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a woman’s journey

Dr. Amanda Nickles Fader is associate professor in the department of gynecology and obstetrics, where she also serves as director of the Kelly Gynecologic Oncology Service and director of the minimally invasive surgery program.

Internationally recognized as a leading expert in high-risk endometrial cancers, Dr. Fader has particular expertise with the surgical and medical management of endometrial, ovarian, cervical and vulvar cancers, as well as treatment of women who are at high risk for a gynecologic malignancy.

With a special interest in caring for patients throughout the entire spectrum of oncologic care: from preventive oncology minimizing key risk factors that can lead to gynecologic cancer survivorship initiatives addressing all aspects of recovery, including emotional well-being and clinical follow-up, her research centers on minimally invasive surgical innovations in gynecologic oncology, clinical trials and innovative targeted biologic therapies, high-risk endometrial cancer, and the role of obesity in carcinogenesis.

She received her medical degree from the Medical College of Virginia and completed a fellowship in gynecologic oncology at the Cleveland Clinic. Dr. Fader will be speaking at the 2013 A Woman's Journey conference here in Baltimore.

Q: Is cervical cancer preventable (hysterectomies, etc.)?
A: In the last decade, cancer has become the second leading cause of death in the U.S.  The good news is that most cancers diagnosed in women are preventable, including cervical cancer.  

There are several things a woman can do to prevent or decrease her risk of cervical cancer. Since infection with the human papillomavirus (HPV) is the most significant risk factor for cervical cancer and cervical dysplasia (pre-cancer), it is important to avoid genital HPV infection. This can include delaying sex, limiting the number of sex partners, and avoiding a sexual partner who has had many other partners. Condoms are important to prevent the spread of sexually transmitted diseases, but they do not provide complete protection against HPV since there may be contact of exposed areas which can transmit the virus. Smoking also increases the risk of cervical cancer by up to five-fold in the setting of an HPV infection, as it decreases the function the immune system.

It is also extremely important that women undergo regular Pap smear screening.  The Pap smear is a test used to screen for cervical cancer, and can help detect the presence of HPV infection or pre-cancerous cells before they become cancerous. There are usually no symptoms or noticeable signs of early cervical cancer but it can be detected early with regular check-ups.  It is the single most effective and successful cancer screening test in history, and many other screening tests used in medicine are modeled after it.  Prior to the introduction of the Pap smear test in the 1940s, cervical cancer was one of the leading causes of cancer death for women in the United States. But after cervical cancer screening was initiated with the Pap, cervical cancer incidence was reduced by 75 percent and deaths from cervical cancer by 90 percent.

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