2024-03-14 05:16:44
[DOUALA] Studies present thermoablation as the “ideal” solution to overcome cervical cancer in the Cameroonian context.
According to Ania Wisniak, the main author of these studies, thermoablation consists of “applying a heated metal probe approximately one centimeter in diameter to the lesions of the cervix for one minute in order to destroy precancerous cells”.
According to the latter, this treatment can be done by a nurse or midwife on an outpatient basis, therefore without hospitalization necessary and it can take place on the same day as the screening took place.
“It hurts a doctor very much to see a patient die of cervical or breast cancer. Treatment is available to everyone these days. The problem is that people generally arrive at the hospital late, when the disease is already advanced and there is nothing more we can do.”
Ader Youmbi Chouambou, gynecologist.
To arrive at this conclusion, the researcher and her team started from a sample of 763 participants, including 221 treated by thermal ablation at the Dschang district hospital in the West region of Cameroon.
Divided into two cohorts, all had undergone a cervical cancer screening test and were aged between 30 and 49 years. The approach was “test, sort, treat” on the same day.
In the first control cohort, 37% of women were obese, 15% had had cesarean sections, some had had at least four children and others had 4 to 5 pregnancies.
In the group selected for treatment, 19% were underweight, 16% had not had frequent partners, 8% were HIV positive and 23% had reported infertility.
After a follow-up of 3 to 5 years, the results showed that women who had been treated with thermoablation were completely cured of cervical cancer and had no side effects.
Results which lead Ania Wisniak to say that thermoablation is adapted to the conditions of exercise in Cameroon because it is inexpensive and quick. Furthermore, it only uses electricity and does not require the presence of specialists who are few in number in the country.
Other methods
However, there are other methods of treating cervical cancer such as conization which consists of the removal of part of the cervix and cryotherapy which amounts to subjecting the affected part of the cervix uterus at very low temperatures. But for Ania Wisniak, these two other methods have limits in the Cameroonian context.
“All of these methods have similar levels of effectiveness and carry little risk of serious adverse effects. But the main limitation of cryotherapy is that to work, it requires compressed gas including nitrous oxide and carbon dioxide, which can be difficult to obtain and transport,” she says.
“Conization requires local anesthesia and is generally carried out by a specialist trained to manage potential complications such as hemorrhage,” explains the researcher who is also a teacher in the department of pediatrics, gynecology and obstetrics at the University of Geneva Switzerland.
In addition, adds Ania Wisniak, “slightly increased risks of prematurity and late miscarriages have been described in women treated by conization.”
She nevertheless recognizes that conization is the only method suitable to date for lesions which extend deeper inside the cervix and which are therefore not reachable by thermoablation probes or by cryotherapy.
For Bertin Nsone Enone, teacher-researcher in health sciences at the University of Douala, although it is innovative, thermoablation carries risks.
“This innovative and targeted technology can evade the target, i.e. metastases, to irreversibly destroy the uterus depending on the volume of the tumor,” he tells SciDev.Net. And in this case, he says, the immediate and almost irreversible consequence is infertility.
Ader Youmbi Chouambou, former gynecologist at Montelimar hospital in France, believes for his part that thermoablation is indicated for the Cameroonian context due to the poverty of the technical platform and the tiny risks associated with it.
But to benefit from this technique, he says, women must consult early: “it really hurts a doctor to see a patient die of cervical or breast cancer. Treatment is available to everyone these days. The problem is that people usually arrive at the hospital late; when the disease is already advanced and when there is nothing more we can do.”
Which makes Jacques Tsingaing Kamgaing, a gynecologist in Douala, Cameroon, say that thermoablation is appropriate for precancerous lesions of the cervix in young women and not in the treatment of proven cervical cancer.
Therefore, specialists advise women to be screened early enough to avoid complications and, above all, to have good intimate hygiene, a healthy sex life and spaced births.
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