HPV & Cervical Screening, Dr Aziza Sesay

HPV & Cervical Screening, Dr Aziza Sesay

If you have a cervix or if you know someone with a cervix, actually, anyone and everyone should listen to this! 

Cervical cancer is one of THE most preventable cancers! 99.8% preventable! 

So lets make sure that you are equipped with a foundation of knowledge from NHS doctor Aziza Sesay, @talkswithdrsesay

We discuss; HPV, Cervical Screening and Cancer. What it is, how it is contracted, how to screen, when to screen and what comes next! 

I believe that everyone (not just those with a cervix) will benefit from this episode! 

 Todays Guest:

Dr. Aziza Sesay is an NHS GP with a passion for health education, awareness, advocacy and empowerment. She channels this through her platform @talkswithdrsesay where she shares short informative videos, infographics, live discussions and tips on a variety of topics including women’s health, cancer awareness, mental health and health inequity. 

Links:

Website | Instagram | Facebook | Youtube

Additional info re. PAP vs HPV screening.
”The new cervical screening test procedure is similar to a Pap smear test. For both tests a doctor or nurse takes a sample of cells from the cervix. However, the Pap smear test used to look for abnormal cells in the cervix, while the cervical screening test looks for HPV infection. The new test for HPV can identify women who could be at risk of cervical cancer earlier than the Pap test could.”

To recommend interviewee guests and suggest topics, please leave a review for the show along with your suggested topics.

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Disclaimer: Material and content discussed on the Nurture Pod are intended for general information only and should not be substituted for medical advice 

Thank you and as always, stay curious!

Candice

Transcript

cervical screening hpv and cancer i cannot tell you how many times i have been asked to go into detail about these topics so i am incredibly excited to share today's episode with you and for you to just indulge in all of dr cesay's knowledge bombs because they are powerful i can assure you that so as i've said today we are going to be talking to dr aziza sis she is a nhs gp with a passion for health education awareness advocacy and empowerment she channels all of this through her platform at talks with dr c say and that is no spaces and sise is spelled s-e-s-a-y where she shares short information videos infographics live discussions and tips on a variety of topics including women's health cancer awareness mental health and health inequity enjoy all of this powerful information coming your way from dr aziza welcome to today's episode of the nurture pod where we will delve into curious questions in pelvic health i am candice langford a public health physiotherapist eager to explore the minds skills and expertise of public health professionals and of course share those conversations and learnings with you but first let's talk about bladder leaks are you using the correct pads or panty liners because periods are not the same as p i'm excited to share that lillets have a new range of dry lock pads and pantyliners specifically designed for incontinence with three times more absorption pads and pantyliners are not a band-aid solution to leaks as a pelvic health physio i believe that the correct products play an important role in giving you the control and the confidence to move through your day whilst working with professionals to improve your symptoms all right so dr sese it's nice to meet you it feels like i know you are ready and if any of you are on social media you'll see that dr sessay and i have done a little reel with the sparse girls which was quite a little throwback um but today we're not talking about the spa schools and all throwbacks and we are here to talk about three important topics which overlap and topics that we all definitely need to know more about so they all kind of deserve it of their own podcast but we really do need to kind of cover the foundation so we're going to do that today and so my girl if you can help us dr sese is going to tell us about cervical screening hpv and cancer give us the low down help us understand what does it mean if we're going for an appointment for a screening and you know if we do get a diagnosis where to from there help us to just understand what's going on with these three terms of course thank you so so much for having me first of all candace and on such an important topic as well we cannot talk about this enough i'm really passionate about it and i hope that anyone who's listening in learns from this and goes on to share the knowledge gained with your family and friends so just like candice said we are talking about cervical cancer cervical screening and hpv which stands for human papilloma virus so i always like to start this off by emphasizing the importance or the fact that cervical cancer is one of the most preventable cancers it is literally said to be 99.8

preventable which is really crazy when you think about it because it means that it's a cancer that affects i think they say about um in the uk you get 3500 people with a cervix diagnosed with cervical cancer every single year and sadly you get about two people dying of the cancer per day and it's prevented wow i thought you were gonna say like per month return per day that's too high it is it is um but this is why i want to raise awareness about the fact that it's preventable and that what we can do to try and prevent it so when we talk about the human papillomavirus this is a very commonly occurring virus um that they say 80 of us will have experienced or being exposed to um within our lifetime but what's amazing about our body is that it's really resilient and we're able to fight it off and we often they say 90 of us will have fought it off um within two years okay um so it's something that our body can fight off but there are hundreds of different types of hpv um and 13 of them are considered high risk and they're considered high risk because they're linked with cancer now hpv is linked with cervical cancer obviously that's what we're talking about it is 99.8 linked with cervical cancer but it's also linked with anal head and neck um volvo and vaginal cancer so when i'm talking about hpv um and it's linked with cervical cancer what happens with hpv is it gets to our cervix through any form of sexual contact so it spreads through skin-to-skin contact and this could be obviously penetrative sexual contact but it could also be as simple as oral sex fingering and sharing unwashed sex toys yeah very very easily transmissible so that's sorry dr um that that's really yeah that's really interesting cause i have heard that it's incredibly um so i have heard that it's really easily transmissible right um and now you are saying how just exactly how easily transmissible it is and what i would like to just kind of just pause on here is wondering how outside of intimate or sexual contact um are these statistics on how many individuals are contracting hpv outside of intimacy outside of partnered intimacy so for example or i don't know like you say using or sharing toys but outside of that there may be the likelihood of touching things or things touching the vulva or are there any statistics on that or you know do we need to be cautious on that front to be completely honest i don't know what the specific statistics on that is what i do know is that they say 80 of us will pick it up in our lifetime um but for it to get to the cervix it is through um sexual contact okay so a really great distinction there um you know because like you said we're really good at fighting this thing off so people don't have to be anxious about everything they come here because it's easily transmissible it's more being cautious of intimate encounters where it would then be transferred to the cervix and i'm just i'm assuming we are just as good at fighting it off or is this something that you are going to get to a little bit later are we just as good at fighting it off when it gets to the cervix yes so um it all depends on what our immunity is like okay so certain things can affect our immunity and if anything affects our immunity it affects our ability to fight off hpv so things like smoking we know that smoking affects our immunity and so it reduces our ability to fight off the hpv which then increases the chances for the cells of the cervix to change and it's because the cells of the cervix change eventually they become abnormal which then forms cancer so if we do things to try and preserve our immunity so eating healthily exercising and also and i'll talk about this at length at some point getting the hpv vaccine which increases our immunity against certain types of hpv again that um improves our chances of fighting it off other things that um can affect our immunity would be certain types of drugs um so for instance people who are on steroids or their specific immunocompromising drugs so patients for instance who may have had transplants they will be on drugs like that so they can increase the chances also if you have the virus hiv which essentially is all about immunodeficiency that again increases your chances um of your immune system being effective within reduce reduces the ability to fight off the hpv so all of these things have uh the potential of affecting our body yes more chances and increasing then increasing our risk of getting cervical cancer okay okay so you like you said in the beginning of that you know our general lifestyle is incredibly important and we see this as a as a thread kind of coming through most topics about health it's about sleep quality stress management healthy eating drinking well you know all of those things exercising all play such an important role in our general health and here it is once again impacting our ability to fight off something so common such as hpv absolutely and the reality is if we talk about statistics they say that about 30 to 40 percent of cancer in general can be prevented by us altering our lifestyle so not smoking making sure that we're healthy weight we're exercising and not remaining sedentary we're not drinking too much alcohol we're eating more fruits and vegetables all of these things impact our chances of developing cervical cancers or cancer in general so it's really important to remember that fact incredible incredible i've definitely come across um you know on other podcasts and in research and just things that i've read where our lifestyle factors are playing such an important role in in like you say in cancers as well um so yeah that thread continues and it's definitely here in this topic of hpv and cancer once again okay i took you on a bit of a tangent there um it's easy to talk about yeah yeah perfect i absolutely agree such a such a um such a juicy topic or juicy topics in general yeah no definitely um okay so we've spoken about hpv we've spoken about it's linked with cervical cancer i wanted to talk about other things as well that increases our chances of getting cervical cancer or something that helps to prevent cervical cancer which is cervical screening it's really really important um it's said to reduce the prevent it said to prevent cancer by such a significant amount and what happens with cervical screening so the newer version is what's called hpv primary screening so it's a test to check the health of the cervix it's not a test to check for cancer and how what it does is it helps to prevent cancer from occurring so what they do is they take samples of the cervix using a brush and then put it onto this preservative liquid and they look at it under the microscope when they're looking for is for high risk hpv and if the person has irish hpv they then check to see if there are any cell changes or any abnormal cells and then depending on the severity they may do certain treatment but often if you have abnormal cells you then get called for what's called coposcopy which is where they look at the cervix under a microscope they may also put a dye so that they can expose the cells they can have a look at the cervix even clearly and expose any potential abnormality and then depending on what they find they may take biopsies or they may do a procedure called let's so that's um loop laser loop excision of the transformation zone so i'm going to talk about the transformation zone i i hope you don't mind um but i want people to understand why they take it from there yeah so our cervix is made up of two different types of cells the inner canal of the cervix is made up of i'm just going to say glandular cells so there's specific types of cells and then the outer one is more sort of a roughing type called squamous cell carcinoma squamous cell sorry and where they meet in between is called the transformation zone and unfortunately within that area because the cells are changing from one to the other that's what increases the chances of cervical cancer developing and that's where cervical cancer will develop and that's why when they do the lets they remove the cells from that area and the hope that they completely get rid of potentially the cancer from developing at all but then they have a look and they can confirm all of that and once they look at the biopsy results okay sure all right so the first thing i want to say i will want to ask you here is is this different from going from for your typical pap smear and i will just be kind of transparent here and say i went i went for a pap smear and the doctor said to me have you been screened for hpv and i honestly said i have no idea i've been perhaps me as before but i have no idea no one's actually asked me so i suppose this question might be two-fold you know are they doing this at the same time if they're doing a specific screening and um then yes yeah let's start there is is is it the same thing is it done at the same time and must i specifically request or our doctor's standard doing it at your pap smear okay so in the uk what used to happen before was that they would do what's called cervical cytology that's where they would look at the cells okay that was what they were doing specifically initially in the screening they would look to see if there were any abnormal cells and then manage it depending on what they find however they've recently and this is over the last sort of two three years changed to what's called hpv primary screening which is where they initially check for hpv those high-risk hpv that we spoke about and if there is high-risk hpv then they check for the cell changes and if there's cell changes you go for colposcopy so that's how it works in the uk and i believe they use a similar method in australia and a couple of other places so you don't need to request specifically or i want to check get my hpv checked or check my cell cytology i don't know if if it's different in the states but what i do know is that over here in the uk for sure they check for hpv first and the reason they do that is because of that close link so the likelihood of you having or getting cervical cancer or you even getting any cervical cell changes is very very very minimal and that's if you don't have hpv and that's why they check for hpv first because as i say the link is 99.8 yeah yeah okay i hope that makes sense yeah yeah that makes sense and are we supposed to be doing what what would you recommend uh with regards to how frequently people should be having the screening yeah so i think that's changed a bit as well yeah that is a really really good question and i think it's also a bit controversial because so many people are a bit um dubious about how things are currently however the reason that they've changed things is because there's been a lot of research and a lot of evidence in keeping with the new method okay so because of how sensitive hpv primary screening is they've now opted for people to be screened every five years so before it used to be at least in the united kingdom it used to be that people between the people the service of women between the ages of 25 to 49 would be screened every three years and the reason that it was that case was because people within that age group are the highest risk of developing cervical cancers cervical cancer is actually more commonly occurring in younger women than older women however because of the new screening and they've only recently again confirmed how sensitive and effective it is because they're using the hpv primary screening it doesn't need to be checked that frequently having said that um this is where women and people to cervix need to be very very aware of what cervical cancer symptoms are okay yes they're not going to be screening as frequently but that doesn't mean that you should just you know wait for whenever your screening is to get tested because um if you are having symptoms just get it seemed to just in case so the symptoms of cervical cancer include any abnormal bleeding or any unusual bleeding so that's if you're bleeding in between periods you're bleeding during or after intercourse or if you've gone past the menopause you start bleeding so when i say menopause i mean you haven't blood at all for 12 months and then all of a sudden you've had a bleed and another symptoms include having any unusual or foul-smelling discharge that you've not had before any pain or aches and pains in the hip area any pain during intercourse when you've not had that before now these symptoms can happen with a lot of other sort of benign conditions so i'm not saying that if you have these symptoms it means you have cervical cancer not at all however if you do have these symptoms they're not one that you should sit on and say oh let me just see what happens please go and see your gp or your doctor tell them about it so they can do the relevant investigations um to rule that out and another thing to say is when we talk about screening because quite a few people get confused about it screening is a test for apparently healthy individuals so these are people we are assuming have no disease so that means they don't have any symptoms at all so it's used to test people to screen them to see if they have any cancer in whereas when we're doing diagnostic tests if you have symptoms you don't go for screening we want to make sure absolutely if you have cancer or not so we would do diagnostic test specific tests i just wanted to emphasize the difference between the two just in case people again think oh i have my screening in two months time i have unusual bleeding let me just wait for my screen you don't need the screening because it might not pick it up you actually need a diagnostic test like colposcopy or all these other things okay yes that's what that was going to be my next question so what would that be and and it's what you explained prior which would be the colonoscopy okay um i just want to make sure that one thing is clear pap smear versus primary hpv screening yeah is it the same thing i believe so so pap smear is an older name and it used to be called pap smear because of the they used to use a spatula or some sort of it was a different type of um device whereas now they used a brush to collect it literally used to be a smear of the cervix whereas now they use this the newer version is the brush but people still use pap smear um interchangeably so i believe technically they are the same thing yes and the newer version is that they're testing they're still testing the cell samples but they're specifically initially testing it for hpv okay all right yes because there wouldn't be anything else that they would be specifically testing for when you were going for a an inverted commas pap smear correct they're specifically looking at those cells unless of course there are other things i mean everyone is so different there are multitude of reasons as to why you might go to your gynecologist but in this specific topic okay perfect thanks for that that clarification there and and i'm glad that you've defined at least in the uk that it would be every five years and in the absence of symptoms if you're symptomatic you need to go to your doctor but in the absence of of symptoms you'd go more or less every five years um because when i was in south africa initially they were saying go for your pap smear every year and then by the time i left which was the end of last year end of 2021 um it was more go every two years and now i'm 32 so i'm definitely in that age bracket so i should actually only be going according to the newer guidelines like you're saying every five years in the absence of symptoms yes but i do want to stress here that the uk they're four different countries and it's at the moment it's scotland and wales that are doing it every five years for that age group between the ages of 25 well actually for all of them 25 to 64. um but in england and this is something that will literally be changing very very very very soon to five years but in england at the moment it's still at three years for the age groups between 25 to 49 however things will change and then in northern ireland they still are using the older technique which is where they test for the cells first so just in case anyone from the uk is listening and they're in either of those places and they think what that's not what i'm having just to clarify yeah yeah yeah absolutely and you know things change so much so we really need to communicate um with our healthcare provider because as with every episode this is not personalized healthcare this is just information sharing so if you're uncertain chat with your healthcare provider in your region because that is going to be first and foremost the most valuable thing that you can do um because we all deserve a personalized and bespoke approach to our healthcare all right so um i just want to stop there before we go maybe look further into um maybe like the sin and maybe going into a little bit more about cancer and about the vaccine the hpv vaccine so when i when i was younger what i recall it was if you haven't had sex you must have the vaccine and then there was all this confusion about what if you have um and you know who's it for is it too late for those that have engaged in penetrative intercourse in particular because because sex can be defined as many different things and so is it too late are we still doing it at what age what are the rules around that okay so how it works with any sort of these type of injections of sorry injections or immunizations what they're trying to do is get your body to build up immunity okay against the organism all right and if we haven't been exposed to it that then improves our chances of building the immunity you understand so if we've never been exposed to it at all and we get it from the injections then we build up the immunity against any of the well the forms that are within the types of vaccines that we're having so there are three at the moment three different hpv vaccines there is the first second and third generation the first generation only had two of the high-risk hpv which included 16 and 18. those are the ones that 70 of cervical cancers are linked to and then the second generation had um included two more which um was to do with warts and the newer generation had has nine different high-risk hpv so it's it's quite good that hopefully it builds up your immunity against those now that's why the age groups that are targeted initially are between the ages of 11 and 13 because the hope is that they're not sexually active at that stage so they get invited they get the injection if you have it between those age groups you usually only need two doses and and you have it six months apart if you are over that age if you're over 15 then the recommendation is that you have three doses and you should have those three doses all within a six month period and the reason you have an extra dose is because there's a potential likelihood that you may have already started sexual activity so they're giving you that booster dose just in case okay and now it is licensed up until the age of 45 and the fact of the matter is they don't know the effectiveness after that age and also between the ages of 15 and 45 if you have it it may not be as effective as it probably would have been at the earlier age and again if you weren't sexually active at all and as i said with hpv getting to the cervix it's any sort of sexual activity so if you've had oral sex or penetrative intercourse fingering sharing toys all of that that you've exposed yourself to hpv so it's most effective if you've not been exposed to hpv at all um so yeah then that's that's basically how it works at at present you can't have it up to at the age of 45 it is licensed but the jury is out about whether or not it's um it's that effective after that point okay okay all right and then one thing on that would one have to go to their gynecologist or would they be able to go to their gp in order to receive the vaccine i'm thinking about moms of young teens and i'm also thinking about potentially young teens who maybe don't want to speak to their mum about this because they're scared of the correlation of their mom thinking oh well that means you want to now engage in penetrative intercourse and we know and we acknowledge that there's a lot of taboo around that so just kind of putting that out there for both moms and and teens that are potentially one is wanting to seek advice of course now that correlation has been so misleading and that's why there were so many kids that missed out on the hpv vaccine so it doesn't mean that because you've had the hpv vaccine that you now have free reign to you know go for sexual activity and not engage in sexual activity that doesn't mean that that's not the case essentially the point of that matter is we want to give it to the young girls and boys it's not just girls it's also boys because boys can also pass hpv you know to to the girls at the end of the day so you can't just protect one end um and also boys can pass it on to boys you know if they are homosexual and so on so it's important that both girls and boys are given the vaccine and the point is to prevent cancer it's not to allow them to engage in sexual activity that's what's really important so if there are any moms who are listening to this please please please this is some if we can get enough of our youngsters uh vaccinated against hpv which genuinely has been proven to be effective there was a study that was released just towards the end of last year that said that it reduces the occurrence of cervical cell changes and also reduces the chances of cervical cancer occurring by 90 that is how effective this vaccine is cervical cancer is preventable there is a potential for it to be completely eradicated and we can only do this if we engage in these sort of programs so in the uk how it works and i keep saying the uk so if anyone's listening on if you haven't guessed it i am a gp practicing in the uk so i'm giving majority of the facts uh based on the uk's but just like can this very kindly and eloquently put if you're unsure please do speak to your care provider but in the uk girls and boys between the ages of 11 and 13 are invited by their school to have the hpv vaccine for free okay if you miss the invitation some schools may allow you to have it the following year however if you can't get it from your school you can go to your gp as long as you're under the age of 25 and you will get it for free okay up until the age of 25 um depending on whether you were a certain if you were around the batch when it first started which was 2008 when that's where girls were first initially invited and interestingly girls were the ones initially invited from 2008 and then eventually they thought wait no actually we need to vaccinate boys as well and i think it was only until it must have been 2018 that they started to vaccinate it took like almost 10 years for them to do the maths but yeah at least what happened um and then after the age of 25 again in the uk you can get it but you have to pay for it privately however there are certain groups who can get it for free over the age of 25 and that include up to the age of 45 and that includes men who have intercourse with men uh people who suffer with hiv and oh there's there's like a long list of oh okay women men who have hiv sex workers and transgender people okay okay that's really really valuable you've uncovered you've covered so many important points there especially about you know the one that i want to just highlight and bring again is that parents mustn't avoid encouraging their children to to go for this vaccine it's not a ticket to engage in intimacy it's a prevention for cancer like it's bigger than that and um if there are concerns about that then then potentially you can chat to someone to help with that knowledge translation between you and your child um and another really important point is that this is for girls and boys and i do recall it was it wasn't so long ago it was 2018 that they all of a sudden thought okay well you know um maybe we should be preventing this in other ways too um and and such is the way with with um sex differences in health care we are continuously trying to play catch up for our old mistakes um but we are most certainly making all the all the good changes um okay amazing so you have really enlightened us um so much around um screening about hpv about cancer itself is there anything else you want to um to touch on i know that we have gone on a tangent or two but it has been really really juicy so far oh thank you so much again thank you so much for this opportunity i really really hope that this helps potentially save lives and just enlighten people one thing that i always stress about is for people to be familiar with what their normal is okay and the reason i'm emphasizing it again here is because say for instance your periods know what your normal is with regards to your periods know that okay my periods my menstrual cycle is say for instance everyone says 28 days let's say 28 days that's my menstrual cycle when i bleed i usually bleed for about three days it might be heavy for the first couple of days and then it's light so that's normal for you if you start to notice changes in your cycle so maybe your cycle seems to be shorter or you are noticing that your periods have become extremely heavy when they weren't before it becomes really really painful or again maybe you know what your discharge is like because it's normal to have vaginal distress know what it's like for you if you start to notice that it's starting to look like more brown or black or there's a really strong smell when you didn't have that before those are all things that you should see your doctor about just in case because again it can be linked with different conditions but what we worry about obviously is cancer so i always stress about knowing your normal because you are basically the ceo of your body and you know your body best right so if if you pick up something that's even the the least bit different trust your gut get it checked worst case scenario best case scenario it's nothing at all worst case scenario it might be something but hopefully you've picked it up so early that it can be treated you know what i mean yeah yeah i love that i love that we are the ceos of our own bodies and if something changes we should have that body literacy to know this is different but not panic take that to the relative healthcare provider and discuss it and not feel that sense of shame and taboo around discussing things associated with for example your vulva but rather bring it to the attention just like you would say my throat is sore and open up your mouth wide and kind of say look inside yeah look at thor we need to have that same level of confidence and comfort in speaking about all of our body parts because they all contribute to our holistic health and well-being um and i think that you you have really i do believe that this is an incredibly powerful um 30 minutes of information so i'm so so so grateful and you are doing an amazing job on social media about you know just just light-heartedly yet powerfully um bringing information to the forefront of people's social media feeds um to change lives so i really i'm so grateful for you've shared here and i'm so grateful for all that you're doing on social media and it's a controversial platform but can absolutely you know just just change the way people experience their day-to-day so you are doing all the right things on on that social media platform of yours so thank you so

you're doing much i i really love whenever you say that the throat and the the vulva vagina and all of these things like it is just part of our body you know and it doesn't it's not a dirty word there's nothing wrong with it we need to be just as comfortable and confident speaking up about these parts of our body and not you know suffering silence i love what you do honestly it's really and i love what you do so thank you maybe we'll do another little spa skills um one day down the line um thanks michael i really do appreciate that and i can echo exactly what you said because you're doing an incredible incredible job um so there like i said in the beginning each of these topics hpv cervical screening cancer they all deserve their own episode because they are big topics and we have really gotten a big chunk of information from today but i can assure you that everyone listening is going to want to know more and want to know more from you because you are just giving us pearls of wisdom here you're just dropping all the information that we need so if you can just share with us how exactly everyone can hear more about you learn from you and yeah tell us exactly where you're at okay so thank you so much so i'm at basically most of the socials facebook instagram um and tick tock i'm at talks with dr susan and i'm also available on my website talks with dr and also if you want to drop me an email i'm at doctors to say 101 gmail.com amazing and everything will be linked in the show notes so um and otherwise you can always see the links to dr sesay on my social media if you are um confused about about um spelling or anything like that but absolutely all in the show notes and yeah you'll see all of my stories because i'll be showing her her good stuff okay thank you so much my girl i am so grateful for your time you are a treasure and i am so grateful to have met you thank you well nurture pod listeners until next time please review and subscribe and as always stay curious as a special treat for listening to today's episode you can head over to the nurturepelvichealth.com website and use the code nurturepod for 20 discount on all public and sexual health courses

this episode is brought to you by the lillettes drylock incontinence range of pads and pantyliners specifically designed for bladder leaks because you deserve to maintain a healthy happy active lifestyle in the presence of leaks this is why when working with patients with incontinence i encourage them to use the correct type of pads as they work towards their treatment goals