BY JAMIE LOBER
Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990 which prompted the Centers for Disease Control and Prevention to create the National Breast and Cervical Cancer Early Detection Program. Progress has been made by leaps and bounds ever since. In 2000 Congress passed the Breast and Cervical Cancer Prevention and Treatment Act which permitted states with women who were diagnosed with cancer in the program to be able to access treatment through Medicaid. “The state guidelines allow us to start the services for women at age 40 and we can go up to age 75 with the state funds, while federal funds are supposed to be used for women between 50 and 64,” said Micki Metscher, nurse and navigator for the breast and cervical cancer control program at WomanWise/WISE WOMAN Clinic.
Healthcare professionals are proud of the work this initiative has done. “The good thing is, we are able to serve a large patient population, and the criteria to get in are living in Forsyth County, being uninsured, in that age group and to income qualify,” said Metscher. If you meet all of the criteria except you are under 40 and have a breast problem, you can still qualify. “When someone comes in, I am not sure if they are more terrified of getting cancer or the fact that they do not know how they will pay for it,” said Metscher. Women are armed with educational materials on how they can take better care of their health. “I do education about the self-breast exam, breast cancer risk factors, breast density, ask if they smoke and give information about cessation and the quit line and for those over age 50 I have to counsel them on colon cancer screening,” said Metscher.
Those who work on the program find it rewarding. “I love women’s health and have been in a unique position to make women feel cared about, important and valuable, and I want them to take care of themselves and feel good about themselves,” said Metscher.
All women should screen early and often. “I advocate to women that I do not care who you are, where you live or how old you are; if you find something in your breast that does not belong there you need to make noise, bang on doors and make phone calls because somebody will get you help,” said Metscher. If you are over 50, remember there are some things you may not be able to see or feel, so the mammogram is vital. “Most insurances will pay for an annual mammogram after 40 which is a good idea, and there is minimal radiation exposure,” said Metscher. For cervical cancer, the Pap smear is recommended starting at age 21. “A regular cytology Pap smear can be repeated in three years, and patients 30 and older are also tested for the human papilloma virus,” said Metscher. If they are negative, it can be rechecked in 5 years. “Guidelines will be adjusted for people that have histories of abnormalities which are determined on an individual basis,” said Metscher.
There is a vaccine for cervical cancer that is highly recommended as well. “We just want women to know that their health is important, they should take care of themselves and not be afraid to talk to somebody if they have a problem,” said Metscher. It is better to be safe than sorry. “Most of the time at 23 a breast problem is a fibroadenoma which is not a cancer,” said Metscher. Knowing your body makes a difference. “There has been controversy about them, but a man did a study a number of years back that said it did not improve outcomes for breast cancer, but I highly disagree with that,” said Metscher. The idea is to be self-aware. “I want to make sure that they put their arm up, go under their arm, cover the whole mound of the breast and the area from the top of the breast all the way up to the collarbone,” said Metscher.
The top two risk factors are being female and getting older, followed by family history. Obesity is also problematic. “Women store estrogen in their body fat, and excess estrogen plays havoc with your uterus and breasts,” said Metscher. Try to stay away from processed foods and have a healthy diet that includes fruits and vegetables and is low in fat and sugar. Exercise is also beneficial for general wellness such as cardiac health and prevention of diabetes.
Since January is considered cervical cancer awareness month, it is a prime time to deliver the message on the importance of detection and screening and share with the special women in your life.