With So Many Advances in Fighting Cervical Cancer, Is Eradication Possible?

An estimated 14,000 new cases of invasive cervical cancer will be diagnosed in 2024, and about 4,000 women will die from the disease. But there have been significant advances over the past several years.

The cervical cancer death rate dropped sharply with the increased use of the Pap test, a screening procedure that can find changes in the cervix before cancer develops. It can also find cervical cancer early − when it's easier to cure.

In recent years, the HPV test has been approved as another screening test for cervical cancer --  since almost all cervical cancers are caused by HPV (human papillomavirus. The HPV test looks for infection by high-risk types of HPV that are more likely to cause pre-cancers and cancers of the cervix. The HPV test can be used alone (primary HPV test) or at the same time as the Pap test (called a co-test).

John P. Diaz, M.D., Chief of Gynecologic Oncology at Baptist Health Miami Cancer Institute.

Moreover, there has been a significant reduction in cancer cases among young women over the last decade with the widespread use of the HPV vaccine, introduced in 2006.

John P. Diaz, M.D., Chief of Gynecologic Oncology at Baptist Health Miami Cancer Institute, is featured in a new Baptist HealthTalk segment, with host Johanna Gomez, Emmy award-winning journalist and frequent TV host, focusing on the advances in diagnosing, preventing and treating cervical cancer.  

“Between the combination of HPV vaccination and cervical cancer screenings, we really should eradicate cervical cancer,” explains Dr. Diaz. “Having said that, it's an exciting time for the treatment of cervical cancer. We have new drugs that have come on board now. One exciting drug is called Tisotumab vedotin, and it's a new class of drugs. They're called antibody drug conjugates, and it's a non-chemotherapy drug that has improved survival in women.”

Antibody-drug conjugates consist of a monoclonal antibody chemically linked to a cancer-killing drug. The monoclonal antibody binds to a protein on the surface of some cancer cells – and destroys the cancer cells. Tisotumab vedotin may also stimulate the immune system to kill cancer cells. It is a type of targeted therapy. Immunotherapy, an advanced cancer treatment that helps the body’s immune system fight cancer, is also being applied to cases of cervical cancer.

“And the other exciting part is immunotherapy,” Dr. Diaz said. “These are medications that use our own immune system to battle these cancers. And these have been approved in the treatment of cervical cancer, and now have been brought up to the frontline treatment. So. it's really an exciting time. For the first time in probably 20 years, we have new drugs to treat this disease. So while the treatment is getting better, the goal really should be to eliminate this cancer.”

Here are some questions and answers from the Baptist HealthTalk segment on cervical cancer with Ms. Gomez and Dr. Diaz:

Ms. Gomez: “Cervical cancer is, obviously, one of the big reasons why we also go (to the gynecologist), and it really can affect women of all ages. Why does cervical cancer develop so much in young women?”

Dr. Diaz: “Cervical cancer is usually associated with an infection called the human papillomavirus infection. And this is transmitted through touch, particularly sexual contact, and over 85 percent of adults in the United States, at some point in their lifetime, have been exposed to HPV. Cervical cancer, thankfully, though, is really uncommon in the United States. As you said earlier, only 14,000 cases a year, and the majority of those women are either from outside the U.S. who have not had cervical cancer screening, or within the U.S. and don't have access to healthcare or have not been able to keep up with their cervical cancer screenings. So, this really is a preventable cancer.”

Ms. Gomez: “A lot of people are scared to go to doctors .. but what are some of the early signs of cervical cancers that we should be looking out for? Common symptoms?”

Dr. Diaz: “The most important thing is to get there before you develop any of these symptoms. Cervical cancer is totally preventable through pap smears and the HPV vaccine … but once you develop symptoms --  symptoms such as abnormal bleeding, pelvic pain, vaginal discharge -- that can be a sign of a more advanced disease. That's what we want to avoid with early screening and early detection.”

Ms. Gomez: “As parents, we hear about it (HPV vaccine) so much. I have a teenager, and that conversation has already started. It doesn't matter if you have a boy or a girl. Why is it so important to get this vaccine?”

Dr. Diaz: “So, the vaccine has been an incredible advancement in medicine. We now have the ability to prevent the development of any of these HPV-related cancers. We're talking today about cervical cancer and there are 14,000 new cases a year, but there are other HPV-related cancers that can affect women like vulvar cancer, vaginal cancer. There are HPV-related cancers that affect men -- head and neck cancers. And for those, we don't have any kind of screening. So the HPV vaccine gives us an opportunity to develop antibodies before the onset of sexual activity.

“It's recommended for boys and girls about nine to 10 years of age. And the idea is to get your body immune to this HPV so that when you do get exposed to it, your body's ready to eliminate or suppress this virus. And you don't go on to develop any of these cancers. That’s the important part – to try and get immunization before the onset.”