HEALTH ADVISER: Pap smear rethink

DESPITE more public health campaigns about the importance of women going for pap smears, the number of cases of gynaecological cancers are not falling, says oncologist Dr Serena Sia.

Regular pap tests are key in the fight against cervical cancer, but many women still neglect their two yearly check-up, or are from a low socio-economic background and unable to make screening a priority.

Armed with new evidence and better technology, the government is launching a new cervical screening program in December it hopes will improve early detection and help save more lives.

While the current pap test can detect abnormal cell changes, the new cervical screening test will detect the human papillomavirus virus that can cause the abnormal cell changes, prior to the development of cancer.

• CT scan of a patient undergoing brachytherapy for cervical cancer, showing the expected radiation dose delivered to the tumour site.

Under the new program, the two yearly pap smear for women aged 18 to 69 will be replaced by a five yearly papillomavirus test for women aged 25 to 74.

The government says that screening women under 25, for the last 20 years, has not reduced the rates of cervical cancer in that age group and that treating abnormalities that normally resolve themselves can lead to pregnancy complications in later life.

Women will be due for the first cervical screening two years after their last pap test.

For those unfortunate enough to have already developed a gynaecological cancer, surgery is not inevitable, and many tumours can be treated with non-invasive, external beam radiotherapy.

Dr Sia says the treatment is mostly used for cervix and endometrial cancer (lining of the uterus).

“If the cancer is picked up very early, then surgery is the preferred option, but if it’s picked up afterwards then radiation therapy in combination with chemo is usually used, because surgery would mean removing lots of surrounding tissue,” she says.

“In addition, there are some cancers like vulva and vagina, where because of the location, surgery would be devastating and involve removing the organ, so in that case, we use radiotherapy at an early stage too.

“Each radiotherapy session lasts only ten minutes and normally takes place over five weeks.”

Genesis Cancer Care is the only WA clinic to use the ground-breaking brachytherapy to treat cervix cancer, where an applicator inserted into the uterus delivers a high burst of concentrated radiation.

“Lots of studies have shown that if you combine the external radiotherapy with the brachy treatment, there is a higher survival rate,” says Dr Sia.

“It’s a very effective complementary treatment.”

Dr Sia says the three cancers she treats the most are cervix, ovarian and womb (uterus), while vulva and vagina cancer are also seen, but less common.

What is Genital Cosmetic surgery (GCS)?
Female genital cosmetic surgery covers several different procedures that women undergo for a variety of reasons. It is sometimes also referred to as vaginal rejuvenation. The procedures can include:
Labiaplasty – Surgery to the labia minora (inner lips) and less frequently, the labia majora (outer lips), which involves reducing the size of the inner lips so they do not protrude below the outer lips. Some women have labiaplasty because their labia causes them chafing, irritation and also limits their participation in activities such as bike or horse riding. Contraindication: This is contraindicated for women who have a gynaecological problem, such as infection or a cancer.
Vaginal Tightening (vaginoplasty)
– Childbirth can overstretch the vagina, reducing tone and strength. Childbirth can also result in vaginal & uterine prolapse and urinary incontinence which can be corrected during this procedure. This procedure can revitalise the sexual experience for women and their partners.
Perineoplasty – Reconstruction of the perineal area to restore and tighten the malformed tissues of the region. Quite often perineoplasty is done together with vaginal tightening.
Clitoral Phimosis – Clitoral phimosis occurs when there is scarring of the clitoris that it is partially or completely ‘buried’. This painful condition can be the result of blunt trauma, chronic infection, or poor hygiene. Clitoral hood reduction combined with labiaplasty is required for this condition when conservative measures fail. Hence, this should not be considered a cosmetic procedure.
Clitoral hood reduction – Reduction of the hood of skin which surrounds the clitoris, exposing the glans (or head) of the clitoris that lies underneath. A clitoral hood reduction is aimed at providing more stimulation, therefore, heightening a woman’s sexual pleasure.
G-spot augmentation – Involves injecting a substance such as collagen into the g-spot in order to enhance its size and, therefore, theoretically also a woman’s sexual pleasure. The effects lasts 3-4 months on average.
Hymenoplasty – Reconstruction of the hymen, predominantly performed for religious or cultural reasons.
What are the risks and complications of GCS? GCS carries with it the associated risks of surgery, such as reaction to anaesthetic, bleeding, infection and scarring. Other risks of GCS include: wound breakdown; pain during sex; nerve damage; loss of sensation; labia asymmetry and blood clots.
For treatment enquiries, please contact Dr. A S Arun MD DNB CCST, FRCOG, FRANZCOG
Waikiki Specialist Centre – 221 Wilmott Drive, Waikiki
Tel: 08 9550 0300,
Fax: 08 9592 9830

A fresh approach at Cosmetic Images
Long lasting, natural looking rejuvenation Cosmetic Images is a busy well established Cosmetic Medical clinic in Mt Lawley. The clinic’s Doctors and Nurses have a combined experience of 40 years with aesthetic injectables.
“Our team stands for excellence, value for money and honesty,” says Director and Registered Nurse Sherilee Knoop.
“We will create an individualised treatment journey for you focussing on your desired outcomes.”
The hot topic this year is MD Codes™, developed by globally-renowned Brazilian surgeon, Dr Mauricio de Maio.
It is a new systematic approach to lifting facial contours using carefully formulated injection points for dermal filler, which are proven to elevate, rejuvenate and enhance, delivering natural-looking results and greatly benefiting the patient, also ultimately using less product.
“This technique focuses on treating the cause, instead of the problem area,” says Sherilee. “So the benefits to patients is far greater and they receive the optimum and long-lasting results from their treatment in a more cost effective way.”
Ask us about this new approach.
Cosmetic  Images
2/595 Beaufort Street, Mount Lawley
Phone 9574 6852

Let your best skin spring forward
I have recently relocated to North Perth.
Beauty Salon owner for six years Alia welcome’s new and current clients.
“I endeavour to give you the best one on one service possible,” says Alia. “I only use the highest grade of equipment and products to ensure you get the best results.”
Specialising in waxing, skin and eye treatments, I use and sell Dermaquest Products which are scientifically proven to have excellent results
“If you have concerns for your skin come in and see our skilled therapists. I will do a thorough full face analysis so that you can find out why you are having problems. I will recommend facial treatments best suited for your skin and give you home care advice to ensure best ongoing results.”
“Clients just love our Henna Eyebrows!”
Henna is a natural semi permanent dye which lasts up to four weeks. Henna can be applied to the hair and skin to create beautifully defined eyebrows. Please ask for a test patch if you have had any reactions to hair dyes.
Safarii Skin &  Body Care Centre
481 Fitzgerald Street
North Perth (located inside Modesty Blaise)
Phone 0432 790 871

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