Look out for approaches that prevent future disease

Dear Doctor,

I have heard of pre-emptive treatment. What does it mean?

The practice of women’s health includes many approaches to prevent future disease.

You will be aware of common screening tests like cervical smears and mammograms, aimed at reducing incidences of cervical and breast cancer.

What may not be common knowledge is pre-emptive treatments, which are part of preventive measures, albeit at higher levels of intervention.

What are examples of pre-emptive treatments?

-Pre-emptive gynaecological treatment ranges from prescription medications to surgical procedures.

A seemingly simple strategy like contraception is a pre-emptive treatment approach. Using effective contraception will avoid unwanted pregnancies and prevent incidences of unsafe abortions.

It means you can plan and space your family to suit your prevailing health and social-economic circumstances. But the uptake of effective contraception is still lower than desirable in our part of the world, despite a wide range of choices to suit nearly everyone.

-Sexually transmitted infections (STIs) are relatively common as well, fuelled by unsafe sexual practices. But there are many pre-emptive measures that can almost bring the rates of STIs to negligible numbers.

Using condoms is pretty easy and effective, but some individuals don’t really bother. If unsure about your partner’s HIV status, you may be suitable for preventive treatment to avoid exposure to HIV.

Ask your gynaecologist about so called pre-exposure and post-exposure preventive treatment. You can go a step further and get advance prescriptions to negate treatment delays.

Your gynaecologist will be happy to discuss what conditions may be suitable for advance prescriptions, and which ones may not.

-Gynaecological vaccines are increasingly available for disease prevention. Think of the HPV vaccine for prevention of cervical cancer.

But why the low uptake rates despite scientific proof of benefits? Don’t rely on misguided hysteria about unsubstantiated ill effects that do not really exist.

Your teenage daughters (and boys), even you to some extent, are better off with the vaccine than without it. Be the first one to get more information about preventive vaccines that may be applicable for you.

-A small group of women may be suitable for pre-emptive surgical treatment to reduce risks of future gynaecological cancer. Breast and ovarian cancer come to the fore.

You need quite a comprehensive medical assessment before being deemed suitable for pre-emptive gynaecological surgery. Majority will suffer harm rather than benefit with pre-emptive surgical approaches if not well-selected.

If there is a disproportionate rate of gynaecological cancers in your family, you may be suitable for pre-emptive measures. Your gynaecologist should be able to give specific advice.

Should I book myself for some pre-emptive treatment then?

The majority of women will remain in good health just by adhering to currently recommended screening tests. It’s only a small number who may benefit from specific pre-emptive treatments. Remember that not all diseases can be prevented, irrational approaches must be avoided. You should always look at the benefit and harm ratio, and settle for what has scientific merit.