Cervical cancer, caused by a virus called HPV (Human Papillomavirus), is a disease that all women are at risk of contracting, so vaccination is a must, according to experts. Women, they said, should understand this and make sure their daughters are vaccinated for their own safety.

The Post sat down with two doctors who specialise in obstetrics and gynecology – Taing Sing Ing, currently working at Sophea Maternity and Polyclinic, and Chheng Hakngoing, from Siem Reap Provincial Referral Hospital – to discuss the topic and also included Than Reaksmey, a woman who has recently been vaccinated against the disease, in the conversation.

On June 8, Reaksmey shared her experience, and the importance of getting vaccinated on her socal media account. She was vaccinated at the Institut Pasteur du Cambodge (IPC) in Phnom Penh.

“I’m definitely worried because the infection is often not the fault of the woman who contracts it. If we are infected, it is usually by our partner. I want to ask what percentage of men we can trust, whether our husbands or boyfriends, and we know what he has done in his life, either before us or behind us,” said the 27-year-old.

“This is a virus that will stay with him forever. As I posted on my Facebook, the vaccine is a gift that we can give to ourselves to ensure that we do not have to live with the fear that we may one day be infected,” she said.

At this point, Dr Sing Ing interjected, saying that all women should get vaccinated against cervical cancer, as the disease can occur quietly, without any symptoms.

If it develops, it will get worse, so if they are in a country where the vaccination is available, women and girls should get the jab.

“In many overseas nations, the injection is a standard part of the national vaccination campaign. Here in the Kingdom, it is not so widespread yet, owing to a limited national healthcare budget. Almost 90 out of 100 women have a sexual partner, and are therefore at risk of contracting the virus,” she added.

“This vaccine is necessary because it can prevent cervical, vaginal and anal cancer,” added Dr Hakngoing.

Reaksmey said she had to inject three doses of the vaccine – with a month gap between the first two and then a six-month break before the final injection.

“If a girl is between 9 and 14 years old, we give her two injections on the same day before she gets vaccinated again in 6-12 months later,” said Dr Sing Ing.

“If they are between 15 and 26, they have to be injected three times, just as Reaksmey described,” she added.

Dr Hakngoing said there are three forms of the vaccine available: Cervarix (bivalent), Gardasil (quadrivalent) and Gardasil 9 (nanovalent), which have slightly different injection gaps and ages.

Reaksmey said she had experienced no side effects, although her doctor had said that she would not have been eligible for the injection had she been pregnant.

However, Dr Hakngoing said: “Actually, there is no ban on pregnancy during vaccination, but we are advised not to inject the first vaccine to a pregnant patient. The second and third are not a problem, as it has not been found that the vaccine causes any abnormalities during pregnancy.”

Dr Sing Ing added that in the case of an accidental pregnancy following the first injection, the final doses should be delayed until the pregnancy had been concluded.

Although IPC charged $67 for the vaccination, Reaksmey was more than happy to have paid.

“If you have the money, it’s worth it to protect your health. Of course, I understand that many people – especially in the provinces – will not be able to justify the expense,” she said.

She said the reason she decided to get vaccinated was because she had gone for a general check-up after the Covid-19 lockdowns ended, and it seemed like a sensible thing to do.

She said that in the past, she had seen false news articles which suggested that women who were already married or had a partner could not receive the vaccine, as it would not be effective. After enquiring with her doctor, she discovered that this was not true.

She explained what the doctor had told her: “Regardless of whether or not you have been sexually active, if you have not caught the virus, the vaccine will be effective. It may be less effective if you have recently been infected, even though the virus might still be in the antibody stage.”

“The effectiveness of the vaccine depends on your age. Women between the ages of 9 and 40 can be vaccinated, but if they are over 45 years old, the vaccine is no longer effective,” said Dr Sing Ing.

“As we get older, vaccines become less effective. In my opinion, another factor could be related to sexual activity. If a woman has been sexually active, she may already have come into contact with the virus. It is recommended that those of us who have already been sexually active should test for the presence of cervical cancer cells before beginning the course of vaccines,” she said.

Dr Hakngoing added: “We recommend administering the injection during adolescence. This is a preventative measure, so it’s better to get vaccinated before the patient has become sexually active.”

Dr Sing Ing said the vaccine is 90 per cent effective, noting that there are 100 variations of cancer, but the vaccine will protect against the nine most virulent. Women should still be receiving regular check-ups, she said.

“In terms of effectiveness of the vaccine against the most common 9 types of cancer, protection is almost 100 per cent. It contributes to some protection against the others, but certainly not as much,” she said.

She explained that the symptoms of this disease are usually minor, but a large tumor could develop in the cervix, which would lead to pain or irregular bleeding between menstrual days.

Dr Hakngoing added that when the disease was advanced, additional symptoms could include a longer menstrual period, pain during sex, lower abdominal pain, bleeding after sex, or bleeding after defecation.

“Cervical cancer is caused by sexually transmitted HPV infection and may be related to smoking, women who have had multiple pregnancies, women with HIV or women who have a history of sexually transmitted diseases in the past,” he said.

The doctor added that the best way to prevent cervical cancer is to get vaccinated. Regular check-ups should also be scheduled every three years. This was especially important for women over the age of 25.

“When abnormal cell changes are found and develop into cancer, they must be treated quickly,” he said.

Treatment could include surgery, radiation or chemotherapy, depending on the type and stage of the cancer.