We tend to think of Africa in terms of strange, exotic diseases, yet the common killers in the United States, such as cancer and heart disease, are prevalent there as well.
Still, it was an eye-opener for Stanford ob-gyn Paul Blumenthal, MD, MPH, to find an astonishingly high incidence of cervical cancer among women in Ethiopia. During a recent visit to the East African nation, he learned from a colleague that 60 percent of all referrals to Ethiopia’s only cancer center were women with cervical cancer.
“I’ve never been to a country where they told me 60 percent of the total number of cancer referrals were for cervical cancer,” said Blumenthal, who has traveled the world organizing prevention programs to spare women from the disease. “I was incredulous.”
At least 6,000 Ethiopian women die of the disease each year, a very conservative estimate, as the country has no methods for tracking the disease. Blumenthal has pioneered a low-tech approach to treating cervical cancer. It’s simple, requiring only some basic household vinegar. A caregiver swabs the woman’s cervix with the vinegar and then examines the result. A pre-cancerous lesion will show up as an opaque raised white patch.
The technique is an alternative to the Pap smear and may catch a cancer early, when it can still be treated. For women who don’t have access to the Pap test, which requires special equipment and laboratories and trained personnel, the low-tech screening test could be a godsend - the difference between life and death.
Blumenthal also uses a relatively simple way to treat the disease, using cryotherapy, or freezing of tissue. This destroys the pre-malignant cells. He and colleagues now are importing these two techniques - a one-stop screen and treat method - to Ethiopian women, using a grant from federal Centers for Disease Control through the U.S. President’s Emergency Fund for AIDS Relief. The project is being done in collaboration with the Ethiopian Ministry of Health and the Boston-based nonprofit Pathfinder International.
“Our objective is to prevent cervical cancer from ever occurring by doing this simple screening, uncovering pre-cancers that could develop into cancers,” Blumenthal said. “We’re really hoping to make a difference for the women of Ethiopia.”
The project is part of the Stanford Program for International Reproductive Education and Services (SPIRES), which aims to advance women’s health in low-resource areas by providing women with safe and effective reproductive health care and services.
Photo of two patients leaving cancer clinic by Paul Blumenthal