PUT UP YOUR GUARD
Prevention of cervical cancer.
Though sometimes overshadowed by the push for breast cancer awareness, cervical cancer prevention has acquired some of the spotlight in recent years with the introduction of Gardasil (the HPV vaccine). But a shot isn't the only remedy, or the appropriate one in all cases. Education is the best prescription for this highly preventable cancer.
Cancer of the cervix is found in the tissue at the base of the uterus, the lower section of the womb. This particular form of cancer still effects nearly 12,000 women a year with approximately 3,850 deaths [1]. Unlike other cancers that are often not detected until late in their progression, cervical cancer can be detected very early through routine Pap smears. This test is done typically at age 21 or three years after the patient becomes sexually active, whichever comes first. The great benefit of the Pap smear is that it can detect progressive changes in the cervix before a true diagnosis of cancer is made. These mutations are called cervical dysplasia or neoplasia. Once detected, treatment can be done to hault progression into cervical cancer. Over half of the women diagnosed with cervical cancer either have never had a Pap smear or have not been tested in the five years prior to the diagnosis [2].
Several causes promote cancerous changes in the cervix, but one of the most researched associations is that of the human papilloma virus (HPV). It is estimated that 6 million new HPV infections occur each year and several forms (up to 100) of this virus may exist [3,4]. Even though estimates suggest that well over half of women may be infected by age 50, most will remain asymptomatic [4]. Among the various types of HPV, some are more dangerous than others in regard to cervical cancer risk. A newer vaccine, Gardasil, protects against four types of HPV, including two of the more dangerous subtypes.
Statistics show that thousands of women are exposed to at least one of the subtypes of HPV and do not get cancer. Most likely, this means that lifestyle and diet play a major role in the development and thus prevention of cervical cancer. In fact, lifestyle is known to influence cervical cancer in two specific areas.
The first is smoking. Female smokers are known to be at a higher risk for the development of cervical cancer [5]. Any smoker who has had an abnormal Pap smear needs to seriously consider quitting. It's a factor that could significantly harm many areas of the body, and makes it that much harder to treat cancerous changes of the cervix. The second factor that dramatically impacts cervical cancer risk is unprotected intercourse with multiple partners. Choosing to use condoms, and avoiding the use of tobacco can provide substantial protection against HPV, and the development of cervical cancer cells.
Folic acid tops the list of nutrients that have been shown to reduce changes in the cervix related to cancer, with inadequate levels associated with high risks of cervical cancer [6,7,9]. Unfortunately, food sources of folic acid may not be enough [8]. Women might need to supplement the nutrient to protect the cervix, but folic acid is safe and tolerated well. Typical dosing should be 400-800 micrograms daily. Any woman of childbearing age should take folic acid to help prevent fetal neural tube defects with pregnancy.
Other vitamins, including thiamine (B-1), riboflavin (B-2) and B-12 can also help fight cervical cancer [10]. These vitamins are all found in a B complex supplement that can be taken daily for prevention. The vitamin needs to complement a diet high in vegetables, especially leafy greens. Dietary B-12 typically comes from animal sources, so vegetarians may need to supplement. Smokers tend to be lower in these vitamins as well [10].
The diet should also target numerous servings of cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) each week. These provide Indole-3-carbinol (I3C, for short), which helps the body metabolize its estrogens through a healthier path in the liver. Data supports the helpful effect 13C and the metabolite diindolylmethane (DIM) have against hormone-related cancer cells in both the breast and cervix [11,12]. Broccoli is a great choice for cancer prevention, typically testing low in pesticide residues. For those wanting extra benefits of I3C or DIM, take supplements at dosages of 400-500 mg of I3C or 200-300 mg of DIM daily.
Females with a family history of cervical cancer or other hormone-related cancers like breast cancer may need to be more aggressive in their lifestyle and dietary habits for prevention. A strong family history of cancer requires cutting out the cigarettes and adding more vegetables to the diet. Folic acid or B complex supplementation would also be strongly suggested. DIM or I3C can help bolster the body's defense against a genetic propensity for cancer.
Reference:
1. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 2004 Incidence and Mortality. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2007. From the CDC Web site: http://www.cdc.gov/cancer/cervical/
2. National Institutes of Health. Cervical cancer: NIH consensus development conference statement. 1996;14:1–38.
3. Cates, W. (1999). Estimates on the incidence and prevalence of sexually transmitted diseases in the United States. American Social Health Association panel. Sex Transm Dis 26, (4 suppl):S2.
4. Erb, T. (2008). Update on infectious diseases in adolescent gynecology. J Pediatr Adolesc Gynecol, 21(3):135-43.
5. Plummer, M., Herrero, R., Franceschi, S., et al. (2003). Smoking and cervical cancer: pooled analysis of the IARC multicentric case–control study. Cancer Causes Control, 14. 805-814.
6. Piyathilake, CJ. (2008). Mandatory fortification with folic acid in the United States is associated with increased expression of DNA methyltransferase-1 in the cervix. Nutrition, 24(1):94-9.
7. Piyathilake, CJ. (2007). Lower red blood cell folate enhances the HPV-16-associated risk of cervical intraepithelial neoplasia. Nutrition, 23(3):203-10.
8. Shikany, JM. (2004). Effect of folic acid fortification of foods on folate intake in female smokers with cervical dysplasia. Nutrition, 20(5):409-14.
9. Plyathilake, CJ. (2004). Folate is associated with the natural history of high-risk human papillomaviruses.
Cancer Res, 64(23):8788-93.
10. Hernandez, BY. (2003). Diet and premalignant lesions of the cervix: evidence of a protective role for folate, riboflavin, thiamin, and vitamin B12. Cancer Causes Control, 14(9): 859-70.
11. Chen, DZ. (2001). Indole-3-carbinol and diindolylmethane induce apoptosis of human cervical cancer cells and in murine HPV16-transgenic preneoplastic cervical epithelium. J Nutr, 131(12):3294-302.
12. Aggarwal, BB. (2005). Molecular targets and anticancer potential of indole-3-carbinol and its derivatives. Cell Cycle, 4(9):1201-15.
Other Trusted Sources:
American Cancer Society
National Cancer Institute
