Focus On Cervical Cancer
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In 1943, George Papanicolaou, M.D., published his work on the diagnosis of cervical cancer by an examination of cells removed from the surface of the cervix. It was 15 or 20 years before the "Pap" was incorporated into most health care programs in North America. The development of the Pap smear raised exciting possibilities. It was possible, by looking at cells easily removed from a woman's cervix during a routine pelvic examination, to diagnose conditions, which, if treated by simple means, could actually eliminate the possibility of a woman's developing invasive cancer.
Even with all the possibilities created by Pap smear screening programs, this year, close to 14,000 new cases of invasive cervical cancer will be diagnosed, and of those women suffering from that disease, many will die needlessly.
The Significance Of The Pap
The Pap smear is a screening test, which has made the early diagnosis of cervical cancer possible. Developed in the early 1940s by New York physician Dr. George Papanicolaou, this test permits the examination of cells removed from the surface of the cervix. Although the use of the Pap smear should virtually eliminate the chances of a woman developing invasive cancer, this year alone, approximately 7,000 women will die of the disease--a disease that is largely preventable.
The Tragedy Of Misread Tests
There are two major reasons why women continue to die needlessly from cervical cancer: One is the failure to get annual gynecological exams and Pap smear evaluations. The other is the doctors' or hospitals' failure to properly perform and interpret Pap smears or to properly treat patients once the diagnosis of cancer or cancer-like conditions has been made.
Because a significant percentage of Pap smears are misread, many women are led to believe that they have no problem, when, in fact, cervical cancer may already be developing. Instead of preventing cancer through early detection, a misread Pap smear actually enables the cancer to grow.
In 1989, the American Medical Association documented that 15% to 30% of all Pap smears that reported showing no adverse change, in fact, had cancer or cancer-like cells present that required treatment. Most women who have these dangerous changes diagnosed can be cured with proper treatment. That's why it is particularly tragic that errors continue to be made in the performing of Pap smears and in the diagnosis and treatment of the conditions they often reveal.
A Need For Vigilance
Over the past several years, investigations conducted by Kapetan, Meyers, Rosen & Louik have confirmed that doctors may be negligent when they take or analyze Pap smear tests, and, as a result, they may begin treatment too late. This negligence is the leading cause of death or disability of clients we have represented. In many cases, even when the Pap smears are properly obtained by the physicians, they may be misread or misinterpreted by the hospitals or laboratories to which they have been sent. Without greater vigilance, these needless deaths will continue to occur.
If a woman develops cervical cancer--even though Pap smears were being performed regularly at the recommendation of a physician--negligence may be the cause. for this reason, we obtain an independent review of the Pap smear slides for each cervical cancer patient evaluated by our office. This review is conducted by a pathologist specially trained to determine whether or not danger signs existed that should have been detected by others.
Unfortunately, many cases come to our attention too late to prevent death. In proving such cases, we must identify the mistakes that caused our clients' harm. In so doing, we hope to make it less likely for the persons who made those mistakes to repeat them.
Eight Steps To Avoid Cervical Cancer
The best protection a woman has against cervical cancer is to develop a trusting relationship with a gynecologist and follow the guide-lines listed below:
- Regular Exams. Visit a gynecologist at least once a year for a pelvic examination and Pap smear. Examinations should be more frequent if a woman has noted an abnormality related to her reproductive organs, such as a change in menstrual regularity, odor or vaginal drainage, painful intercourse, etc.
- Report Changes. Report all changes to the gynecologist, including specific reasons for the visit and any changes in function which have occurred since the last visit.
- Agree On Testing Practices. Insist that the gynecologist personally contact the laboratory that evaluates the Pap smears and establish that the Pap smear will be evaluated by a physician with special expertise in cytopathology.
- Agree On Reporting. If an abnormality is reported on a Pap smear, insist that the gynecologist discuss the results directly with the physician who made the interpretation to completely understand the conclusion.
- Repeat Tests. Insist that any repeat Pap smears be performed within three months. If any abnormality persists on a repeat Pap smear, ask to have a magnified visual inspection of the cervix conducted by a gynecologist skilled in the performance of colposcopy.
- Sample Tissue. Even if no visible abnormality of the cervix is seen during the colposcopy, one may exist in the endocervical canal, a part of the cervix that cannot readily be seen by colposcopy. Therefore, a sample of the tissue in the canal should be taken to look for any abnormalities revealed by earlier Pap smears but not necessarily visible upon magnified inspection of the cervix.
- Have A Biopsy on any abnormality seen on the cervix during the colposcopy.
- Ask For A Clear Diagnosis. A biopsy showing dysplasia or cervical intraepithelial neoplasia or CIN II or higher, or described as a high-grade squamous intraepithelial lesion requires specific treatment; insist on it. If you don't understand the words, ask your gynecologist to explain it to you in words you can understand. Any precancerous condition must be treated immediately. Don't accept "let's wait and see how it looks next year."
Modern medicine offers many therapeutic miracles to women diagnosed with invasive cancer. Prevention, however, is far better than cure.
© 1999 Meyers Kenrick Giuffre & Evans, LLC