Abnormal PAP Smears

cervical dysplasia cancer abnormal PAP smear

Cervical Cancer

What to Do About an Abnormal PAP Smear

Do you have an abnormal PAP smear? Want to know how to prevent it from happening again? As a naturopath, I offer treatment and prevention of abnormal PAP smears to prevent a recurrence.

What is a PAP Smear?

A PAP smear is a screening test that your doctor will do if you are female to check the health of the cells that line your cervix.

What is the Procedure for a PAP Test?

Here are the steps for a PAP test:

  1. You will need to remove your clothing from your waist down
  2. Your MD will supply you with a gown or paper to drape over yourself
  3. You will lie down on your back on his or her treatment table
  4. You will put your feet in footrests
  5. Your doctor will insert a device into your vagina called a speculum.  This is a sterile, disposable plastic or sterilized metal tool that will open up your vagina.  This is so that he or she can see your cervix and collect a sample for the test
  6. A skilled physician will be able to do this with minimal discomfort to you
  7. Next, a small brush is inserted into the cervix and used to collect cells for testing
  8. Your doctor will send these to a cytology lab for examination to determine the health of the cells.  In some cases, a sample is also sent for HPV testing to determine the presence or absence of high-risk HPV strains.  High-risk strains include primarily HPV 16 and 18, but more rarely also HPV 31, 33, 34, 45, 52, and 58.
  9. After a PAP test, you may notice some light bleeding or spotting.  This is normal.  If it persists or is heavy, talk to your doctor or gynecologist.

How Often Should I have a PAP Test?

Screening for cervical cancer is recommended in women aged 21 to 65 years with cytology (Pap smear) every 3 years.  This changes if your PAP test is abnormal.

Facts about PAPs and Cervical Cancer

  • Over 90% of cervical cancers can be cured when detected at an early stage and treated.
  • Cervical dysplasia is not cervical cancer. It is considered a “pre-cancerous” condition.  Dysplasia is graded as ASCUS (abnormal squamous cells of undetermined significance), LSIL (low-grade squamous intraepithelial lesion) or HSIL (high-grade squamous intraepithelial lesion)
  • Treatment of cervical dysplasia (low grade or high grade) by a LEEP procedure, in some cases, weakens the cervix causing difficulty in maintaining a subsequent pregnancy.

What Increases the Risk of Cervical Cancer?

The following increase your risk of cervical cancer:

  • Human Papillomavirus (HPV).  Almost all cases of cervical cancer are linked to infection with HPV. Strains 16 and 18 are high-risk strains of HPV.
  • Smoking.  Women who smoke are at higher risk of cervical cancer.
  • Weak Immune System.  Since HPV is a virus, a healthy immune system helps a woman get rid of the HPV infection.
  • Sexually Transmitted Diseases (STDs).  Infection with other sexually transmitted diseases like herpes (HSV) increases your risk of cervical cancer.

What Causes an Abnormal PAP Smear?

Most times it is assumed that the PAP is abnormal because of the Human Papilloma Virus or HPV.  It is a virus that is strongly associated with abnormal cells on your cervix.  Sometimes doctors will test for HPV, sometimes they won’t.

What Causes an Abnormal PAP Smear Besides HPV?

The exact cause of an abnormal PAP other than HPV is unknown.  Risk factors for cervical dysplasia include:

Does Tampon Use Cause Dysplasia?

To date, there hasn’t been any research showing that tampons cause changes in the cells of your cervix.  However, if they are irritating your cervix or creating an unhealthy environment in your vagina, tampons may, at least, contribute to the problem.

Does Menopause Cause Abnormal PAPs?

Menopause brings about many changes to the vagina and the cervix.  For example, there is a loss of estrogen and progesterone that accompanies menopause.  This change in hormones alters the health of the vaginal tissue. Also, this drop in hormones changes how your immune system works.  Therefore, menopause is a risk factor for dysplasia.

How Common is an Abnormal PAP Smear?

Various studies estimate how often PAPs come back abnormal.  Estimates range from 2.6-3.8%.  The lifetime risk of having an abnormal PAP test is 77% for a 15-year-old.

What Happens After an Abnormal PAP Smear?

That depends.  The factors that your medical doctor will take into consideration when deciding what to do about an abnormal PAP include:

  • Your family history
  • Your history of PAP’s – have you had previous abnormal ones or is this your first? How severe is the abnormality?
  • Do you have risk factors for cancer?

Most times, for a first abnormal PAP, particularly if it is low-grade or ASCUS, your medical doctor will take a wait-and-see approach.  This means that he or she will wait and see how your next PAP looks.  Most times, an abnormal PAP will resolve on its own without any intervention.  If it is not your first one, or if it is high-grade, then your medical doctor may send you for a colposcopy.

What is a Colposcopy?

A colposcopy is a procedure where a medical doctor will examine your cervix with a scope.  It allows your doctor to get a closer look at your cervix, and vaginal tissues.   From there, your doctor determines the next steps.

What is the Procedure for a Colposcopy?

For a colposcopy, you will need to remove your clothing from your waist down.  Your MD will supply you with a gown or paper to drape over yourself.  You will lie down on your back on his or her treatment table.  You will put your feet in footrests.  Your doctor will apply a vinegar solution to your cervix. This makes abnormal cells easier to see.  Depending on the results of the vinegar test, the doctor may take a biopsy.  A biopsy is a small sample of cells that will be sent to a lab for further examination.

Does a Colposcopy Hurt?

There may be some discomfort associated with the colposcopy, but it shouldn’t be particularly painful.  If a biopsy is taken, that may also cause some mild discomfort.

Are There any Side Effects to a Colposcopy?

After a colposcopy, there may be some bleeding for a few days.  You should avoid intercourse for a week after a biopsy.

What Will the Colposcopy Show?

The colposcopy will allow the MD to see abnormal cells. Also, it allows him or her to take a biopsy from the abnormal area to send for testing.  This testing of the biopsy allows the lab to give a grade to the dysplasia of CIN I, II or III or cervical cancer.

Natural Treatment of Abnormal PAP Smears

The best medicine is always prevention.  Quit smoking, strengthen your immune system and always use condoms.  Otherwise, I employ some or all of the methods below.

Liver detoxification

Enhancing phase I and phase II liver detoxification helps to clear out excess estrogen and estrogen mimickers.  Too much estrogen (estrogen dominance) contributes to certain reproductive cancers.  Estrogen-mimicking chemicals from plastics, pesticides, and pollution create further problems related to estrogen.

Antioxidants

Women with cervical dysplasia have lower levels of antioxidants like vitamins A, C, E, and selenium.  These vitamins help protect DNA and strengthen your immune system.

Folic acid

Folic acid helps prevent DNA damage and genetic mutations that lead to cancer.  Dysplasia can be treated and prevented with folic acid. However, up to 60% of the population cannot take regular folic acid supplements and convert them to ACTIVE folic acid.  Which means that supplementing folic acid does no good.  It may, in fact, be harmful.  There is a blood test available to determine if you have this genetic mutation.  It is known as MTHFR.  To be on the safe side, I always only supplement women with the active form of folic acid.  This is called L-5-Methyltetrahydrofolate or L-5MTHF.

Vitamin A

Vitamin A is very important for mucous membrane tissue.  This is the tissue that lines the vagina, respiratory and digestive tracts.  Vitamin A is also a powerful antioxidant.  That means that it prevents free radical damage and acts as an anti-viral. Vitamin A locally helps to heal cervical tissue.

Naturopathic treatment with conventional treatment speeds up the healing process.  It is also used after conventional treatment to prevent recurrences. Some of my patients who had dysplasia recurrences before natural treatment stayed healthy after adding natural treatment.

The Benefits to Naturopathic Treatment of Abnormal PAP Smears or Dysplasia

  • You not only remove unhealthy cells, but you also repair and heal the tissue
  • You address all aspects of your health that cause or contribute to the abnormal PAP smear
  • Prevention of future recurrences

If you would like help with an abnormal PAP, book an appointment here or call the clinic for more information at 416-481-0222.

by Dr. Pamela Frank, BSc(Hons), ND

Research on Natural Treatment of Dysplasia

A treatment group of women 20-60 years old with high-risk HPV and low-grade dysplasia received twice-weekly self-administered intravaginal infusions of 0.5 mM zinc citrate solution containing CIZAR (zinc chloride and citric acid anhydrous) for 12 weeks. After 12 weeks of the zinc citrate solution vaginal infusion twice per week, high-risk HPV is eliminated in 64.47% of patients compared to the spontaneous clearance rate in 15.25% of patients in the control group. Source: Gyn Onc 2011;122:303-306

In this study, a significant preventive effect for cervical neoplasm [cervical dysplasia, carcinoma in situ (CIN) and invasive cervical cancer] is found with the highest intakes or serum levels of vitamin B12 vitamin C, vitamin E, beta-carotene, folate and lycopene compared with the lowest intake group or serum level. Source: BJOG 2011;118:1285-1291.

Sadeghi S B; Sadeghi A; Robboy S J. Prevalence of dysplasia and cancer of the cervix in a nationwide, Planned Parenthood population. Cancer 1988 Jun 1 61 23592361

DISCLAIMER: The information provided here may not apply precisely to your individual situation. Diagnostic and therapeutic choices must always be tailored to the individual patient’s circumstances, and consultation with a licensed naturopathic physician should be undertaken before following any of the treatment strategies suggested in this web site.