Social implications of sexually transmitted cancer.

Abstract

The long, tedious search for the causes of and cure for the human nemesis, cancer, has not resulted in one astounding breakthrough discovery. Instead, researchers have slowly and painstakingly made small inroads into the understanding of the way cell growth goes awry and becomes malignant, destroying tissues and, if unchecked, spreading to other organs of the body and eventually causing death. One of those inroads is the discovery that a cancer of the uterine cervix is almost certainly caused by a virus transmitted through sexual contact. This article presents the biological, clinical, and psychosocial aspects of cervical cancer. Cancer of the cervix usually is preceded by a slowly progressive preinvasive lesion, dysplasia, which can be detected by a screening test, the Papanicolaou smear, and effectively treated with organ-preserving local therapy. Because dysplasia and early invasive cancer usually develop in young women, the need for conservative management is of utmost importance to preserve a woman's ability to have children. The social and psychological impacts of a cancer occurring in young women are enormous and are further magnified by the fact that this cancer may be caused by a sexually transmitted virus. Sexual practice patterns, number of sexual partners, smoking, and other behavioral aspects contribute to the complexity of this disease. However, early detection of preinvasive and invasive cancer is possible with fairly simple and inexpensive means, and curative therapy is available. The disastrous impact of cervical cancer theoretically could be contained if patients at risk regularly participate in early detection programs. Also, the disease could, to a large extent, be prevented altogether through healthful behavior and sexual practices. The social challenge is to provide this information to the public in a nonthreatening, nonmoralistic fashion. We especially need to help young people to accept that sex within a caring, responsible relationship is a healthy human response and, at the same time, understand that there are dangers associated with transmittable diseases that can have profound effects on their ability to have children and on their lives.