Cervical Cancer Explained: Causes, early signs, prevention and treatment|Medical Matters

Ajouté : 2026-05-12

[00:00:02]Cervical cancer is one of the most preventable yet deadly cancers around the world that is affecting women in large numbers. About 600,000 women are diagnosed and 340,000 of those eventually die. In Uganda, our figures are going almost to 7,000 of women that are diagnosed and half of those, as you heard from the doctor, end up dead because we have not figured out what exactly is the problem that is increasing the numbers of cervical cancer. And it's actually very common in sub-Saharan Africa. We are yet to find out why that part and not the rest of the world. So, today morning, we are joined by a doctor, but before that, you're welcome and we always appreciate you being on our episodes. And it's NTV Medical Matters. I am Viola Nakachwa. We are supported by Bill and Melinda Gates Foundation. So, on this morning, we are joined by Dr. Elena Nachintu from Midland Healthcare in Kawempe. She's already here with us. You're welcome, Elena.

[00:00:54]>> Thank you. Thank you for having me.

[00:00:56]Thanks for coming and so good morning good morning to you and to our viewers.

[00:01:00]We are going to start from the top and by the top, that is just understanding cervical cancer. In the simplest terms, simplest language, what is cervical cancer? Okay.

[00:01:09]Yeah, thank you. Um cervical cancer is just like cancer. Very common common word that people understand. It's a cancer of the opening of the uterus. The cervix is the opening of the uterus, opening of the womb. So, that opening gets um cancerous and then we say the lady has cervical cancer.

[00:01:31]>> Yes. So >> Uh in its because those are two words, right?

[00:01:34]>> Yes. Cervical cancer.

[00:01:36]>> Yes. So, separating them, you you'd say it's a cancer like any other, but not everyone even understands cancer. What's happening with the cells in cancer and then we shall talk about the cervix.

[00:01:44]Okay. So, the the the cervix, the opening of the womb, gets infected with a virus which is uh widely uh widely known human papillomavirus, which we shall call HPV in short.

[00:01:59]Uh so, when it gets affected, um human papilloma virus is is is is a sexually transmitted virus.

[00:02:07]And the beauty with it is that it gives us time, okay? So, it's not that as soon as someone has gotten infected with HPV on the cervix, they are going to get cervical cancer.

[00:02:18]So, cervical cancer will will develop after close to 10 to 14 years after the infection with HPV on the cervix.

[00:02:27]>> a chance Yes, so it it usually people say it's generous because it gives us time to screen, but something good also with cervical cancer with HPV is that it is self-eliminating.

[00:02:39]If your immunity is good, your body will eliminate the HPV. So, what does that mean? That you can get reinfected and then it wipes out, then you get reinfected, but by the time you are having persistent infection at [snorts] the cervix with human papilloma virus, that is when you actually get full-blown cervical cancer. Yes.

[00:03:01]>> And so, for the cervix, how would you explain that for someone to understand what I'm suffering from is actually an STD, something just different, but this particular one is cervical cancer. Uh How would you explain the cervix and where is it located? How can somebody understand this is now different? This is not an STI. Okay.

[00:03:19]Um So, um the cervix is located uh right inside inside the womb, okay? I would imagine this is this is the the the female genital organ, the outside that we see. Now, if you look inside there, that's where the cervix is, very far inside there. So, when a woman says that when when we say that you have cervical cancer, we have been able to diagnose either HPV at that at the cervix or there is a wound or there is a discharge, or the anatomy of the cervix has changed. So, coming back to your question, how do we get to know that actually this is cervical cancer?

[00:04:01]We screen.

[00:04:03]We screen. And I usually tell women to avoid self-medication. Many women will have discharges, they'll have all kinds of discharges, and they'll they'll self-medicate, they'll take metronidazole, they'll take all they'll put all kinds of pessaries inside there, they'll go to the pharmacy, they'll go to the hospital, but if you have not been screened for cervical cancer, you cannot know, because cervical cancer will not come and show itself. Here I am, this is cervical cancer. No, there are signs, there are symptoms, there are things that we see that are taking us towards the road to cervical cancer.

[00:04:38]And then also, I think something that we lack is the correct kind of information that we give to the women.

[00:04:46]I take for instance, we are here. So, we we talk we talk to the corporate women, we are speaking in English. Other television stations we'll speak in Luganda. So, who's speaking in Alur?

[00:04:55]Huh, who's speaking in Runyankore? Who's speaking in Runyankore? Who is in the eastern, the northern Karamoja? Because every woman has a cervix.

[00:05:04]And as long as you have been sexually active, you have they say 80% you have suffered from HPV. So, the awareness bit of it is very, very significant that we have to look at, because the country is also overwhelmed. It is a very big burden for the country. You know, it's sometimes called a silent killer. And why is it so difficult to notice until late stages? Some women realize when it's actually very late, and we have the numbers you have you have just told me.

[00:05:31]That's a very good question. So, I I I'm I'm lucky to speak to many women, and I'll share with you what they tell me, cuz I screen quite a lot of them. So, some of them will tell me, "Well, I have no symptoms. I don't have any problem, so I have no reason to screen. Yes.

[00:05:48]>> Yes. Yes.

[00:05:48]>> Yeah. So, why? Why would you >> my life I'm not >> you screen when you're normal? You have no pain. Okay, you had a discharge and you got some medication and it has now cleared. So, there's no reason to screen. That's what they'll tell me. Others will tell me, "The lines are too long. Okay? In as much as I know I have to screen, but the lines are too long. Okay?" And this is where the government is actually working hard to put points in place to avoid.

[00:06:11]So, you will go to a corporate woman.

[00:06:14]She's fine. She's in She's in her office. And then you're telling her to go and make a long line to screen.

[00:06:19]And then the fear, "What if they tell me that I have cancer?" Cancer itself, the word itself is very scary. So, they say, "I would rather not know."

[00:06:29]>> [sighs and gasps] >> Yeah.

[00:06:29]>> These are the These are the things they are telling me. "I would rather not know." Because the duty of every health practitioner, I'll say an obstetrician or a midwife, as soon as you are in my office, okay? And I am working for the government of Uganda. I have my country at heart. I have to make sure that I take you into the path you have to follow to help you make a choice to screen for cervical cancer because it is a huge burden financially on the country. Okay? So, others will say, "I cannot go to test because my husband will say, 'Why are you testing for STD?

[00:06:58]Mhm. What have you brought to the family?'" [laughter] Yeah.

[00:07:01]>> So, there is that kind of fear. Uh Also, the lack of information, we have talked about it because they don't know that they have to screen. Mhm. You because you feel normal, you're just going to work, doing your work, and you have no problem.

[00:07:12]>> Yes.

[00:07:12]>> Um you spoke about how it spreads, and I want to take you back a bit. It spreads asexually. So, I have seen that young girls have sometimes gotten the vaccine.

[00:07:21]What Why does that happen if they are just in school? They are not sexually active.

[00:07:25]Um the history of human papillomavirus is that it will come and affect the cervix. It will As long as the root is now open, your first sexual debut, the root is open.

[00:07:37]Um HPV will come onto the cervix, okay?

[00:07:41]And it will eliminate itself, but you can still get re-infected.

[00:07:45]>> Where does it come from?

[00:07:47]Um like I said, it's uh sexually transmitted. So it's carried by the men?

[00:07:50]Yes, but I don't want to judge them so much because in part of the things that we say is either the lady has multiple sexual partners and she's picking it from different men or your partner has other multiple sexual partners. Okay? So it could be either way, but as long as that root is open, you're sexually active you can you are going to get HPV at one point in your life.

[00:08:14]And then the the the young girls that get vaccinated. So because it gives us time virus doesn't have treatment like um you go and get some amoxicillin or like a bacteria. Viruses usually are vaccinated against like we all got vaccinated against measles, against uh DPT. So that is why the Ministry of Health advises that we we we vaccinate the young girls between the age 10 and 14.

[00:08:41]10 and 14? 10 and 14. Why?

[00:08:44]Because like I said, HPV self-eliminates depending on your immunity. So right now you will you will stand near someone who has measles and you'll probably not get it or you'll just get a mild flu or just a mild rash. You will not get the full-blown full-blown measles. So it's just the same way with HPV. So we vaccinate girls between age 10 and 14 to help them get that immunity. So that by the time they are sexually active, they already have the immunity against HPV.

[00:09:08]It will eliminate itself. However being vaccinated does not mean you will not get HPV. Being vaccinated does not mean you cannot get cervical cancer, but it is a way in which you build immunity just like any other uh viruses that we vaccinate against. Yeah.

[00:09:24]Okay, so I I see emphasis on screening and I have actually seen the Ministry of Health talk about screening screening.

[00:09:30]They really have spoken about it. Um when you talk about screening, why is Is so critical for women to to screen, but also what exactly happens during the screening?

[00:09:40]>> Do you think it's the reason why some women fear to come through? Just talk to us about it. Yeah. That's a very good question. So, women um women are are very interesting and we have they have to be handled in a very sensitive way because it's not easy to undress. Mhm. I see.

[00:09:59]>> It's that's a very sensitive issue. You are not going to get a 45-year-old say um Muslim with her modesty, with all her dignity and her self-respect, and you just tell her go to this facility, undress, and screen.

[00:10:14]We have to tailor the information in a very sensitive way. And what I see is that women lack that person to talk to to convince them that, you know what, allow me to to to look down there. Okay?

[00:10:27]So, screening per se is something that we have to be aware of. We have to help women make informed choices on screening.

[00:10:37]But, good enough, Uganda is now moving towards testing the HPV itself.

[00:10:42]When we are screening, there are different modalities of screening for cervical cancer. Let me start with the best of the best that I'm sure that most women would be interested in knowing because why are we here? We want women to screen and reduce the burden on the country. Okay? So, that's the test on HPV itself.

[00:11:01]Many women fear the speculum. They fear they say, "Oh, that thing the machine is very painful." And actually, when they come, they say I usually ask them, "What is your greatest fear?" They say, "Doctor, they say you're going to pull out my womb." Oh dear lord. That's the information they have. You're going to pull out my womb because when they look at this, this is something that is very it's not [laughter] so good. We we have the plastic ones that are also small.

[00:11:23]However, it's still scary. But then, the country is now going towards HPV testing itself. You test yourself.

[00:11:31]Okay. Yes. You test yourself Yeah, you it's This is the brush. This is a self-test HPV brush, okay? So, um you you have a health worker who will assist you. Just raise your leg and they assist you. This is better when it's actually supervised. In the beginning, women used to go with it at home, but then we get false negatives, false tests, tests that are not really relevant, results that are not relevant.

[00:11:53]So, it's good to be supervised. There's your privacy, but they just tell you what to do. You just push this brush as deep as you can see because the cervix is inside here. So, you push the brush as deep as you can, and then you get the cells off. Okay? And when you get the cells off, you you give them back to the um midwife or the lab person who is helping you, then they take the cells off. Now, this one tests for the HPV itself, the virus itself. This is one of the best, and that is where Uganda is going. The availability in facilities mainly it's in the HIV clinics, but when you go to facilities like Kawempe, the health workers decide on what modality you should take. So, this is one of the the very good things that is happening in Uganda right now. On a scale of 10, how painful is it for someone wondering how painful is this thing?

[00:12:43]Now, I'll tell you about this brush.

[00:12:45]First of all, it's it's it's scary. Allow me to open it because they look at these these these white things, eh? So, as you go in, they cause some kind of irritation. So, that it's just that small irritation that you have to you can you can be able to to handle. Yes. So, it's not painful because you're putting it there yourself. You just raise your leg and insert it as far as possible.

[00:13:08]Now, we'll get back to to to to the speculum.

[00:13:12]Is there a better way we can test without these things that look scary?

[00:13:17]No, I started with that because it's the easiest.

[00:13:21]>> It's the easiest?

[00:13:22]>> It's the easiest.

[00:13:23]>> It's a It's 90% accurate, actually over 95% accurate for the HPV itself because it's a positive organism. Okay?

[00:13:32]Positive virus. Now, the problem we are having is it the availability in our facilities, the lines and etc. But in the private facilities, the women who can afford can get it.

[00:13:44]>> is it? Um it depends, I think, on because some we have funders like PEPFAR, we have those people who are putting it in facilities and widely available. I know in Kampala it's it's very much available.

[00:13:55]Now, the beauty Let me get back to this.

[00:13:58]The beauty with this is that when I put this inside and go to the cervix, first of all, I'm using my eyes. I am visualizing the cervix, okay? And when I put um that is another method called the visual inspection with acetic acid. So, you just put um the the the liquid on the cervix and you visualize the changes on the cervix. And those changes are critical because they can be treated.

[00:14:23]The changes tell you that there's something happening with your cervix and we are now on the road to cervical cancer. So, there I see and treat. Here, you test yourself and they test for HPV and then you have to come back for me to see and treat, okay? But like I usually tell women, the best test for the best screening method for for for cervical cancer is the method that that is closer to you. That is closest to you. I'm not going to say they're all good. HPV is 90 over 95% VIA is good and it also has its its its good side. Why?

[00:14:56]Because when we look, we see other things.

[00:15:00]Women are suffering in silence, okay? We see other things. We see other infections. We see You can actually see TB of the cervix. So, when I look, I see other things. The other infections, discharges, and other rashes that probably the woman is suffering from.

[00:15:15]How different is cervical cancer in its beginning stages um from uh STIs or STDs, somebody else might say, I I think it's just an STI, let me go get some antibiotics and I'll be fine. So, what differences are there that um you can tell? Okay. So, by the time, unfortunately, by the time you are now getting those differences, you have moved.

[00:15:39]You are at a particular stage. That is why screening screening is important so that we do not even get there.

[00:15:45]I'll start with uh bleeding, post postcoital bleeding or bleeding when you're having sex or after sex. That is a very common symptom that women tell you about it. So, she will tell you she bleeds every after sex, even when she has finished her period. Then we have a foul-smelling vaginal discharge that just doesn't go with any kind of medication. So, they'll medicate, have all the treatments, but the discharge will remain. Could be um I I I won't go into colors because colors may may lie. It may be superimposed on to a may maybe a green discharge, a yellow discharge, but that discharge can get uh smelly at times.

[00:16:23]And then, when you get medication, it will stop maybe for a week, and then it will come back.

[00:16:29]And and then also uh there'll be abdominal pain, back ache. The in advanced stages, we may have blood in the urine. Okay, we may have um bone pains, we'll have abdominal swelling, um but the most important thing it's is uh the bleeding. Yeah. The there's a particular age where by you're not supposed to bleed, and then women will tell you I am just bleeding bleeding.

[00:16:51]So, we look at the cervix, and then there's obviously a lesion. 80% in Uganda are diagnosed late from the Uganda Cancer Institute. That's quite unfortunate that by the time they come with all those symptoms, 80% of them it is late.

[00:17:06]And you know, early screening actually saves lives. Um so, how often should somebody go for screening? [clears throat] And uh how soon can you detect cervical cancer once somebody has come to you for screening? Uh that's a very good question. How often do you should you go for screening? So, can I start from that age? Yes, please.

[00:17:24]Um in the clinics, we usually see girls, they will come 25 years, um 20 years, and they say, "Okay, we've heard about this or I have this discharge."

[00:17:36]We were recently in Katanga and we had young girls coming and we had to screen them.

[00:17:41]Uh Uganda today, we screen from 35, rather 25 years.

[00:17:45]>> 25 >> 25 years to 45 years. But like I said, there are different screening modalities. 65-year-old, you should screen because you have a different screening modality for your age, okay?

[00:17:56]So, how often should you screen?

[00:17:58]We advise to screen every 3 to 5 years, depending on the method.

[00:18:03]If you If someone is HIV positive, now for our friends who are HIV positive or those who have really reduced immunity or probably due to anti-cancer drugs, diabetes, those ones with uh we tell them to screen um at least every year because the cancer will progress very fast. Yeah. Yes, the cancer will progress very fast if your immunity is low. Remember, we said it HPV is self-eliminating if your immunity is good.

[00:18:28]So, as long as your immunity is not good, we advise that you screen every year.

[00:18:33]So, if you have screened today, you screen again um count of months. But then ideally, it should be 3 to 5 years to go back for um a screening. And then it also depends on what method they have given you.

[00:18:44]>> Oh, you mentioned that.

[00:18:46]>> Yeah. If you have I have seen girls coming into coming into the clinic, she's 23 years old.

[00:18:53]But remember, if you do not take the history of this young girl, you're going to miss cervical cancer. You'll miss a lesion that can actually be treated. She probably started having sex at 8 years, okay? So, 8 years who are sexually active, 9 years who are sexually active, she's now struggling with discharges.

[00:19:08]And what happens in some facilities, they tell them, "No, you're not eligible for screening."

[00:19:13]>> And then she'll go to the next, "You're not eligible." And by the time she comes to you who is a little aggressive, you say, "No, I have to look there." You find a lesion. So, this is also something that we have to take note of.

[00:19:24]The history of the lady is very important. Pre- that age at which you start having children matters a lot, and it is also a predisposing factor.

[00:19:33]Uh early sexual debut, when you start sexual activities early, that is also a very important risk factor. So, we have to screen according to your history, and um according to the method that's available. The best is the one you have access to. Please, go and screen. Mhm.

[00:19:48]Yes. I like how you emphasize that. Um the Pap smear, that's the one that is out there that we hear about.

[00:19:54][clears throat] Mhm. So, I need to understand the Pap smear, but uh that we shall pick up when we return from the break. So, let's first break off. We shall start off with the Pap smear. Uh if you're just joining us, we want to go for a break, but uh cervical cancer is the discussion today on the Medical Matters. Stay with us.

[00:20:08]We'll return shortly.

[00:20:16]We are supported by Bill and Melinda Gates Foundation. I am Violet here, and if you're just joining us, we were discussing cervical cancer in women where Uganda's numbers keep going up, and we are almost at 7,000, a very, very terrifying number to listen to. And uh our doctor here, Eleanor Nacin투, is talking to us about cervical cancer. And before we broke off, we were tackling the Pap smear. So, let's do that and then talk about the vaccination as well.

[00:20:40]So, the Pap smear, what what happens during that process? Okay. So, the Pap smear is also another modality for screening, and with the Pap smear, we must use this.

[00:20:51]>> [laughter] >> Yes. We just put the speculum inside, and then um we use a brush.

[00:20:58]It's not painful. Are you serious?

[00:21:00]>> The only discomfort is this, and I said we have to talk to women about this.

[00:21:04]Yes. So, we go in smoothly, okay, and avoid Of course, when your bladder is full, this is very irritating and it's tingling. So, you It's all about counseling and telling her you empty your bladder. This is going to go in.

[00:21:15]Take a deep breath as I go in. I have now seen your cervix. So, then we For our pap smear, we use these two, okay?

[00:21:22]This also helps us to get the cells of the cervix. So, after we have accessed the cervix, we use this one to go in, okay?

[00:21:30]>> bristles soft or are they rough?

[00:21:31]>> They're They're They're very soft. You can feel them, please. Please feel.

[00:21:35]They're very soft. So, our dear ladies, please don't get scared about this.

[00:21:38]>> soft. You can trust me.

[00:21:40]>> You won't even feel. You won't know what's happening inside there, okay? So, that goes inside because we are getting cells from inside, and then this will just get the cells from the external what we said the ectocervix, the external, and then we put them on the slide. That's The kit comes with a slide. So, we just put them on the slide and take them to the laboratory for testing, and it also tests the changes in the cells. So, they classify according to the how the changes are from one to three, and so on and so forth. So, that the treatment can be tailored to what has come out of the laboratory. I like that. And how long does that take? Uh how many minutes approximately? Um Taking Taking this is is is a minute.

[00:22:18]>> Oh, no. Just getting this from the lady.

[00:22:21]I'm trying to make sure that we are not scared of this.

[00:22:24]>> Yes. So, getting Getting these these uh these cells from the cervix is just a minute, or even less, or even less, and then we put the speculum out, and then you go, okay? So, it shouldn't be very scary. Um It It all It all depends on how you have counseled the woman.

[00:22:41]>> All right. So, quickly, let's talk about vaccination. Yeah, how available is it?

[00:22:46]What is the progress so far? What are the results?

[00:22:48]What would you say about how it's helping the the women and the young ladies?

[00:22:52]>> Okay. So, I First of all, I want to to give credit to the Ministry of Health because 3 months ago our PS launched uh Initially, it used to be two vaccines 6 months apart for the girls between age 10 and 14. But now it is only one vaccine.

[00:23:06]So it's just a single vaccine and it keeps you protected against HPV, okay?

[00:23:11]So it just boosts your immunity, like I said, because you still have your sexual It's a course you'll get exposed to HPV, but your immunity to fight it will be good. And something else that comes mostly with with with women, especially when we're talking about vaccines, eh?

[00:23:28]They have a tendency to come and say, "Well, my mother died of breast cancer, so I have to vaccinate my daughters against cervical cancer." That is very good, but the information here we have to understand is yes, breast cancer, ovarian cancer, endometrial cancer, those are family related.

[00:23:46]Cervical cancer per se because you you you cannot pass your family on to sexual activity, you know?

[00:23:53]Yeah, so as long as she she If you If your mother had sex and she she had HPV infected, you will have it. So it doesn't matter whether it is in your families. So if you come vaccinating a girl because maybe it runs in your family, that is all good, but that is not the kind of the right information.

[00:24:12]It does not really run in families like other reproductive health cancers in the female. But now it's it's it's ongoing.

[00:24:19]It's in all government facilities. I'm sure there's an HPV vaccine for the girls in schools. We talk to the head teachers, the the the the senior ladies to make sure the girls are vaccinated and protected.

[00:24:30]And these are our daughters. We have to keep them protected against HPV.

[00:24:35]Let's talk about stigma, which I believe is one of the reasons as to why you have few women coming to for the screening.

[00:24:42]So what role do do the men in these women's lives play when it comes to encouraging them to come and screen?

[00:24:49]What can you say to the men that are watching?

[00:24:52]Um the information Let me Let me Let me start with the men.

[00:24:56]Our men have a very important role to play in elimination of cervical cancer.

[00:25:02]Okay? Not Not in a judgmental way because like I said it could be the woman with multiple sexual partners. But also in a way that the strength of a woman, we cannot run away from culture.

[00:25:14]We can't run away from the strength of men in our families. So, the woman will draw strength from you.

[00:25:21]If you are against it or if you do not have the right information, she probably will not screen. But remember you also have daughters. Okay? So, if you if most most women say no, he said I'm coming to test for an STD. And then she's not happy about it. She's having the discharges but she cannot test for cervical cancer because you say no, he'll say why am I testing for STD? What am I either promiscuous? So, the men can encourage the women to come for screening. The men can also help disseminate this information. And like I said, there's something that we are not doing well exactly. We need to go into all languages. Languages that can be widely understood. Is that something the ministry should do because they are they actually disseminating information but it's majorly in English. So, perhaps maybe they could just up the percentage of local languages.

[00:26:11]>> If we have 45 languages, the information should be in 45. If there are 60, it should be in 60. If not, we are going to continue complaining. The taxes is too much. The you know, the consumption is too high. The lines are too long at the cancer institute. And yet we have the right. We have the we have that we've been equipped with that information. Screen and eliminate the cancer. So, our men out there, let us not judge the women. Okay? Let us protect them. A condom per se.

[00:26:40]Like I said, you will get HPV whether you have just had sex, whether you've been married as a virgin, whether your husband is has been a virgin, you know, as long as that root is open, you are are going to get protected against HPV.

[00:26:51]You will get the HPV. Unless you want to wear a condom that is like an overall.

[00:26:55]Because HPV is everywhere.

[00:26:56]>> I have a question for you.

[00:26:59]On the HPV, you talked about getting married and you were a virgin and so both of you have not had sexual partners. So where does the virus come from?

[00:27:08]That's a very good question. Like I said, unless you wear a condom that is like an overall, HPV is everywhere. But you know that men if on the skin even on the male private private parts, but for them they'll bathe and wash and it will go off, okay?

[00:27:21]Although penile cancer is also caused by HPV. But you can imagine the men will go and bathe and it will go off. But by the time you you you bathe inside here, okay? Because he is directly entering and putting the virus the cervix the cervix is very attractive. It has a the way it is the kind of I don't want to go into the science, but it is a very good bed for the HPV to go there and get those micro laceration micro wounds so that it sits in there and it keeps digging and it gets integrated into the cells of the cervix and it will sit there. So by the time you washing inside there, you can you just cannot eliminate it on your own, okay? So the male have an important role to play. It will you will get it whether you've been a virgin or not, it will be there. So you just have to make sure you check in with your health worker and screen. Then for the myths, there are quite a number of myths.

[00:28:11]For our women out there >> Yeah, you read my mind. I was actually going to ask you about the myths you've heard as you encounter as you you deal with these women. And very very interesting myths, but I we do not judge the women because some myths actually like I said, you won't run away from culture. Some myths make a lot of sense culturally.

[00:28:30]That is why it is important for every health worker who interfaces a woman not to to be very careful as you're disputing this myth. It may be something that she has held on and it has helped her to feed her children. So for me coming and telling you, "No, you don't have to do this. No, this is" I have to bring it in a very a very tricky way to help you understand. So, some health workers will just come and say, "No, you're they're lying to you." You say, "Yeah, I have heard that a woman does not eat cabbage.

[00:29:01]I see them." Say, "You're doctor, they told me since I my mother has just died of cervical cancer. I have now not eating I've stopped eating cabbage. I've stopped eating cucumber." Or she will tell you, "My blood type my blood group is this and this. So, we for us we don't suffer from cervical cancer because I'm blood group O." Okay?

[00:29:22]So, they'll tell you all those kinds of things. Or even after having sex, you can be able you can get lemon water and flush because you probably have a family history of cervical cancer. And women do this. They they do this and they will come when their cervix is is bruised and it's burned. Say, "No, because I use lemon water so that I can avoid maybe HIV or pregnancy or all these things."

[00:29:44]>> There are quite a number of myths out there, but please I encourage you to come to the health facility and get the right information to protect yourself, protect your daughter so that we can be able to to eliminate this together. You spoke of lemon water and it's got me thinking. What are some of the ways that women can take care of themselves at home that may reduce the risk of catching cervical cancer? Mhm.

[00:30:06]Yeah. And are there like home remedies or something? Yeah. Thank you. That's a very good question. So, cervical cancer I'm a believer. I pray. I pray and I believe in God.

[00:30:16]>> Yes. But you you will go and pray.

[00:30:20]You will pray. You will do all kinds of things. You'll go to the mosque.

[00:30:25]If you have not screened it will be difficult for that cervix for for that HPV to to to be detected. It will be difficult for that lesion to be seen and treated.

[00:30:36]>> who who wash with the herbal herbs or herbal water or whatever, don't those things work at all? Like the lemon water, that's aggressive, I know, and the other things.

[00:30:47]>> Yeah, there are there are there are herbs that people use. Unfortunately, from my experience, you will use them, but later on, you will have to come back and get proper treatment because a herb Well, there there are so many herbs out there. We are not sure which one eliminates, whether it will eliminate the HPV, but what I know is that you will soon come back either with a discharge, with a foul smell because herbs sometimes before you even examine, as you put your speculum, you are removing removing like leaves.

[00:31:16]Some of them put leaves even up to there. So, you have to first help the woman to remove the leaves with a smell, and then you have to help them. Okay, that is good. It has helped. Can you at least try to drink it or find a way, okay, because this is something she believes in, but then you find a way of letting her know that this is just not the right way to do it. I I looked at the figures and they show that in sub-Saharan Africa, that's where cervical cancer is most predominant.

[00:31:41]What do you think is the cause? Do you And also speak to us about culture. How does that influence how then the women go to seek for treatment? Okay.

[00:31:49]So, sub-Saharan Africa, um like I said again, culture. They we believe in um witchcraft, and we still have women today, I would say even those who are educated, who will be strong and say this is my co-wife.

[00:32:05]That is why I'm bleeding. That is why I have this discharge.

[00:32:08]She's the one who had it at first. So, hers got cured, and now she has given it to me. So, she is bewitching me. So, there's something There's something that I don't know how best to say it, but we cannot run away from it. I'll go back to the to the modesty of our women, okay?

[00:32:23]Our women the our the Muslim women, we'll talk about the ones in who come from South Sudan because they're quite a number in new income in Uganda here. So, [snorts] and also just the dignity of of a woman.

[00:32:35]Even at this age, a woman will come and she wants to tell you something but she will not even look at me and she will speak everything while looking the other way.

[00:32:44]Okay? So, we can't downplay that it is a fact that the culture, what we believe in, what we we know that herbs have always been used by our forefathers. So, women will still use them even those who are educated, even those who know everything, they'll still use them. So, it's the way we handle these women. Okay. And so, are there any of you with the numbers on the screen? You can call in ask your questions as we wind up this discussion about a cervical cancer. So, feel free to call in and ask any pressing questions you might have in your experience. I have a question for you, Elena.

[00:33:18]Do people with HIV have a higher chance of catching cervical cancer?

[00:33:23]100% and that is why some organizations, especially donors like PEPFAR, have put especially this self self-test kit.

[00:33:32]You'll find it in almost many of HIV clinics.

[00:33:38]It is just to help them.

[00:33:40]It's just to help the country that okay, if you are afraid of your of undressing, please do it yourself but do it under supervision so that we can be able to pick the HPV. Your immunity is low so you have HIV so you will have HPV because they move they they they'll move together. So, HIV and other other conditions that lower immunity, you have a high a high chance of getting HPV but also, most importantly, the clearance of that HPV from the cervix is not very fast. Oh, we have somebody.

[00:34:12]Hello. Yes, please. I can hear you.

[00:34:15]What's your question? What's your question?

[00:34:18]Thank you for the for the for the for the information about the Yes, please.

[00:34:26]But as you talk about this cervical cancer, Yes. can't we men to circumcise?

[00:34:36]To do what?

[00:34:37]To circumcise. Ah, I see you.

[00:34:40]I see you. Yes, please.

[00:34:43]Okay, thanks for your question.

[00:34:45]Mhm. Okay, um yeah. Uh do we have another caller? Circumcision as a way to prevent or assist women uh prevent cervical cancer.

[00:34:57]I like how he's thinking. It's It's just so far away from what we we were just talking about.

[00:35:04]>> Yeah.

[00:35:05]Circumcision.

[00:35:06]Do we have another caller on the line?

[00:35:08]I need to take some questions about four of them so that we can answer them quickly in our remaining time.

[00:35:15]Okay, as we wait for you, let's tackle circum- We have somebody on the again.

[00:35:20]>> I'm Dennis from Tororo. Yes, please, Dennis.

[00:35:23]I would like to know if there are HPV vaccine for adults.

[00:35:31]HPV vaccine for adults. That's an amazing question. Thank you, Dennis.

[00:35:35]Thank you.

[00:35:36]HPV for adults vaccine for adults.

[00:35:41]Do we have anybody else?

[00:35:45]I actually >> Hello. Yes, please.

[00:35:47]>> Yes, this is Aaron from Bali. Yes, please.

[00:35:51]Now, me I want to just see put an addition here. Yes, please. That we should do medical checkups because it's very important. Yeah? Yes.

[00:36:02]>> Because somebody you find out that he's having cancer when sometimes it is too late. But when you go for medical checkups, you might find when it is too early and it can be treated. Thank you so much, Arnold.

[00:36:19]Do we have Okay, I like how he's advising people.

[00:36:25]So, dear viewer, go for checkups always for anything, everything. Whatever you feel that is a discomfort, go for checkup, which is good. Yep. Also, we have another caller.

[00:36:35]Hello, NTV. Yes, please. What's your name and your question?

[00:36:39]Um Francis from Fort Portal. Yes, please.

[00:36:43]Um I would like to understand something clearly. We've gotten these issues of uh bacterial infections. Yes, please.

[00:36:55]They're becoming so serious nowadays, can they also result into cervical cancer? Okay, thank you so much for that amazing question.

[00:37:06]Okay, um so so can bacterial infections uh result into cervical cancer?

[00:37:13]If you need the doctor's number, please be on standby because I'll ask her in a while. Uh so, prepare your pen and paper so that we we shouldn't have to repeat over and over. So, let's talk about circumcision.

[00:37:24]Okay. Okay. First, I want to to to thank the gentlemen for for calling in. I want to thank them for understanding that this is they're also part of the struggle. Yeah. Um so, circumcision is is good.

[00:37:38]However, it does not eliminate HPV entirely.

[00:37:45]Okay? Circumcision keeps you healthy.

[00:37:49]Actually, if you're not circumcised, the clearance of circumcision from the from from from from from the penis, excuse my my language, is not as fast as the one who has been circumcised. So, you will actually end up infecting more if you're not circumcised, okay? However, that does not mean that for those who are circumcised cannot spread HPV. Okay, so we are out of time. I just do it in in in a very very short time. HPV vaccine for adults, yes or no?

[00:38:17]>> Yes, there is. There is.

[00:38:19]>> Yes. Okay. And I would ask was advising people to go for a checkup.

[00:38:22]So okay, it's cleared. So bacterial infections are becoming very common. Can they result in cervical cancer?

[00:38:28]No.

[00:38:29]But what they do is that that continuous um the continuous wounds on the cervix creates even a home for the HPV. Okay.

[00:38:39]And so lastly, read your number, please, so that our viewer Okay. My number is um Before we actually do the number, talk about your camp. Where will it be and what time? Oh, yes. Thank you very much.

[00:38:50]Oh, yes. Yes. We have a We have an upcoming camp for female reproductive cancers, hereditary cancers. So we'll go all the way from cervical cancer, ovarian cancer, endometrial cancer. So it's in a Midland Health Care, Kawempe, on the 5th and the 6th 6th of June. So we welcome all women. We welcome the men also because we'll have a team screening for prostate cancer. So the aim is elimination of cancer. In as much as we say it can not go up to zero, but we won't walk blindly. We want it to go down, down, down. So 5th and 6th of June at Midland Health Care, we have a camp for women, all female reproductive cancers and other services, non-communicable diseases. Please call and book your slot because we are going to have visiting gynecologists from outside the country, from India, from Manipal Hospitals, but also our local gynecologists are going to be there.

[00:39:43]Thank you very much. And so please this is your [clears throat] camera. Read out your number.

[00:39:46]>> 0783 39 70 30. That's my number.

[00:39:52]>> time, slower. 0783 39 70 30. And that number is also on WhatsApp. Okay. Yes. Thank you very much, Helena. We've finished our time and we can now safely get out of here.

[00:40:06]Thank you, our dear viewer, for being a part of today's episode of NTV Medical Matters on cervical cancer. It's always a pleasure having you.