“Let me share with you the story of Carmen. She was only 37 years old when she was diagnosed with cervical cancer. She had three children; two girls and one boy. She was married, but by the time we had met, her husband had abandoned her.” It’s a story Jose Jeronimo has retold over the last 20 years, after meeting Carmen while he was in Peru working as a gynecological oncologist, an expert on women’s cancer.
“It was not uncommon,” Jose continues, “I’ve seen many [women] abandoned by their husbands after a diagnosis of cervical cancer.” Carmen had three children to care for and love. She was determined to go to treatment. She completed her radiotherapy and shortly after that, Jose met her.
“I had to tell her the treatment didn’t work.”
What really touched Jose about Carmen was her bravery in the face of her mortality, and her devotion to her children.
“She was very afraid about the future of her kids. She was asking me for time because she needed enough time to find somebody to take care of the kids.”
Transforming a killer into a preventable disease
Cervical cancer is caused by the human papillomavirus (HPV), a common sexually transmitted infection that can cause cancer in some women with persistent infection. Jose, now a senior advisor for women’s cancers at PATH, has seen how the new highly effective HPV vaccine protects girls and young women against this cancer-causing virus, as well as the improvements in early screening and treatment. These developments provide even more opportunity to prevent cervical cancer and save lives.
And yet most developing countries lack the laboratories, trained technicians, and financial resources to effectively screen. It is the second most common cancer among women globally, and the largest cancer killer among women in most lower- and middle-income countries.
But there’s hope. Recent innovations for lower-income countries are proving to be just as effective as the methods used to reduce cervical cancer incidence in high-income countries.
New hope for women and families
Although the HPV vaccine protects girls and young women from the virus that causes cervical cancer, there are millions of women who are too old to get full benefit from the vaccine. These women need screening and treatment to prevent the development of the disease.
Cryotherapy is a freezing treatment that’s been around for over 30 years for the treatment of precancerous lesions on the cervix. Unfortunately, the technology depends on a constant supply of refrigerant gas, which is expensive, heavy, and difficult to transport. For hard-to-reach or low-resource areas, the cost and expense can be a burden.
This is why Jose and his team are involved with advancing a very effective treatment called thermal coagulation (previously called cold coagulation). Jose is partnering with other organizations to build evidence that thermal coagulation is an effective course of treatment. His team is also working with Liger Medical, a medical device manufacturer, to design a new battery-operated unit that is both small and portable, easy to operate, and doesn’t need gas. The equipment has sensors to ensure treatment temperatures remain consistent and the device cycles off so practitioners know when the treatment is complete.
The team is ready to take the next steps and see how the Liger Thermocoagulator works in the field.
“We’ll be going into health facilities in Honduras with devices that are much lighter and easier to hold,” says Jose. “Then we will collect data on the acceptability of the device by women and health providers.”
PATH has already received feedback from some colleagues and health providers. “We took an earlier prototype to Uganda,” says Jose, “and Dr. Carol Nakisige, who leads the Gyn-Oncology department at the Uganda Cancer Institute, was one of many who were impressed. They have a backlog of patients waiting for treatment; cryotherapy was no longer a feasible option. She asked us to leave the portable thermocoagulator with them!”
The way forward
The device is designed to be significantly cheaper and powered by battery for low-resource health facilities with limited access to consistent power sources. It’s also small and light so a midwife, a doctor, anyone properly trained can use the device and transport it to clinics and communities.
PATH’s manufacturing partner, Liger Medical, has received FDA approval for marketing the new device and prospects are good that it will be commercially available by the first quarter of 2017.
“This is an innovation that could improve the health of many,” says Jose. “Twenty years ago, had this been available for Carmen’s treatment, it may have saved her life.”
- Tracy Romoser is a communications officer and the blog editor at PATH.