Smear tests to check for abnormal cells that lead to cervical cancer are expensive and require specialist equipment. So doctors in India are trying a different method - vinegar swabs.
Cervical cancer used to kill more women in the United States than any other cancer. Today, deaths in the US are almost unheard of thanks to a decades-old test called a pap smear, which allows for early detection and treatment.
In India, however, tens of thousands of women still die each year from cervical cancer.
"It's just not possible for us to provide [the pap test] as frequently as it is done in the West," says Dr Surendra Shastri, a cancer specialist at Tata Memorial Hospital in Mumbai.
The pap test requires trained personnel and well-equipped labs, which many parts of India don't have.
"So what do we do?" Shastri asks. "We can't let the women die."
It turns out there may be a simple answer. It's a cheap and easy test developed by scientists at Johns Hopkins University and other institutions. And it relies on something many people have in their kitchen.
In the village of Dervan in the state of Maharashtra, doctors have set up a temporary clinic in the shell of an empty store. A sheet hangs from the ceiling to provide some privacy. There is no electricity - not even a light bulb - in the storefront.
About a dozen Muslim women in headscarves have come for the test. One is on the exam table, her long brown skirt pushed aside. With her friends sitting nearby, she looks calm and ready.
Dr Archana Saunke takes a cotton swab and applies a clear liquid to the woman's cervix.
"We wait for one minute, and we see if there is any yellowish patch," she explains.
If the liquid makes the normally pink cervix turn white or yellow, that means there are pre-cancerous cells - cells that could become cancer.
Within a minute or two, the doctor has good news for her patient.
"It's normal," Saunke says. The woman smiles broadly.
When tests yield bad news and show abnormal cells, these can be removed on the spot with a squirt of liquid nitrogen. No return trip is needed.
So what is this clear liquid Saunke uses? Acetic acid, or common household vinegar.
These tests being done as part of a trial programme run by Mumbai's Tata Memorial Hospital and Walawalkar Hospital in Dervan, where Dr Suvarna Patil is medical director.
Patil says when the vinegar test was first brought to the villages, women were not interested, even though it was free.
"Whenever we used to go to their houses, they used to shut the doors. They would say, 'No, we don't want [it]. You go away.'"
Many women found testing a bother, says Patil, and were embarrassed to have a vaginal exam. And for what? They assumed cancer couldn't be treated.
India being a country of hi- and low-tech solutions, Patil sent out health workers with computers loaded with PowerPoint presentations. They put up posters around town and performed plays. They talked to students in schools and to village leaders.
Still, Patil says, the women wouldn't come.
"Muslim ladies, they will never come because it's their culture," she says. "Even Indian ladies, they are very shy. So we appointed all-female staff."
The staff got awareness training. They were taught to test not just for cervical cancer, but also for high blood pressure, dental problems, diabetes and other diseases women were worried about. Men were also invited for those other screenings - and male support for the programme was a key factor for the women.
All that got women in the door. Then it was a matter of time for attitudes to change.
Patil says it made a big difference when women saw other women actually beat cancer.
"Now they are seeing the results, because if the cancer is picked up in early condition, the patient is doing well," she says. "People are coming to us and telling us, 'Please arrange a cancer screening camp for our ladies.' But it took eight years. It was so difficult."
It is evident that those years have paid off.
Back at the temporary testing clinic, Sojata Sanjay Kapril says she's happy she underwent the screening. Her test result was negative, but if an abnormality had been found, "then we can cure it".
The vinegar technique has been adopted in several countries now, and there's another more expensive test for cervical cancer that some say may eventually prove to be even better.
These tests could save the lives of many thousands of women in India each year - as long as they continue to be convinced to use them.
Cervical cancer worldwide
- Map above shows mortality rates for cervical cancer
- 32,000 deaths from cervical cancer every year in developed countries
- But 242,000 deaths in developed countries
- 80% of women in developing countries have not been screened for the disease
As someone who had lost one of their family members because of cervical cancer, I really think that cervical cancer examination is very important for women. The fact that this disease can be cured or prevented with simple medical examination made me really think that the only thing that are holding a lot of women from having medical examination are cultural barrier and their perception that cancer cannot be cured with simple treatment. While there aren’t a lot of free cervical examination in Indonesia such as those in India, women can always go to the Puskesmas or public hospital for cheap medical examination that usually costs less that 100.000 Rupiah; and if that thing is still considered as expensive, there are a lot of cancer organizations that offer you free cancer examination such as Yayasan Kanker Indonesia (YKI), and many else. While I’m not blaming women’s reluctance to have a cervical examination entirely on them, I think that other factor such as families and society should also support and remove the cultural barrier, so that more cancer can be prevented in the future.
ReplyDeleteCancer in general has always been an underrated theme of sickness as people usually avoid thinking that they have cancer although the signs can be very very obvious. The cost itself can be a barrier between an individual and the realization of having cancer. In Indonesia, we have thousands and thousands of cancer treatment institutions but the barrier that are created between the individual and the cancer institution is the cost that someone can barely afford. The thought of not being able to be treated not because of the capability but because of the ability to pay creates a strong barrier between them and the ability to be healthy again. What should be promoted is that how cancer could be cured by going to the institutions and consulting over problems that they have, for example, financial problems. The lack of promotion shows how much the government actually spends their time on thinking of the prosperity of the lives of their citizens.
ReplyDeleteMany to most people underestimate just how susceptible they are in getting cancer and because of this false belief, they don’t bother checking and taking the cancer tests. Not to mention the costly procedure it requires. Thus many subtle forms of cancer, especially cervical cancer, go unnoticed and continue to claim many lives. For developing countries like India and Indonesia to have the vinegar test is very helpful for women whom are in the working and/or lower class that don’t have enough money to pay for the conventional checkups. It’s great to hear that continuous education programs were able to change the narrow perspective civilians had on these tests. I hope Indonesian women will allow themselves to educate and change their perspectives regarding checking for cervical cancer the same way it had in India. While the definite cure for cancer is still far from mankind’s reach, the discovery of the vinegar test provides an inexpensive substitute that will greatly help reduce the late diagnosis of cervical cancer.
ReplyDeleteHaving a medical checkup done regularly is really recommended, especially for older people because when we are getting older, our body cells are becoming less immune to pathogen. But nowadays, diseases like cancer are getting more frequent in young people. The changing of lifestyle are contributing to this situation. People used to eat healthy and self prepared food, but now we are eating more junk food than we used to. Pollution is also contributing to the health. In big cities like Jakarta, Shanghai, Beijing, the air was really polluted with dangerous chemical that can causes cancer.
ReplyDeleteEveryone has their own cancer cells, but it is up to them to whether feed it, by having unhealthy lifestyle, or to suppress it by living healthy.
But, having medical checkup is not affordable for some people. In developed countries, it is easy to have medical checkup. But in backward countries like India, Indonesia, and etc, this vinegar swabs test could be really helpful to prevent cervical cancer and I hope we can find many cheap alternatives like this in the future.
I think this whole new breakthrough (Vinegar for cervical cancer testing) is amazing. I am very much aware that sometimes in remote areas, there are limited facilities that could not provide proper medical services such as cancer testing. With this new breakthrough, cervical cancer testing can be done anywhere easily. The only problem is the people themself. As stated in the article above, women’s awareness towards the dangers of cervical cancer is still low. The traditional cultures of the society makes a lot of women remain closed and shy to check the health of their feminine areas, whereas this is very important because cervical cancer can endanger lives. I think the world health organization (WHO) must aggressively carried out a lot of socialization to increase the public awareness, especially women, towards the danger of cervical cancer and how cervical cancer can be cured if diagnosed early. Let’s hope that this can encourage women so they can be no longer shy to check the health of their feminine areas.
ReplyDeleteAs we move on forward in the twenty first century, society has taken a much more analytical approach towards the surrounding around them. And health is a crucial part of that analysis which need a more intense development. In terms of health, cancer is a sickness which has taken the lives of numerous people loved ones around the world. The problem that is always recurring with the sickness is prevention and cure of it. In my opinion to increase the mortality rate towards this particular sickness a number of steps must be taken in order to succeed. First of all we need to promote awareness towards cancer and especially cervical cancer in this case. The second step that must be taken is, the suppression of expense that is needed for identification and treatment of cancer. The last step that must be taken is, the commitment to invest towards research for prevention and treatment of cancer.
ReplyDeleteEveryone has cancer cells in their body and we should be aware of it. With the changing of the era, everything changes from the way we interact up until our lifestyle. Compared to the era before, people from this new era tend to be less healthy as most of us do not control of what we are consuming. At the same time, we are growing in a dirty environment, in a polluted environment. Doing regular checkups is very important as we cannot control diseases. Up until now, there is no medicine that can cure cancer in a short period of time. Cancer has taken lots of lives and should be prevented as soon as possible. This vinegar method of curing cervical cancer could be a start to a brilliant formula of curing cancer. As a student, we could help by reminding people to do regular checkups and find the cure to this disease.
ReplyDeleteWith the increasing number of young women with cervical cancer, especially with the widespread spread of HIV infection, a new and simpler diagnosis method for cervical cancer is needed. For this reason, scientists have found that vinegar can be useful for diagnosing cervical cancer. Dr. Cindy Firnhaber from Helen Joseph Hospital in Johannesburg also revealed that cervical cancer cases continue to increase and women who are HIV positive are also at high risk of infection.
ReplyDelete"In the past many women died from tuberculosis or meningitis and other infections so they did not live longer to feel cervical cancer. But now we know we will see more cases of cervical cancer so we need to be more aggressive in conducting early scanning and treatment, "said Firnhaber. Limitations to health services make doctors in India think creatively. To detect cervical cancer or cervical cancer, they use vinegar instead of using more expensive and complicated pap smears. As a result, the death rate from cancer decreased 31 percent.
To run a pap smear, which involves trained practitioners to take samples of cells from the lining of the cervix and then send them to the laboratory for analysis, it is not easy for countries like India. As a result, cervical cancer has killed 22,000 women per year in the country. Compare that in the US which 'only' takes 4,000 women per year. Dr. Shastri's idea was to use vinegar to rub the cervix. After about 1 minute, lumps due to cervical cancer and pre-cancerous cells will turn white, while normal healthy cells remain pink. AIDS Counselor at Orange Farm, south of Johannesburg, Lilly Xaba said because she was HIV-positive herself, she also understood the importance of regular pap smears and encouraged all the women she met to do so. According to Xaba, if women were more able to take the initiative knowing the condition of their body they will get help faster. Dr Firnhaber said the vinegar testing method has also been shown to be effective in detecting pre-cancerous cells in HIV-positive and HIV-negative women.
ReplyDeleteEven so, this method is actually not new in Indonesia. With a test called IVA (Visual Acetate Acid Inspection), a similar test is carried out to detect cervical cancer with an almost equal level of accuracy with pap smears. Unfortunately, there are still many people who do not understand this examination.
Living in a family keen of health issues has made me aware of cervical cancer since a young age. My mother had even set an agenda for my cervical cancer vaccine once I hit 19. As my doctor said that starting 19 years of age, cervical cancer is most likely to occur. The cervical cancer test itself, commonly known as pap smear, often followed with various other screening tests are fairly inexpensive, but for some people it’s useless and the money would be better used for other necessities. This is the problem, millions of women out there, especially those living in rural and remote areas are still unaware that cervical cancer could jeopardize their lives. Some of these women might feel the symptoms but are reluctant to visit the hospital as medical treatments, especially for progressive diseases like cancers are associated with lots of money. I think that convincing these women in the rural areas, approaching them and convincing them to test for cervical cancer for further prevention is a life-saving and innovative idea as it is not just affordable for everyone but is also practical, there’s no laboratories or operating rooms needed, it is modest but is able to change the attitudes of women on cervical cancer tests. It is high time for every women to understand their bodies and also the diseases that could be inflicted, it is time for them to be taught to love themselves by first taking care of their own body
ReplyDeleteCervical cancer examination is indeed very important for women above nineteen years old. Looking to our country, women of Indonesia are still having low awareness of cervical cancer. The perception of that were embarrassed to have a vaginal exam are still high in our country. The development of the awareness are pretty astonishing though, we can see now some companies or even restaurants celebrates “Pink Day” to raise the awareness of cervical and also breast cancer. I think it’s one of the best ways to overcome this problem of unaware women. This developed invention of cheap and easy test by scientists at Johns Hopkins University and other institutions is actually really helpful. But I do think that this should be promoted more since I’m pretty sure that the ‘marketing’ of this way of examination is not enough. It is indeed a very easy way since we only need vinegar which is a basic kitchen thing that women would probably have in their houses.
ReplyDeleteI became really interested when I directly saw the title and after I read it, it really gives me some new knowledge that now you can actually detect cervical cancer easily just by using acetic acid which can you get from a common household vinegar. Although I know that this method must have some weakness than the modern method but I know for sure that it is clearly very useful for people who are busy or are not capable enough to do a test in a hospital, because the price difference by using just a vinegar and a modern tool is really high. I hope that this kind of information can be more widely spread so that not only a few people that know about it but so can other people who doesn’t have access to the internet. Because I think if me who often browse the internet for information doesn’t know about it then what about other people right?
ReplyDeleteEven if I think it is sad that not every woman in the world have the same access to health facilities for lack of financial resources, the fact that cervical cancer can be identified with a such common product as vinegar is amazing. Even if this method is not 100% reliable, it is still a very useful way to detect cells affected by cancer, and until they don’t have more financial resources to do more reliable tests, they should really continue to use this. The initiative taken in India is fantastic and more countries should follow this example as it could help save thousands of lives every year. However, I understand that this can be difficult to implement due to the different cultures and common beliefs that cancer cannot be cured. Therefore, hospitals and other health institutions should continue to invest on health education for all the population before implementing testing infrastructures.
ReplyDeleteLack of awareness and inadequate economic condition drives Indian women to be resistant to getting into cancer test. They don’t know the fact that early cancer identification results to early cancer cells removal, which could prevent it to grow bigger and have more potential to destruct the human body. The vinegar test is a highly innovative invention as it utilizes kitchen stuff. People don’t need to pay, thus the test is economically affordable for most Indians. However, further promotion and public seminar are needed to raise more Indian women’s awareness of the importance of early cancer test. Culture is one of the hindrances in executing the project, but as time goes by, more people are proven to be cured from cancer and people would eventually shift their mindset that health is one of their basic necessities. It is justifiable to put their cultural beliefs aside for the improvement of the Indian women’s lives.
ReplyDelete