As women, we know that we're supposed to have a PAP smear
every year. If we remember and we're organized enough, we
may actually even do it! It's never been more critical,
since new research indicates the incidence of abnormal PAP
smears in women under age 35 is on the rise.
percent of cervical cancer occurs in women over age 65, most
of whom did not have regular PAP smears at an earlier age.
It is often a lack of understanding and fear of the
unknown that prevent women from using this simple,
inexpensive and effective method of screening for cervical
cancer and choosing the most appropriate therapy.
is a PAP test and what does an abnormal result mean? A PAP
smear is simply a sample of cells taken from the surface of
the cervix during a routine gynecological exam. (The cervix
is the lower end of the uterus, which extends down into the
vagina about one inch). The cells are then applied to a
slide and viewed microscopically to determine if they are
normal and free of infection that may progress to
The PAP test was developed in the 1930's
by a Greek physician, Dr. Papanicolaou, and was
later abbreviated to "PAP" smear. Several major risk
factors predispose to the development of cervical cancer:
(1) sexual intercourse before age 20, (2) multiple sexual
partners, 3) cigarette smoking and (4) infection with Human
Papilloma Virus (HPV).
The incidence of HPV infection has
dramatically increased. It is estimated that15-25% of the
population of the U.S. has been exposed to HPV. Another
virus, Herpes Simplex II, is considered a co-factor for
cervical cancer, as well.
Abnormal PAP tests range from
detecting mild inflammation to invasive cancerous cells. If
these cellular abnormalities are discovered and treated at
an early stage, more invasive therapies to treat cervical
cancer may be avoided. Failure to do so may allow
inflammatory changes to progress to cancer of the cervix,
uterus and the rest of the body. This can be prevented by
early detection through screening all appropriate women with
regular PAP smears. Women who have one or more risk factors
simply must be screened yearly. All women over the age of18
or who have been sexually active should be tested every
year. Such testing should continue until age 65, after which
it may be discontinued if two consecutive normal smears are
If an abnormality (such as inflammation) is detected,
appropriate treatment is begun and the PAP test is repeated
in 3 months. If inflammation persists three months
following treatment, we refer to a gynecologist for a
diagnostic test called "colposcopy".
It is a brief,
in-office procedure which involves direct microscopic exam
of the cervix, during which a biopsy can be taken.
Depending on the degree of cellular abnormality detected,
various treatments are available.
Conventional medicine uses
surgical removal of the abnormal area by scalpel, laser,
cryosurgery (freezing) or more recently, by a technique
called Loop Electrosurgical Excision Procedure (LEEP). All
are effective at removing the zone of abnormal cellular
growth, but like most procedures, have some drawbacks.
is important to remember that since these cellular changes
may be caused by a virus, systemic treatment
which strengthens the immune system may be essential to
any permanent cure. Because many women choose not to use
surgery as a first line of treatment, they come to
Naturopathic physicians seeking an alternative.
Naturopathic doctors have been using an eclectic approach
and getting remarkable results. This treatment consists of
the topical application of specific herbs, enzymes and
herbal suppositories for 6 weeks. Specific nutrients that
have been demonstrated to assist the cervical cells
in returning to normal structure are recommended . Also,
appropriate lifestyle and dietary measures are explained and
Portland's National College of Naturopathic
Medicine has just completed a preliminary study of 43 women
with abnormal PAP smears, measuring the effectiveness of
such treatment. Of the 43 women, ten had carcinoma in situ
(cancer localized to the superficial layers of the cervix).
Following the study, 38 patient's PAP tests had returned to
normal, 3 showed partial improvement and 2 remained the
same. No one in the study worsened.
These are very
encouraging results that warrant more extensive studies,
which are ongoing. If you or a friend have recently had an
abnormal PAP test, discuss with your naturopathic doctor
whether you might be a good candidate to utilize this
protocol as a first line of treatment.