Pap smear test helps to detect cancer

JAKARTA (JP): "I was scared to death when a doctor discovered a serious ovarian tumor through my Pap smear test," said a 35- year-old housewife.

Fortunately, the tumor did not develop into cancer because she received appropriate medical care at a very early stage of the disease.

Titi Handayani (not her real name) admitted that she had never thought about having such a test until her menstrual period became longer than usual and so extremely painful that she couldn't bear it any longer. She also experienced excess bleeding outside her normal menstrual cycle.

"I suffered from this pain for nearly five years, and I thought it was just a menstrual syndrome which was quite normal for certain women. My sister urged me to have a Pap smear and finally I realized that I was so careless for not having the test earlier," Titi said, sharing her experience with a number of women at a family clinic run by the Kusuma Buana Foundation (YKB) in Pal Batu, South Jakarta.

Titi is now a regular patient at the clinic. She undergoes a Pap smear every six months to check her health condition. Unsatisfied with her status as a regular patient, Titi also registered as a volunteer counselor at the foundation to promote a Pap smear program among her close relatives and other housewives in her community.

Yenni Mardiani (not her real name), 26 and a member of the group, said she learned about the clinic's Pap smear program from her friend. "A few years ago, I was about to have a Pap smear at a well-known hospital in Central Jakarta. But, when I saw that the test would be carried out by a young handsome doctor, my body trembled and it started to swell because I felt so ashamed and uncomfortable," confided the beautiful mother of two.

Last year she enrolled at the YKB clinic near her house. "The clinic is small but its staff, mostly midwives and female health workers, are so very friendly that I feel comfortable having a Pap smear here," Yenny said.

Once a month, a large number of women meet in a cramped room at the clinic to be counseled about the Pap smear program, family planning program and other health issues.

Nanny Soewito, 48, says the Pap smear saved her from the deadly cervical cancer.

"When I had my first Pap smear at this clinic, I was diagnosed as having an abnormal cell, a polyp, in my uterine. I was later transferred to a hospital and underwent a series of therapies to treat my illness," Nanny said.

She now has a Pap smear every three months.

"My husband and my children keep encouraging me to have the test. When I forget to have it, they will immediately remind me adding that they want their mother healthy," Nanny said proudly.

Nanny said many women in her neighborhood fail to have the test because of a lack of money and awareness of the danger of cancer.

Her friend, a mother of twelve children, recently died of cervical cancer because she did not have the time or money for proper medical treatment.

Cervical cancer is the largest cause of death among Indonesian women in their reproductive years (between 20 and 40 years old). But it also strikes younger and older women. In Indonesia, cancer inflicts one of every 1000 people, of which 22 percent suffer from cervical cancer.

Cervical cancer can be discovered early with a simple Pap smear. Developed by a famous Greek physician George N.Papanicolaou (1883-1962), the Pap smear is currently regarded as the most effective way to detect pre-cancerous symptoms.

The accuracy of the test is more than 90 percent. The test is carried out by taking liquid from vaginal or uterine areas which is put on a special tissue to be examined in a pathology laboratory.

The test is recommended for women who have had sexual intercourse more than once. Women with menstrual or other abnormal uterine conditions should also have the test.

"Western women have great awareness of the importance of preventative medical measures. They regularly undergo pap-smears to check their health. Such efforts have more or less reduced any possibility of having cervical cancer," Adi Sasongko, head of the program, said.

In Indonesia, only a few women considered these preventive actions important. "As long as they feel healthy, they will not have a medical examination," he added.

The American Health Magazine says that the number of cervical cancer sufferers, once the leading killer of women in the United States, has dropped dramatically over the past 50 years thanks largely to the Pap test.

Indonesian women can learn from their counterparts overseas how to improve their health with various preventive actions. (raw)