Replacing the Pathologist and Gynecologist with Vinegar and CO2
Posted Oct 04 2011 12:00am
Some of the better minds in public health and medicine these days are being directed toward developing low-cost diagnostic and treatment strategies for developing countries. A recent article covered how to identify atypical patches of cervical mucosa quickly and cheaply (see: Fighting Cervical Cancer With Vinegar and Ingenuity ). The lesions are then frozen to eliminate the cancer threat. Here are the details:
What allowed [a] nurse [in Thailand] to render [a benign diagnosis of a cervical lesion] was a remarkably simple, brief and inexpensive procedure, one with the potential to do for poor countries what the Pap smear did for rich ones: end cervical cancer’s reign as the No. 1 cancer killer of women. The magic ingredient? Household vinegar....Nurses using the new procedure, developed by experts at the Johns Hopkins medical school in the 1990s and endorsed last year by the World Health Organization, brush vinegar on a woman’s cervix. It makes precancerous spots turn white. They can then be immediately frozen off with a metal probe cooled by a tank of carbon dioxide, available from any Coca-Cola bottling plant. The procedure is one of a wide array of inexpensive but effective medical advances being tested in developing countries. New cheap diagnostic and surgical techniques, insecticides, drug regimens and prostheses are already beginning to save lives....The procedure, known as VIA/cryo for visualization of the cervix with acetic acid (vinegar) and treatment with cryotherapy, can be done by a nurse, and only one visit is needed to detect and kill an incipient cancer. Because cervical cancer takes decades to develop, it is too early to prove that Thailand has lowered its cancer rate. In fact, Roi Et Province, where mass screening first began, has a rate higher than normal, but doctors attribute that to the extra testing. But of the 6,000 women recruited 11 years ago for the first trial, not a single one has developed full-blown cancer.
What interests me in all of this is the potential for some of these techniques/devices to bounce back to developing countries. The latter are under extreme pressure to reduce the cost of healthcare. I don't know of the extent to which VIA/cryo has relevance for more affluent countries. I do know, however, that there is a shortage of cytopathologists in many of them. I posted a note nearly five years ago about a severe backlog of pap smears in Ireland and a six-month waiting period for reports (see: Irish Pap Smears Imported by Quest ). As a result, the pap smear were being exported to a Quest laboratory in the U.S. for interpretation. There surely must be some prognostic implications in having Irish women wait months for Pap smear results. Would not the VIA/cryo technique serve them better, at least as a temporary measure?
Some of the better minds in public health and medicine these days are being directed toward developing low-cost diagnostic and treatment strategies for developing countries. A recent article covered how to identify atypical patches of cervical mucosa quickly and cheaply (see: Fighting Cervical Cancer With Vinegar and Ingenuity ). The lesions are then frozen to eliminate the cancer threat. Here are the details:
What allowed [a] nurse [in Thailand] to render [a benign diagnosis of a cervical lesion] was a remarkably simple, brief and inexpensive procedure, one with the potential to do for poor countries what the Pap smear did for rich ones: end cervical cancer’s reign as the No. 1 cancer killer of women. The magic ingredient? Household vinegar....Nurses using the new procedure, developed by experts at the Johns Hopkins medical school in the 1990s and endorsed last year by the World Health Organization, brush vinegar on a woman’s cervix. It makes precancerous spots turn white. They can then be immediately frozen off with a metal probe cooled by a tank of carbon dioxide, available from any Coca-Cola bottling plant. The procedure is one of a wide array of inexpensive but effective medical advances being tested in developing countries. New cheap diagnostic and surgical techniques, insecticides, drug regimens and prostheses are already beginning to save lives....The procedure, known as VIA/cryo for visualization of the cervix with acetic acid (vinegar) and treatment with cryotherapy, can be done by a nurse, and only one visit is needed to detect and kill an incipient cancer. Because cervical cancer takes decades to develop, it is too early to prove that Thailand has lowered its cancer rate. In fact, Roi Et Province, where mass screening first began, has a rate higher than normal, but doctors attribute that to the extra testing. But of the 6,000 women recruited 11 years ago for the first trial, not a single one has developed full-blown cancer.What interests me in all of this is the potential for some of these techniques/devices to bounce back to developing countries. The latter are under extreme pressure to reduce the cost of healthcare. I don't know of the extent to which VIA/cryo has relevance for more affluent countries. I do know, however, that there is a shortage of cytopathologists in many of them. I posted a note nearly five years ago about a severe backlog of pap smears in Ireland and a six-month waiting period for reports (see: Irish Pap Smears Imported by Quest ). As a result, the pap smear were being exported to a Quest laboratory in the U.S. for interpretation. There surely must be some prognostic implications in having Irish women wait months for Pap smear results. Would not the VIA/cryo technique serve them better, at least as a temporary measure?