Jornal Médico – Fátima Faustino: “It may be possible to achieve the goal of eradicating cervical cancer by 2030”

Fátima Faustino: “The goal of eradicating cervical cancer by 2030 may be achieved”

In assessing the well being of Portuguese girls, Fátima Faustino famous that “Portugal has gone from the worst indicators in Europe to turn into one of the finest in the world in phrases of maternal and baby well being. ”. According to the coordinator of the gynecology and obstetrics division of the Lusíadas Hospital in Lisbon, though “there may be nonetheless a manner out” in areas resembling hormone alternative in menopause or the prevention of osteoporosis and cancer. coloration, endometrial and ovarian, are “the extra essential the extra essential. thought of for the analysis and remedy of gynecological ailments in Portugal ”. Read the complete interview.

Medical Journal (JM) | In Portugal, maternal and baby well being and signs have improved dramatically. How is girls’s well being after practically 43 years of standing with the National Health Service?

Fatima Faustino (FF) | According to information from the Director General of Health (DGS), in Portugal, in 1970, 63% of youngsters have been born out of hospital; many ladies spent days at work, at house, with out analgesia or medical help, with excessive maternal and/or fetal mortality charges and illness. At that point, the maternal mortality charge was 73.4/100,000 and the start charge was 38.9/1,000. Over the years, hospital situations, entry to well being care and human sources have enormously improved, regardless of the inherent difficulties in human sources and the enchancment of the services. remedy in some hospitals in the National Health Service (SNS). For instance, in 2000, the out-of-hospital start charge rose to 0.3%, the maternal mortality charge to 2.5/100,000 and the maternal mortality charge to 6.2/1000. The proportion of non-hospital births was at the very least 0.1% in 2010. In the final decade, from 2010 to 2019, the proportion of infants born out-of-hospital was 0.7%, maternal mortality charge was 7.15 / 1000 and toddler mortality. at 3.9/1,000. In 2017 and 2018, for instance, maternal deaths exterior the hospital have been 25 instances increased than in -hospital. Comparing these information with these of different international locations, we discover that Portugal has moved from the worst index in Europe to one of the finest in the world, in phrases of maternal well being and the baby. I might additionally like to level out that regardless of the “noise” and totally different concepts about humanity in childbirth, I refuse to settle for the time period “childbirth violence” and I nonetheless imagine that the workers of all well being providers on this space, or in the NHS. or in the non-public sector, they do the whole lot to enhance the well being of the mom and the well being of the new child.

JM | How do you at the moment view the Panorama of Women’s Gynecological Health?

FF | I believe girls are extra cautious with their complaints and accepting sure “myths” doesn’t occur with equal ease. Nowadays, entry to data unfold by way of the Internet is free and, whether or not it’s good or unhealthy, the reality is that it has the benefit of skepticism, main girls to search medical consideration. Nurses play an essential function of their orientation, whereas physicians play an essential function in analysis, data and remedy.

JM | Do you suppose that the analysis and remedy of girls’s gynecological pathologies is mostly given extra significance in Portugal?

FF | In basic, I believe that extra significance has been given to the analysis and remedy of girls’s gynecological pathologies in Portugal, with the safety of human useful resource limitations in some NHS hospitals. In my opinion, the lack of entry to the Medical subject for a number of years means a scarcity of professionals in some areas, which additional will increase the quantity of retired docs. Thus, as a lot as you need to reply, it isn’t at all times possible at the desired time.

JM | What is the function of the household doctor in diagnosing, diagnosing/monitoring and treating pregnant girls?

FF | I imagine that household physicians, as a result of of their contact with the basic public, can intervene in a particular manner at totally different ranges of main and secondary prevention of gynecological ailments, enjoying an essential function in ‘main to main pathologies for hospital providers. or at a non-public heart.

JM | What, in your opinion, is the space of ​​gynecology girls’s well being that has undergone higher improvement and is most uncared for and desires promotion?

FF | There is little question that there have been excellent progress in the subject of maternal care, which is mirrored in the above-talked about indicators, regardless of the massive quantity of girls who, due to instability socially and familially, postponed her first being pregnant. years later, with a rise in the penalties of pathologies resembling gestational diabetes, preeclampsia, untimely start, fetal development restriction and postpartum issues. Reproductive medication additionally, for that reason, faces rising and overcoming challenges. In the subject of gynecology, the software of cervical cancer screening, the humility of efficient remedy and the public acceptance of the HPV vaccine lead us to imagine that it’s possible to achieve the goal of eradication of cervical cancer, by 2030. Note that the HPV vaccine is included in the National Vaccination Program (PNV) for 10-yr-outdated ladies, however ranging from October 2020, the boys born since 2009 may get the vaccine free of charge in the subject of PNV. In addition, the analysis and remedy of breast cancer is one other space of ​​fixed improvement, each in phrases of analysis and remedy, and of benign pathologies resembling uterine fibroids and endometriosis. has additionally been broadly mentioned in the ongoing analysis of new therapies that may be delayed or prevented. surgical procedure. I believe that maybe it’s obligatory to pay extra consideration to the pathologies of the most superior age teams, whose well being is extra essential as a result of of the improve in endurance. In this context, I believe that hormone alternative remedy in menopause, osteoporosis prevention, urogynecology, and prevention of colorectal, endometrial, and ovarian cancers, are areas that want promotion to achieve all girls.

JM | How are gynecological exams right now?

FF | As famous, screening for breast and cervical cancer is advancing quickly. Regarding screening for endometrial and ovarian cancer, sadly we should not have an efficient main prevention resembling cervical cancer: Primary prevention and extension of the HPV vaccine for males. Ovarian Cancer: Inhibitor of PARP, a kind of oral chemotherapy, at the moment utilized in tumors the place there are adjustments in the BRCA1 and BRCA2 genes, however is believed to be utilized in sure varieties of ovarian cancer. all. Uterine fibroids: a brand new molecule containing relugolix, estradiol and norethisterone for the remedy of average or extreme signs, i.e. irregular bleeding. Endometriosis: Extensive analysis on the improvement of new remedy molecules, i.e. in the group of GnRH antagonists and aromatase inhibitors in addition to on the use of older molecules resembling metformin. Contraception (tablet): New drugs containing progestogen, drospirenone, no estrogen and extra lately a mixture of bioidentical estrogens, estetrol and drospirenone. Rehabilitation of the… area of the uterus (vaccination) and gynecological examination and transvaginal ultrasound are usually not efficient in asymptomatic girls to cut back mortality. I emphasize, nonetheless, that it’s up to the gynecologist to take benefit of the so-known as annual session to keep away from the danger of dangers and signs resembling irregular bleeding, peri or put up -menopause. When identified with ovarian cancer, it’s much more tough as a result of tumors which might be very poor in signs and illness are, in lots of instances, late.

JM | What are the newest diagnostic and remedy developments in the subject of girls’s well being?

FF | In basic in gynecological cancers, I emphasize early screening, which has included improvements in the subject of genetics and in the software of synthetic intelligence strategies. In phrases of remedy, I emphasize the function of immunotherapy, used as a complement to different therapies or as a primary line, thus activating the immune system to particularly battle in opposition to tumor cells, thus lowering cell injury. wholesome, with fewer unintended effects. I additionally spotlight molecular-objective therapies, resembling having a much less aggressive radiofrequency than standard radiotherapy and fewer invasive surgical procedure, or utilizing 3D laparoscopy, robotics and even synthetic intelligence.

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