Mexico's Unmentioned Cancer

WOMEN’S WORLD

Two years ago, a then-40-year-old Eleazin León García began having bouts of severe abdominal cramping and erratic vaginal discharge.

When the pain became unbearable, she consulted her physician, only to discover that she had cervical cancer, with a nine centimeter tumor growing at the opening of her uterus.

The next year included a dizzying marathon of surgery, 25 sessions of radiation, four sessions of chemotherapy and three sessions of targeted therapy at the State Oncological Hospital in her native Toluca.

Today, León García is cancer-free and living a full and healthy life.

But León García was lucky.

Cervical cancer is the second-leading cause of cancer death in Mexican adult females, killing about 11 women every day, according to the Mexican Institute of Gynecology and Obstetrics.

“Cervical cancer is the cancer that no one wants to talk about because too many people associate it with promiscuity, which makes having it socially stigmatized,” said Lucely del Carmen Cetina Pérez, medical oncologist and academic director of the Mexican Oncology Society (Smeo), during a press conference late last month to announce a nationwide campaign to prevent and promote early treatment of cervical uterine disease.

“Consequently, while there are plenty of national programs and campaigns to encourage breast cancer and awareness, there is very little being done to promote cervical cancer awareness, and that means too many Mexican women are dying of a disease that is both preventable and curable if diagnosed and treated early.”

Cervical cancer occurs when abnormal cells in or around the cervix (the lower part of the uterus) begin to grow out of control, forming a cyst or tumor.

It usually starts in the cells lining the cervix, but like most cancers it can metastasize and spread to other organs, and it is often not until this stage that patients begin to notice symptoms.

In most cases, cervical cancer is caused by a virus called the human Papillomavirus, or HPV, which is usually passed through sexual contact.

There are many strains of the HPV virus, but only a few of them are considered high-risk and can cause cervical cancer.

Some other HPV viruses cause genetal warts, but others are essentially benign.

Most sexually active adults have been infected with HPV at some time.

“In fact, about 80 percent of Mexican adults have the virus in their bodies,” said gynecologist Eduardo Malagón Abín, who is also working on the national cervical cancer awareness campaign.

“But only about 30 percent of them are infected with the HPV viruses that causes cervical cancer.”

Whether a women infected with the high-risk virus will get cervical cancer depends on a number of factors, such as lifestyle habits (smoking) and the state of her immune system.

That is why it is important for women to have annual Papanicolaou tests (better known as Pap smears), which screen for potentially pre-cancerous and cancerous processes in the cervix.

“The Pap smear is the gold standard in early detection,” said Cetina Pérez.

“The general rule is to start having annual Paps three years after you become sexually active, and you should continue to have them the rest of your life, even after menopause.”

In addition to Pap tests, there are other early detection methods, such as colposcopies.

The cost of an annual Pap smear is minimal, Cetina Pérez said, as little as 50 pesos ($2.73) per slide, and the test can be highly effective in detecting abnormalities in cervical cells.

“If a patient has an abnormal Pap smear, then we can perform other tests and follow them more closely to see if cervical cancer develops,” she said.

Also, treatment of early-stage cervical cancer or precancerous lesions is relatively simple and inexpensive, she said.

Laser surgery, freezing or cauterization may be used to remove malignant cells from the outer layer of tissue, and even when a hysterectomy is required, the surgery can now be done endoscopically.

“A Pap test can detect changes in cervical cells before they turn into cancer,” Cetina Pérez said.

“If we treat these cell changes, we may prevent cervical cancer.”

But, according to Mexican College of Gynecology and Obstetrics, only about four in every 10 Mexican women have annual smears.

“Early detection and screening are the real key to preventing cervical cancer deaths in Mexico,” Cetina Pérez said, “and in urban areas, we have been quite successful in reducing the incidence of the disease.”

But in rural parts of the country, where many women are still uncomfortable having gynecological exams, the cervical cancer death toll is still very high, she said.

She said that the incidence of HPV infection is at least twice as high in rural areas because these women are not always taught proper protection techniques, such as the use of condoms.

“Most of the women who do not get regular Pap tests are economically and/or socially marginalized,” Cetina Pérez said.

“They are poor, rural women who either don’t have access to adequate medical care or are afraid to have gynecological checkups because they do not understand their importance. That’s why we need to take discussions about cervical cancer out of the closet and promote awareness.”

Cetina Pérez said that with appropriate detection and treatment, almost all cervical cancer patients can be cured, even those in more advanced stages of the disease.

“But nothing is more effective in treating cervical cancer than prevention,” said Carolina Eslava, head of the Fundación Conocer para Vivir (Know to Live Foundation), which is organizing the four-month cervical cancer campaign.

“And fortunately we have vaccines that, if given to young men and women during their early adolescence, can prevent them from ever contracting the virus.”

The introduction of the Human Papillomavirus vaccines 10 years ago — commercially known as Gardasil and Cervarix — means that young girls today can actually prevent cervical cancer by avoiding HPV infection when they become sexually active.

Ideally, every Mexican girl and boy between the age of nine and 14 should be vaccinated against the virus, Malagón Abín said.

“If administered properly and at an early age, the vaccine is 98 percent effective in preventing cervical cancer later in life,” he said.

But with the cost of a single dosage of HPV vaccine running between 900 and 1,200 pesos, and each patient requiring three doses to develop effective immunity, economics have been a serious obstacle to universal immunization in Mexico.

Also, in those areas of the country where the vaccine is covered by public health services, the usual protocol is to apply only two dosages, which Malagón Abín said could be less effective in preventing cervical cancer.

“We are trying to get the word out that there is no reason for any Mexican woman to die of cervical cancer,” said Escalva.

“But it is going to take a while for the prevention and early detection programs to take hold and for the most vulnerable segments of society — such as rural women and sex workers — to get the message and take responsibility for their own health through prevention and early detection. Once they do, we will be able to essentially eradicate cervical cancer deaths in Mexico.”

WHAT’S NEW

Makeup Galore
Get an early start on your holiday shopping with the new gift collections at Sephora. From Bare Minerals and Caudalié to Make Up Forever and Josie Maran, just about every brand the makeup palace carries has a special Christmas set with delectable ranges of lip colors, eye shadows, skincare and foundation cosmetics. Available in Mexico starting this month, these limited edition collections tend to sell like hotcakes, so be sure to get yours before they run out. (And while you are at it, buy a second one of each to stuff your own stocking. Hey, you’ve been good, haven’t you?) Based on past years’ sales, there are several collections that are sure to sell out quickly, like the Too Faced mega color pallets and the Ole Henrikson sets with a special post-party pick-me-up gel that is perfect for the morning after your holiday bashes.

Café Express
Inspired by the Eiffel Tower and full of rich coffee and chocolate shades of brown and russet, Dior’s new Skyline fall 2016 makeup collection is geared to turning you into the ultimate seductress for the upcoming season. Comprising mesmerizing eyeshadow palettes, cheek and lip products, the long-awaited collection is now available in Palacio de Hierro and Liverpool. The collection gives your face that majestic play of light and shadow, creating a kind of enigmatic beauty that’s truly obsessive and very, very French. While the complexion is kept natural and clear, all the focus centers on the edgy lip makeup and the heavily accentuated eyes, without looking overwhelming stark. It’s the highly coveted look Peter Philips created for the Dior fall 2016 runway show. The range includes an innovative sculpting stick duo that features a matte contouring shade on one end and a shimmering softer color on the other that is perfect for highlighting. There are also two eyeshadow pallets with muted urban shades of brown and silver with touches of plum and pink. And in case you crave a more dramatic look, there are mono-shade shadows in six highly saturated hues with matte, metallic, silky and glittery finishes, inspired by the fabric textures the brand used in its fall collection. An illuminating powder to brighten up your face even more serves as the best finishing touch to your flawless complexion achieved with the help of the brand’s Diorskin Forever foundation. And just in case there are imperfections, Dior has four skin perfecting sticks in light blue to mask yellowness and removes signs of fatigue, apricot to conceal under-eye dark circle, light yellow to hide vascular mesh, and pastel green to neutralize redness. For the lips and nails, the Dior Skyline collection offers three new shades with a soft sheer texture and rich brown undertones.

Need for Speed
Just in time for the Formula One Grand Prix auto race in Mexico, which will take place between Oct. 30 and Nov. 1, the Swiss luxury watch company TAG Heuer has created a special limited edition Formula 1 timepiece especially for the occasion. To be sold only in Mexico with just 300 numbered watches available, these extraordinary precision wristwatches boast the colors of the Mexican flag along with a sapphire crystal face that won’t crack under pressure. They also have a chronograph minute hand and a date window, with beautifully polished hands equipped with luminescent markers and a polished screw-fitting case back and screw-in crown. This is a definite collector’s item for Formula One aficionados. And it may just be that ideal gift for the hard-t0-please man in your life.

Totally Playful
Starting this month, Mexican triple-play operator TotalPlay customers are able to access the GameFly Streaming platform. The service will initially provide unlimited access to over 30 games for 159 pesos per month and is being offered via TotalPlay’s fiber-optic network, which now reaches six million homes in 20 cities throughout the country. “We want to offer our customers the most innovative and fun experience by launching the GameFly Streaming service to our platform,” said Eduardo Kuri, Totalplay CEO, during a media event to announce the new service. “Totalplay’s high-speed internet allows GameFly Streaming customers the ability to play great games with low latency and HD quality gameplay on any television.” The company recently announced that it has invested a total of $400 million to expand its fiber capacity and offer faster connection speeds of up to 300 Mbps to its customer base of 450,000 subscribers.

THE NEWS