CERVICAL DYSPLASIA

CERVICAL DYSPLASIA refers to abnormal cells of the cervix, the lowest portion of the uterus. Most women learn about cervical dysplasia through the results of a Pap smear. If you’ve just gotten a report from your doctor that your Pap smear shows “abnormal” cells, you should know about the test itself, as there has been a great deal of controversy about Pap smears and the significance of their result.

A Pap test is a sampling of the cells of the cervix. It’s the most common screening tool for cancer of the cervix, and it depends on the doctor’s providing an adequate sampling of the cells and an accurate interpretation or analysis of the cells sampled. A Pap smear does not yield simple negative or positive results. In other words, both the lab analyzing the cells and the doctor interpreting the report from the lab must be competent. The Wall Street Journal recently reported on the scandalous inefficiency of some lab analyses of some Pap smears and the failure of prompt reporting to women who had levels of abnormality.

In addition, there has always been some confusion concerning what the various levels of abnormalities revealed by a Pap smear really mean. Under the system that’s been in place for years, there are five different classifications: class I indicates normal cells and class 5 indicates cancerous cells. But the in-between classes-2, 3, and 4-are open to interpretation. For a woman to get a test result that tells her that she has a “class 3 Pap smear” is terribly confusing. Today there’s a new system adopted by many labs for interpreting Pap smears called the Bethesda system. It uses uniform terminology and gives clear diagnostic results. Whether or not a laboratory adopts the Bethesda system is at its own discretion, so you might check with your doctor as to which test will be used next time you’re having a Pap smear.

In addition to the confusion over Pap test results, there’s also some dispute about their significance. In fact, only one in ten pre-cancerous lesions of the type discovered in a Pap test are likely to develop into cancer if left untreated.

Despite this confusion, the Pap test is a valuable diagnostic tool that should be part of every woman’s routine health care. The question is, “How do you interpret any abnormal results?” Of course, your doctor is your first resource. But here is what I tell my patients who ask about an abnormal Pap result. Most often an abnormal test is simply an alert; a follow-up test will be requested. Cervical dysplasia that has progressed will, of course, require surgery. But between the abnormal test and the follow-up, you have a chance to improve your condition by using nutritional medicine. Most women (and many doctors) take no action at all once they have an abnormal test result: They simply schedule another test. But you shouldn’t be passive in this regard. If you’ve had an abnormal test, you should make every effort to improve your next reading, and a simple program, which I’ll outline, can make the difference between another abnormal test and one that’s perfectly normal.

There are a number of risk factors connected with cervical cancer including sexual activity at an early age, multiple sexual partners, long term use of oral contraceptives, two viruses-the herpes II virus and tile human papilloma (wart) virus-and smoking. There’s nothing you can do about these factors (except smoking) at the time you get an abnormal Pap smear. But there is a great body of evidence that nutritional factors play an important role in the development of cervical cancer. Blood tests of cervical cancer patients have shown that 67 percent had at least one abnormal vitamin level.

Folic acid deficiency is closely linked to the development of cervical dysplasia. There have been reported cases of women who, after a diagnosis of cervical dysplasia, began taking folate supplements and subsequently had a completely normal Pap test.

Beta Carotene and vitamin A deficiencies closely associated with the development of cervical dysplasia. In one study, women deficient in vitamin A were three times more likely to develop severe dysplasia. Vitamin A and beta-carotene supplements have been shown to improve cervical dysplasia to the point that no abnormal cells are in evidence.

Vitamin C is also important in controlling the development of cervical dysplasia. Women who consume less than 50 percent of the RDA of vitamin C can have ten times the risk of developing the condition.

If you’ve had an abnormal Pap smear, stop smoking;, begin nutritional therapy as I’ve recommended, have a follow-up Pap smear at the time recommended by your doctor, schedule the second test for the middle of your menstrual cycle, don’t douche before the test, and ask your doctor if the lab that will examine your test uses the Bethesda system.

NATURAL PRESCRIPTION FOR CERVICAL DYSPLASIA

• If you smoke, stop. This is important, as smoking is closely linked with the development of dysplasia.

IN ADDITION TO YOUR DAILY SUPPLEMENTS, TAKE:

• Folic acid: 5 mg twice a day for three months or until your follow-up Pap smear. (Folic acid comes in 800-mcg. tablets; you need to take about nine a day, and you can take them all at one time.) Also increase your consumption of foods rich in folio acid, including raw deep green leafy vegetables such as spinach, beet greens, kale, turnip greens, broccoli, asparagus, and endive as well as liver, wheat germ, and lima beans.
• Vitamin A: 50,000 I.U. dally for two months (do so only under medical supervision); then 10,000 I.U. daily or until follow-up Pap smear. Also increase your consumption of foods rich in vitamin A, Including carrots, squash, sweet potatoes, dark leafy vegetables, and broccoli.
• Vitamin C: 1,000 mg. daily.

IN ADDITION: If subsequent testing indicates that you do require surgery, the tile standard treatment is a cone biopsy, in which a cone-shaped piece of tile cervix is removed. The procedure must be done in an operating room under general or spinal anesthesia. But there is a new treatment called Loop Electrosurgical Excision Proceclure (LEEID), which was developed in Britain and is becoming increasingly available in this country. LEEP has many advantages over the cone biopsy in that it requires only local anesthesia, is fast, causes no post-op pain or discomfort, and the possibility for infection following the procedure is eliminated. Of course, your doctor is the best judge of which procedure is appropriate for your condition, but, if indicated, LEEP could simplify your treatment.