Joanne Sullivan-Senft, RN, BSN, Public Health Nurse, Former Case Manager
Penn State Cancer Institute | Jsullivan2@pennstatehealth.psu.edu
January is “Cervical Cancer Awareness” month. As a patient navigator, this month is an ideal time to consider ways in which you can best support your patients with a cervical cancer diagnosis.
As many as 12,000 women in the United States are diagnosed with invasive cervical cancer each year, with about 510 of them in Pennsylvania. The rate of cervical cancer incidence in Pennsylvania is slightly higher than it is in the United States (7.4/100,000 in PA compared to 7.5/100,000 in the U.S.). Most all of these cases were due to Human Papilloma Virus (HPV) infection.
If you haven’t seen the 80-minute documentary, “Someone You Love; the HPV Epidemic,” I highly recommend it. The film documents the struggles of 5 young women who are diagnosed with cervical cancer. The film also includes important statistics and scientific information about HPV-related cervical cancer from cancer specialists.
However, the film is NOT intended for a patient newly diagnosed with cervical cancer. Rather, it is a useful tool for the navigator because it explores the rejection, disappointment, and fear faced by a cervical cancer patient. The film has been widely used as an “HPV prevention” tool – underscoring the fact that HPV-related cervical cancer is highly preventable through regular Pap screening and HPV vaccination prior to the onset of sexual activity.
Additional information about the film “Someone You Love; the HPV Epidemic
Susie is a young Hispanic woman and mother of two young children. She relayed that “in her culture” women don’t see a gynecologist on a regular basis. It was only after the birth of her second child, did she follow her physician’s recommendation to address her early stages of cervical cancer. She was subject to emotional abuse and rejected by her husband because of her diagnosis. Without understanding HPV infection and transmission, Susie was wrongly accused of being promiscuous and unfaithful to her husband. Navigators can ease their patient’s feeling of guilt by explaining that HPV is present at one time or another among as many as 90% of the sexually active population.
Tamika and Christine, both in their early 30’s, experienced radical surgeries and disfigurement in order to treat their cervical cancer and suffered the loss of ever giving birth to their own biologic children. This is an extremely important issue for the patient with cervical cancer; an issue that demands a great deal of support from partners, family members, and friends, as well as the navigator.
Kristen and Kelly, young, vibrant and healthy women, lose their life to cervical cancer. The film reminds us of the life changing challenges of chemotherapy, radiation, and weakness that the patient experiences. And without preventive Pap tests and HPV vaccination, the disease can accelerate, often without symptoms until the disease has progressed. Navigators can serve an important preventive role, by reminding members of their community, friends and co-workers of the importance of regular Pap screening and receiving the “cancer-preventing” HPV vaccine.
Navigators may be likely to work with patients like Kristen and Kelly. Finding out that their cancer has reoccurred or is at Stage IV, a patient can be devastated. When all a patient hears is “stage” and “cancer” it is often up to the navigator to help the patient have a better understanding of the disease and options for treatment. For your reference, here is a breakdown of the Staging for Cervical Cancer.
Conclusion
The incidence of cervical cancers has declined dramatically over the past 10 years due to promotion of regular Pap testing and the availability of an effective HPV vaccine that protects against 9 of the most common strains of HPV. However, navigators will continue to work with patients at various stages of cervical cancer. Although staging gives us a starting point for treatment, the navigator encounters the patients fears and understanding of the disease. As in all cases, the navigators’ knowledge of the disease, their trust and commitment to supporting a cervical cancer patient is paramount to a successful outcome and survivorship.
Additional information about cervical cancer is available from the National Cancer Institute at https://www.cancer.gov/types/cervical.
For more information on the documentary “Someone You Love; the HPV Epidemic” – go to https://www.hpvepidemic.com/ where you will find options for renting or purchasing the film. DVD’s are available from the Pennsylvania Department of Health in English or Spanish. For group showings, contact Joanne Sullivan-Senft at Jsullivan2@pennstatehealth.psu.edu for more information.