Related Resources
Transcript
Katherine Banwell:
You know, Dr. Gray, unfortunately, many women can sometimes delay or neglect their own screening visits. Can you talk about some of the common barriers that prevent women from undergoing cancer screening?
Dr. Heidi Gray:
Yeah, that’s a really important question. I think that for some women, some of the barriers can be being embarrassed, particularly if they have a symptom, maybe they’ve not paid as much attention to.
One example I can think of is, sometimes women can develop sores or growths on the vulva, and people can be kind of embarrassed about bringing that up. It’s not an area most folks feel comfortable talking about or bringing attention to, and they are worried about the provider not maybe being as sensitive – or also worry about needing to have a test, like a biopsy, which can be painful.
Other barriers can be some harms that they may have, and biases that they have encountered before with other providers. Maybe they saw a provider who treated them poorly or didn’t listen to what they were saying, and so they’re thinking, “Why am I going to go spend money to go see this person who isn’t going to really listen to me or treat me with respect?” So, I think that those are definitely some important barriers that we need to, as providers, make sure that we’re aware of – particularly around the sensitivity of pelvic exams and the trauma that many people have around pelvic exams.
So, it’s really important, as a provider, to make sure you provide a very safe space for patients and have a conversation to make sure you understand what their concerns are before doing the exams.
Katherine Banwell:
Are there resources or programs available for women who don’t have easy access to regular screenings or specialists?
Dr. Heidi Gray:
Yeah, so, one of the really important tools that was developed was the concept of self-screening with HPV. So, as I talked about before, HPV is the virus that causes cervix cancer. And we know, when women have HPV that’s kind of still lingering around in the cervix or the vagina, they’re at higher risk of developing either precancer of the cervix or cancer. Historically, patients had to kind of come in, have a pelvic exam to do the swabs and all of that to test for the Pap test and the HPV – which, again, for many patients, can be a barrier.
Subsequently, what has been developed is the concept of self-collection of HPV swabs. And this was actually approved by the FDA in 2024, in which patients can use – it’s just like a little Q-tip, basically – and collect their own – do a self-collection in the vagina, and send it off to a lab, and it screens for HPV. And it’s incredibly accurate in detecting – meaning that if the HPV isn’t there, the test will come back negative, and that’s a really reassuring thing for a patient. If it does come back positive, it also means that that patient is at risk of developing a precancer or a cancer, and that then is the point where they should engage with the medical community for additional testing.
Katherine Banwell:
What are some common myths and misunderstandings about gynecological cancers that maybe you could clear up for us?
Dr. Heidi Gray:
Yeah, I think just the name sometimes people, like, grapple around. So, I think for a lot of cancers, they’re very solo – like breast cancer, lung cancer, gynecologic cancers.
We have this incredible spectrum of cancers that we manage, and they’re all a little different and unique in their presentation, and their risk factors, and things like that. So, I think that sometimes it’s hard for patients to kind of know what we are treating or how to engage with us. I think that, again, for a lot of patients, also, there can be a lot of fear and anxiety about the worry about losing some of their gynecologic organs if they need to have a surgery or a treatment – the uterus, the tubes, and ovaries – which, to have surgical intervention or other interventions that affect those organs, can be very, very huge barrier and have a lot of concerns for patients about that, so.