1 00:00:00,160 --> 00:00:04,080 S1: Now. Each year, around 1000 women here in Australia are 2 00:00:04,080 --> 00:00:07,360 S1: diagnosed with cervical cancer. And I remember what it was 3 00:00:07,360 --> 00:00:09,559 S1: like for me all those years ago. So joining us 4 00:00:09,560 --> 00:00:13,880 S1: this morning is Professor Annabelle Farnsworth, who is a gynaecological 5 00:00:14,040 --> 00:00:18,160 S1: pathologist and also spokesperson for the Australian Cervical Cancer Foundation's 6 00:00:18,200 --> 00:00:21,280 S1: Awareness Week. Thank you so much for joining us today Annabelle. 7 00:00:21,880 --> 00:00:22,720 S2: Good morning. 8 00:00:22,960 --> 00:00:26,360 S1: Now let's start with the basics. Can you please explain 9 00:00:26,360 --> 00:00:29,440 S1: what cervical cancer is and how it starts for most 10 00:00:29,440 --> 00:00:31,680 S1: people okay. 11 00:00:32,159 --> 00:00:35,360 S2: Cervical cancer is a cancer that arises in the cells 12 00:00:35,360 --> 00:00:37,599 S2: of the cervix. The cervix is the lower part of 13 00:00:37,600 --> 00:00:41,680 S2: the womb or the uterus that literally holds the baby in, 14 00:00:41,880 --> 00:00:44,800 S2: you know, while you're pregnant. But those cells can get 15 00:00:44,800 --> 00:00:51,839 S2: infected with a virus called the human papillomavirus. That then 16 00:00:52,200 --> 00:00:56,280 S2: is a really common virus. It's spread during sexual activity. 17 00:00:56,600 --> 00:00:59,520 S2: But and most people clear it all by themselves. But 18 00:00:59,520 --> 00:01:02,680 S2: in some people, we don't know why. Some people that 19 00:01:02,680 --> 00:01:06,890 S2: virus persists. And we actually know that about 99% of 20 00:01:06,890 --> 00:01:09,770 S2: all of this disease. Cervical cancer is actually caused by 21 00:01:09,770 --> 00:01:11,970 S2: this this particular virus. 22 00:01:12,010 --> 00:01:14,530 S1: Mhm. Oh lucky me to be part of the 1%. 23 00:01:15,290 --> 00:01:19,890 S1: Yeah I like to be an overachiever sometimes. Annabelle you 24 00:01:19,890 --> 00:01:20,529 S1: know what I'm saying. 25 00:01:21,130 --> 00:01:23,330 S3: No no I know, I know. And it's funny in 26 00:01:23,330 --> 00:01:24,850 S3: this world we always talk about. 27 00:01:25,209 --> 00:01:27,929 S2: You know, percentages. But when it's a real person, you 28 00:01:27,930 --> 00:01:29,730 S2: don't want to be the 1% you. 29 00:01:29,890 --> 00:01:30,570 S3: Um, yeah. 30 00:01:30,569 --> 00:01:30,729 S2: Yeah. 31 00:01:30,770 --> 00:01:33,690 S3: No, I totally get that. Yeah. And so, Annabelle, can 32 00:01:33,690 --> 00:01:35,770 S3: you tell us about some of the symptoms of cervical 33 00:01:35,770 --> 00:01:38,490 S3: cancer and when we should know to see a doctor? 34 00:01:38,930 --> 00:01:43,810 S2: Yeah. Okay. Well. Cervical cancer, we'll talk about that in 35 00:01:43,810 --> 00:01:45,690 S2: a minute. We're actually hoping to prevent it. 36 00:01:45,730 --> 00:01:46,729 S3: Yeah. Um. 37 00:01:47,050 --> 00:01:50,010 S2: And so it's one of those cancers that we can 38 00:01:50,010 --> 00:01:53,170 S2: pick up in what we call the pre-cancer stage when 39 00:01:53,170 --> 00:01:56,170 S2: the cells are, you know, making all the changes that 40 00:01:56,210 --> 00:02:00,050 S2: eventually become a full blown cancer. But the important thing 41 00:02:00,050 --> 00:02:04,690 S2: is that symptoms can occur, and that's usually bleeding is 42 00:02:04,690 --> 00:02:07,050 S2: probably one of the main things. And it's bleeding that's 43 00:02:07,050 --> 00:02:11,690 S2: unusual for you. So if it's between a period or 44 00:02:11,730 --> 00:02:15,730 S2: postcoital bleeding that you haven't had before, or something unusual. 45 00:02:15,730 --> 00:02:20,890 S2: You can also have a discharge that's again unusual for you. 46 00:02:21,010 --> 00:02:24,770 S2: And the important thing is that it's just a visit 47 00:02:24,770 --> 00:02:30,690 S2: to the your local healthcare provider to talk these things through. 48 00:02:31,169 --> 00:02:35,290 S2: And it's like any symptoms, just don't ignore them. Um 49 00:02:35,690 --> 00:02:39,410 S2: and but but yeah so but those type of things 50 00:02:39,410 --> 00:02:43,570 S2: will will often um present with you know or cervical 51 00:02:43,570 --> 00:02:45,050 S2: cancer will present like that. 52 00:02:45,090 --> 00:02:48,209 S4: Anabel the focus is obviously on a prevention strategy that's 53 00:02:48,210 --> 00:02:52,890 S4: simple and understandable. Yeah. My concern I have three daughters 54 00:02:52,889 --> 00:02:56,130 S4: and Sarah has three daughters as well. Uh, mine are 55 00:02:56,130 --> 00:02:59,610 S4: all grown up, married with their own children. But what 56 00:02:59,650 --> 00:03:04,649 S4: role does the male play in spreading this human papillomavirus? 57 00:03:04,650 --> 00:03:06,690 S4: Most people think papillomas. They're the things you get under 58 00:03:06,690 --> 00:03:09,170 S4: your feet. So how can it possibly how can it 59 00:03:09,210 --> 00:03:11,650 S4: possibly survive in a different area of the body? But 60 00:03:11,650 --> 00:03:16,900 S4: this is a very serious, very infectious virus but obviously 61 00:03:16,900 --> 00:03:19,700 S4: spread by the blokes. So how do we screen them? 62 00:03:20,940 --> 00:03:24,580 S2: It's such a sorry. It's such a good question. And 63 00:03:24,620 --> 00:03:28,860 S2: the sad part of this is that we can't screen them. Um, 64 00:03:29,139 --> 00:03:33,739 S2: once again, the burden falls on the women. It is, um, 65 00:03:33,780 --> 00:03:38,260 S2: transmitted during sexual activity, as I already said. Um, and 66 00:03:38,260 --> 00:03:42,060 S2: the men would be carriers of it. The difference in 67 00:03:42,060 --> 00:03:45,700 S2: women is that they have something called a particular funny 68 00:03:45,740 --> 00:03:49,940 S2: area in the cervix called, we call the transformation zone. 69 00:03:50,340 --> 00:03:52,660 S2: And this is an area in the cervix that changes 70 00:03:52,660 --> 00:03:57,740 S2: constantly with hormones and during the menstrual period, even, um, 71 00:03:57,780 --> 00:04:02,060 S2: all of those things. So it's a very unstable area. 72 00:04:02,060 --> 00:04:07,660 S2: And so it's the virus infecting that particular area that then, 73 00:04:07,900 --> 00:04:10,860 S2: you know, can then can lead not always, but can 74 00:04:10,860 --> 00:04:15,740 S2: lead on to disease. Men for reasons that, you know, 75 00:04:16,100 --> 00:04:18,380 S2: just it's the way it is, do not have that 76 00:04:18,380 --> 00:04:22,620 S2: type of an unstable area. Um, and so by the way, 77 00:04:22,660 --> 00:04:28,020 S2: men can get viral HPV associated diseases, but it's much rarer. 78 00:04:28,060 --> 00:04:30,820 S1: Yeah, yeah, they definitely do make up a low percentage 79 00:04:30,820 --> 00:04:34,540 S1: of of HPV related cancers for the men. So it's, 80 00:04:34,980 --> 00:04:36,980 S1: you know, in a way actually quite devastating that they 81 00:04:36,980 --> 00:04:39,380 S1: don't have that opportunity to screen the way that we 82 00:04:39,380 --> 00:04:40,180 S1: do Annabelle. 83 00:04:40,580 --> 00:04:43,820 S2: Absolutely. And I mean, it's and by the way, it's 84 00:04:43,820 --> 00:04:45,099 S2: not for want of trying. 85 00:04:45,260 --> 00:04:46,220 S3: I mean, obviously. 86 00:04:46,220 --> 00:04:48,620 S2: The question and I mean, it's kind of like the 87 00:04:48,620 --> 00:04:50,020 S2: good news and the bad news. The good news is 88 00:04:50,060 --> 00:04:53,940 S2: we know so much about the what causes this disease now. 89 00:04:53,980 --> 00:04:57,539 S2: It's probably one of the cancers that we have known 90 00:04:57,540 --> 00:05:00,820 S2: more about for longer than any other cancer. And I 91 00:05:00,820 --> 00:05:04,020 S2: think it's because there have been screening programs. So it's 92 00:05:04,020 --> 00:05:08,180 S2: been a heavily investigated with lots and lots of science 93 00:05:08,180 --> 00:05:13,900 S2: behind our understanding of this particular disease. So obviously understanding 94 00:05:13,900 --> 00:05:17,980 S2: that it's a sexually transmitted disease, that obviously there are 95 00:05:17,980 --> 00:05:21,299 S2: men involved, people have been looking, but there's just never 96 00:05:21,300 --> 00:05:27,109 S2: been a reliable test. And remember to, um, make something 97 00:05:27,110 --> 00:05:29,549 S2: like this worthwhile. It has to be highly reliable, and 98 00:05:29,550 --> 00:05:32,510 S2: it has to be something that can be repeated in 99 00:05:32,510 --> 00:05:34,990 S2: any part of Australia. You know, whether you're in the 100 00:05:34,990 --> 00:05:38,469 S2: Northern Territory or in Melbourne, you need a reliable test. 101 00:05:38,470 --> 00:05:40,830 S2: And there just has never been one developed for men. 102 00:05:40,870 --> 00:05:42,630 S2: Not not for want of trying, as I said. 103 00:05:42,670 --> 00:05:46,190 S3: Yes, definitely. Um, now, in terms of the cervical screening, 104 00:05:46,390 --> 00:05:48,950 S3: some women may find the idea of it a bit daunting. 105 00:05:48,950 --> 00:05:52,589 S3: So we understand now that there's testing with two options. 106 00:05:52,589 --> 00:05:54,029 S3: Can you tell us a bit about that? 107 00:05:54,070 --> 00:05:58,870 S2: Yeah, yeah. No, it's, um, a fascinating thing that all 108 00:05:58,870 --> 00:06:02,430 S2: screening programs, whether they be breast or bowel or cervix, um, 109 00:06:02,589 --> 00:06:04,950 S2: we're so lucky to have them in Australia. And we 110 00:06:04,950 --> 00:06:08,549 S2: have a particularly good cervical screening program, but it can't 111 00:06:08,550 --> 00:06:12,310 S2: work unless people avail themselves of this screening program. So 112 00:06:12,310 --> 00:06:17,510 S2: we need people to participate. And so once again, a 113 00:06:17,510 --> 00:06:20,030 S2: lot of people have worked out or done a lot 114 00:06:20,029 --> 00:06:24,589 S2: of research into why people why anyone with a cervix, um, 115 00:06:24,589 --> 00:06:28,950 S2: will not participate when it's so freely available. It is free. Uh, 116 00:06:28,950 --> 00:06:34,880 S2: it's a great program. And so with the new test 117 00:06:35,120 --> 00:06:37,560 S2: as part of the cervical screening program, which is the 118 00:06:37,560 --> 00:06:41,200 S2: HPV test, as opposed to the old fashioned pap smear, 119 00:06:41,240 --> 00:06:43,880 S2: which you know, was around, you know, years and years ago, 120 00:06:45,000 --> 00:06:46,920 S2: there is now an option to do what we call 121 00:06:46,920 --> 00:06:51,359 S2: a self-collect test. And so this can be a test 122 00:06:51,400 --> 00:06:56,440 S2: taken by the person. And it can be done. It's 123 00:06:56,440 --> 00:06:58,599 S2: usually done. And the best thing to do it's not 124 00:06:58,600 --> 00:07:01,839 S2: a send out test. It's something that really should be 125 00:07:01,839 --> 00:07:06,080 S2: still managed by, you know, a medical colleague so that 126 00:07:06,080 --> 00:07:10,720 S2: they can help the person understand how it's done properly, 127 00:07:10,720 --> 00:07:12,880 S2: because we want to make sure it's a great it's 128 00:07:12,880 --> 00:07:14,920 S2: done really well because we don't want it to be 129 00:07:15,120 --> 00:07:18,040 S2: negative because it wasn't, you know, taken the right way 130 00:07:18,080 --> 00:07:21,120 S2: or something like that. Um, and also to the other 131 00:07:21,120 --> 00:07:24,640 S2: thing that happens is if it's positive, the person is 132 00:07:24,640 --> 00:07:27,320 S2: going to have to come back and have them some 133 00:07:27,320 --> 00:07:30,960 S2: further investigations. Um, by the way, it's really important to 134 00:07:30,960 --> 00:07:34,600 S2: know that if you are positive for HPV. So if 135 00:07:34,600 --> 00:07:37,320 S2: the doctor rings or the clinic rings or you get 136 00:07:37,320 --> 00:07:40,360 S2: a letter or something. It doesn't mean you have cervical cancer, 137 00:07:40,720 --> 00:07:43,600 S2: it just means you need further investigation. So once again, 138 00:07:43,640 --> 00:07:46,800 S2: women should not be frightened. But the great thing about 139 00:07:46,800 --> 00:07:51,640 S2: Self-collect is that you don't have to have a vaginal examination. Um, 140 00:07:52,120 --> 00:07:54,520 S2: but now. But that's also the only other little kind 141 00:07:54,520 --> 00:07:57,800 S2: of rider there is. If you, as we talked earlier about, 142 00:07:57,800 --> 00:08:00,160 S2: do have some symptoms or signs, a bit of that 143 00:08:00,160 --> 00:08:03,280 S2: abnormal bleeding that we were talking about before, then you 144 00:08:03,280 --> 00:08:08,480 S2: probably do need a proper examination so that the, um, 145 00:08:09,200 --> 00:08:11,640 S2: the medical person can can have a look at the 146 00:08:11,640 --> 00:08:12,640 S2: cervix as well. 147 00:08:12,720 --> 00:08:15,559 S1: Absolutely. I mean, the current guidelines recommend that women between 148 00:08:15,560 --> 00:08:18,680 S1: the ages of 25 to 74 go and get screened. 149 00:08:18,680 --> 00:08:21,600 S1: But as always, if you have concerns, just pop off 150 00:08:21,840 --> 00:08:24,360 S1: to the doctor and go and chat with them. Unfortunately, 151 00:08:24,400 --> 00:08:27,080 S1: we're running out of time, Professor Annabelle Farnsworth, but I 152 00:08:27,080 --> 00:08:30,160 S1: can't thank you enough for joining us this morning. Okay, 153 00:08:30,200 --> 00:08:32,240 S1: not a problem. If you would like more information on 154 00:08:32,240 --> 00:08:36,240 S1: the Australian Cervical Cancer Foundation's Awareness Week, which includes registering 155 00:08:36,240 --> 00:08:38,880 S1: for a Girls Night in fundraiser to support their Orange 156 00:08:38,880 --> 00:08:40,880 S1: Hearts Health program, you can head to.