for enlightening us with all the information that I think most of the women were having and that was very very helpful. Thank you for coming and thank you for like you know you are such a big influencer. So it's my pleasure to like you know speak to you and maybe through you all the followers will get to know what it is and how. There is such a big value add I will tell you doctor I am so privileged to have a conversation with you because this is something which is such a value add for the society because many people are not aware of it and I think right now Google is the biggest doctor that everybody follows. For every question we go to Google and YouTube but getting it to hear from the doctor herself is a big thing so it's really helpful for all of us. Maybe all the followers will definitely benefit from you absolutely absolutely. It was pleasure talking to you doctor and thank you so much.