LAST EDITED ON Aug-02-04 AT 01:14 PM (CDST) by Rajah (admin)
Getting Your Cells in Line
It gets scraped during a Pap test, bumped during intercourse, stretched open
during childbirth and occasionally covered with latex or squirted with foam
when you’re trying to avoid pregnancy. But other than that, your cervix is
not really a focal point of your life. Out of sight, out of mind, right?
Right. Until your gynecologist says that something is wrong.
For somewhere between 250,000 and 1 million women every year, that something
is cervical dysplasia, a condition in which cells lining the cervix stop
organizing themselves into nice, neat, horizontal layers that reflect their
maturity from youngest to oldest.
Instead, a few older cells apparently decide to hang out with the younger
crowd, then become disruptive when their increasing growth no longer allows
them to neatly fit in among their younger siblings. They push the other
cells around, which eventually disrupts the rows.
Fortunately, the fact that these cells are out of line signals itself on a
Pap test. Depending on how many of these juvenile delinquents there are, a
lab technician will label the test either “low-grade squamous
intraepithelial lesion” for the minor disruptions of mild dysplasia or
“high-grade squamous intraepithelial lesion” for the more significant
disruptions of moderate and severe dysplasia. Carcinoma in situ, which is
also a high-grade squamous intraepithelial lesion, is not a form of cancer,
despite its name. Dysplasia becomes cancer when the delinquent cells quit
jostling their brothers and sisters and invade the cervix itself.
And that, of course, is what most women who find out they have cervical
dysplasia are afraid of. Although not all dysplasia progresses to cervical
cancer, most doctors surgically remove or otherwise destroy the cells
involved because they feel that dysplasia is the first step down the road to
But that thinking is beginning to change.
“Researchers are studying both the progression of cervical dysplasia toward
cancer and its regression back to the normal state (which is far more
common),” says Nancy Potischman, Ph.D., a senior staff fellow at the
National Cancer Institute in Rockville, Maryland. So instead of just asking
themselves “Why are these cervical changes evolving into cancer?”
researchers are also asking “What blocks the cervix’s return to normal?”
“Human papillomavirus (HPV), in combination with other genetic and
environmental factors such as cigarette smoke, is believed to be the main
cause of cervical cancer,” says Dr. Potischman. But there may also be
nutritional factors that affect whether dysplastic cells return to normal.
Based on what she has seen so far, says Dr. Potischman, “it may be that
vitamin C, vitamin E, beta-carotene and other carotenoids play parts in
whether your cervix returns to normal.”
What vitamins C and E and beta-carotene have in common is that they enhance
immune function. They are also antioxidants, which means that they protect
your body’s healthy molecules by neutralizing naturally occurring unstable
molecules called free radicals, which cause cellular damage by stealing
electrons to balance themselves.
Evidence that antioxidant vitamins can reverse dysplasia is impressive.
In a study at Albert Einstein College of Medicine in New York City, for
example, researchers took blood samples from 43 women with cervical
dysplasia and compared them with blood samples taken from women who did not
have the condition. The comparison revealed that lower levels of
beta-carotene and vitamin E corresponded to a significantly increased risk
of cervical dysplasia.
And what really knocked the socks off the researchers was a direct
correlation between the amounts of beta-carotene and vitamin E in the blood
and the stage of cervical abnormality.
In other words, says study leader Prabhudas R. Palan, Ph.D., assistant
professor of obstetrics and gynecology at Albert Einstein, the less
beta-carotene and vitamin E in a blood sample, the more dysplasia in the
An older study of vitamin C, also done at Albert Einstein, showed similar
results. In that study, researchers figured out the amount of vitamin C in
the diets of 87 women with dysplasia, then compared it with the amount of
vitamin C in the diets of women without dysplasia. They found that women who
consumed less than 30 milligrams of vitamin C a day were ten times more
likely to develop dysplasia than women who consumed more.
But will increasing your intake of antioxidants help heal dysplasia?
Perhaps, says Dr. Palan, who is conducting a study to find out. In this
study, women with the condition are being given 30 milligrams (about 50,000
international units) of pure beta-carotene every day for nine months.
In any event, the signs are good, since other studies have already
demonstrated that a diet rich in beta-carotene, vitamin C and vitamin E can
prevent cervical cancer.
In a study in four Latin American countries of 748 women with cervical
cancer, for example, researchers found that women who got more than 300
milligrams of vitamin C and 6,000 micrograms (about 10,000 international
units) of beta-carotene a day from fruits and fruit juices were roughly 30
percent less likely to develop cervical cancer than women who got less of
How beta-carotene, vitamin C and vitamin E might keep cervical dysplasia in
check is still unknown, says Dr. Palan. Some researchers suspect that these
nutrients enhance the ability of your immune system to fight off attackers
such as HPV, which is known to increase your risk of dysplasia. Others feel
that the nutrients work by increasing the amount of vitamin A available to
“We’ve found that the antioxidant properties are important,” says Dr. Palan.
Depending on supplements alone is not the best way to guard against cervical
dysplasia, says Dr. Palan. That’s because the fresh fruits and vegetables
rich in cervix-protecting vitamins, particularly beta-carotene, may contain
other beneficial substances.
But supplements can provide added benefits to a diet that already gets five
servings of fruits and vegetables a day. Many nutrition experts do recommend
taking daily supplements that include 50,000 international units of
beta-carotene, 500 milligrams of vitamin C and 100 international units of
Beta-carotene, a precursor of vitamin A, is important in the prevention and
treatment of cervical dysplasia. But it's not the whole story. There are
other members of the carotenoid family--lycopene, lutein, zeaxanthin,
beta-cryptoxanthin and alpha-carotene, for example--that may be equally
important. Medical researchers say that many of these carotenoids, which are
responsible for the yellow and red pigments found in foods, may have healing
Advances in technology have given scientists the tools to measure these
carotenoids individually. Here are some carotenoid-rich foods that may be
Eat tomatoes. In a study conducted at Albert Einstein College of Medicine in
New York City, researchers found that lycopene, a carotenoid found in
tomatoes, has a direct effect on the development of cervical dysplasia.
Studies are ongoing, says Prabhudas R. Palan, Ph.D., assistant professor of
obstetrics and gynecology at Albert Einstein, who is leading the study. But
right now it looks as though the more tomatoes you eat, the less cervical
dysplasia you get.
Reach for the leafy greens. Kale, raw spinach and fresh parsley are good
sources of the carotenoids lutein and zeaxanthin.
Get more fruits. Fresh papaya, tangerines and dried peaches are good sources
of the carotenoid beta-cryptoxanthin.
Eat deep orange vegetables. Carrots and pumpkin are good sources of
Prescriptions for Healing
A broad array of nutrients found in fruits, fruit juices, green, leafy
vegetables and orange and red vegetables have been shown to reduce the risk
of cervical dysplasia.
Some experts also recommend that you get the following nutrients from foods
or supplements on a daily basis to protect your cervix.
Nutrient Daily Amount
Beta-carotene 50,000 international units
Folic acid 400 micrograms
Up to 800 micrograms for pregnant women
Vitamin C 500 milligrams
Vitamin E 100 international units
MEDICAL ALERT: If you have been diagnosed with cervical dysplasia, you
should be under a doctor's care.
If you are taking anticoagulant drugs, you should not take vitamin E
Folic Acid Fixes
Although antioxidants such as beta-carotene, vitamin C and vitamin E clearly
play pivotal roles in protecting your cervix from dysplasia, folate (the
naturally occurring form of folic acid) may actually be more important.
Researchers have been studying the effects of folate on cervical dysplasia
for years, yet the relationship between folate levels and dysplasia is so
complex that study results have been equivocal. Some studies indicated that
a low level of folate in the body increases the risk of dysplasia; others
indicated that it doesn’t.
But researchers have begun to suspect that these inconsistencies,
frustrating as they may be, are the smoking gun that is actually pointing
them in the right direction. So instead of looking just at how many women
with low levels of folate have dysplasia versus how many women with high
levels of folate have the condition, researchers are looking at the
relationship between folate levels and risk factors such as smoking, oral
contraceptives, pregnancy and HPV infection. All of these things are known
to be associated with dysplasia.
In a study at the University of Alabama in Birmingham, researchers compared
the amount of folate in the red blood cells of 294 women with cervical
dysplasia with that of women without the condition. Then they checked with
the women to see whether they smoked, used oral contraceptives, had given
birth or had an HPV infection. And in each case, they found that the risk
factor was more likely to be associated with dysplasia if the women had low
levels of folate. Women with low levels of folate who were infected with
HPV, for example, were five times more likely to develop dysplasia than
women who were loaded with folate.
“Micronutrients such as folate are involved in nucleic acid synthesis and
repair. And folate deficiency is a cause of chromosomal breaks,” explains
Tom Becker, M.D., associate professor of medicine at the University of New
Mexico in Albuquerque, who is studying the nutrient. It’s possible that
cervical cells that have had DNA damage related to low folate levels could
be further damaged by cigarette smoke by-products or an HPV infection, could
become dysplastic and may not be able to repair themselves. As a result,
they may very well be blocked from returning to normal and instead progress
to cervical cancer.
Given that possibility, it may be more risky to be low in folate than to be
low in antioxidants, says Dr. Becker. “Research suggests that a diet with
plenty of cereals, fruits and green, leafy vegetables, as well as orange and
red vegetables, will help prevent cervical dysplasia,” he said. So there’s
yet another reason to learn to love those colorful veggies.
The recommended Daily Value for folic acid is 400 micrograms a day, although
pregnant women should get up to twice that amount. Unfortunately, most
American women get only about 236 micrograms a day.