{"id":30985,"date":"2011-03-23T12:46:01","date_gmt":"2011-03-23T16:46:01","guid":{"rendered":"http:\/\/dominicanewsonline.com\/dno\/?p=30985"},"modified":"2011-03-23T12:46:01","modified_gmt":"2011-03-23T16:46:01","slug":"health-talk-cancer-of-the-cervix","status":"publish","type":"post","link":"https:\/\/dominicanewsonline.com\/news\/homepage\/columns\/health-talk\/health-talk-cancer-of-the-cervix\/","title":{"rendered":"HEALTH TALK: Cancer of the cervix"},"content":{"rendered":"

\"\"INTRODUCTION<\/strong><\/p>\n

Cancer of the cervix is one of the most common cancers that affects not only the woman\u2019s reproductive system, but the woman as a whole.\u00a0 A variety of strains of the human papilloma virus (HPV), a sexually transmitted infection (STI) \u2013 we don\u2019t say STD much anymore \u2013 are the cause of the majority of cases of cervical cancer.<\/p>\n

When exposed to HPV, the immune system response in most women keeps the virus under raps.\u00a0 In a small group of women, however, the virus survives for years, then eventually converts some cells on the surface of the cervix into cancer cells.\u00a0 50% of cases of cervical cancer occur in women between the ages of 35 and 55.<\/p>\n

Thanks largely to PAP test screening, the death rate from this cancer has diminished significantly over the last 40 years.\u00a0 But it still claims far too many victims, underscoring the need for women to get their PAP test done. It is still our best means of early detection so that we can lick this thing when we find any hint of cancer.<\/p>\n

WHAT ARE THE SIGNS AND SYMPTOMS?<\/strong><\/p>\n

Early cervical cancer generally produces no signs or symptoms. As the cancer progresses, some signals may appear:<\/p>\n

\u2022\u00a0\u00a0 \u00a0Bleeding from the vagina after intercourse, called post-coital bleeding.\u00a0 Bleeding may also occur between periods or after menopause when, of course, it shouldn\u2019t.
\n\u2022\u00a0\u00a0 \u00a0Watery, bloody vaginal discharge that may be heavy and have a foul odor.
\n\u2022\u00a0\u00a0 \u00a0Pelvic pain (below the waist) or pain during intercourse (dyspareunia).<\/p>\n

WHAT ARE THE RISK FACTORS?<\/strong><\/p>\n

Here are some factors which increase your risk of cervical cancer.<\/p>\n

Many sexual partners.\u00a0 The greater the number of partners you\u2019ve had, and the greater the number of partners that they\u2019ve had, the greater your chances of being infected with the HPV.<\/p>\n

Early sexual activity.\u00a0 Having your first sexual encounter before age 18 increases your risk for getting HPV.\u00a0 Girls, listen to your parents!\u00a0 Immature cells seem to be more susceptible to the pre-cancerous changes that HPV can cause.<\/p>\n

Other STI\u2019S.\u00a0 Having Chlamydia, gonorrhea, syphilis or HIV\/AIDS means you have a greater chance of being exposed to HPV.<\/p>\n

Cigarette smoking.\u00a0 How cigarette smoking contributes to the problem isn\u2019t known for sure, but tobacco use increases the risk of precancerous changes as well as cancer of the cervix.<\/p>\n

A weakened immune system.\u00a0 Most women with HPV never develop cervical cancer.\u00a0 However, if there is a co-existing condition that weakens the immune system, cervical cancer is more likely to develop.<\/p>\n

SCREENING AND DIAGNOSIS<\/strong><\/p>\n

Almost everyone, men included, have heard of the PAP smear or a PAP test.\u00a0 The doctor, or nurse uses a brush or Q-tip-like swab to remove cells from the cervix, smears them onto a glass slide and sends the slide to the lab where a cytotechnologist, then a pathologist, examines it.\u00a0 The latter then reports the findings.<\/p>\n

A newer approach to the PAP screening uses a liquid to transfer the sample of cells to the laboratory.\u00a0 The cells are collected the same way, but the brush is rinsed in a special liquid, which preserves the cells for examination later.\u00a0 At the lab, a microscopic slide that\u2019s clearer and more easily interpreted than the traditional method, is prepared.<\/p>\n

A PAP test allows for the detection of abnormal cells.\u00a0 This is the precancerous stage, when the abnormal cells are only in the outer layer of the cervix and have not invaded deeper tissues.\u00a0 Left untreated, the abnormal cells may\u00a0 become cancer cells which may spread in various stages into the cervix, the upper vagina, the pelvic areas and to other body parts.<\/p>\n

Cancer or precancerous conditions that are caught at the pre-invasive stage are rarely life-threatening and usually can be treated on an out-patient basis.<\/p>\n

HPV DNA TEST<\/strong><\/p>\n

This test may be used to see whether you are infected with any of the 13 types of HPV (unlucky 13) that are most likely to lead to cancer of the cervix. It also involves collecting cells from the cervix to test at the lab.\u00a0 It can detect high-risk strains of HPV in cell DNA before changes to the cervical cells can be seen.<\/p>\n

This HPV DNA testing is not a substitute for regular PAP screening, and is not used to screen women younger than 30 with normal Pap smear results.\u00a0 Most HPV infections in women of this age group clear up on their own and are not associated with cervical cancer.<\/p>\n

WHAT ABOUT TREATMENT?<\/strong><\/p>\n

PRE-INVASIVE STAGE<\/p>\n

This is when only the outer layer of the lining of the cervix is involved.\u00a0 Treatments include:
\n\u2022\u00a0\u00a0 \u00a0Conization. A scalpel is used to remove a cone-shaped piece of abnormal cervical tissue.
\n\u2022\u00a0\u00a0 \u00a0Laser surgery.
\n\u2022\u00a0\u00a0 \u00a0Loop electrosurgical excision procedures (LEEP).\u00a0 A wire loop conducts an electrical current; it cuts like a surgeon\u2019s knife and removes cells from the mouth of the cervix.
\n\u2022\u00a0\u00a0 \u00a0Cryosurgery. Cancerous and precancerous cells are frozen and killed.
\n\u2022\u00a0\u00a0 \u00a0Hysterectomy. This removes cancerous and precancerous areas, the cervix and the uterus.<\/p>\n

All women with pre-invasive cervical cancer can be cured with appropriate treatment.<\/p>\n

INVASIVE STAGE<\/p>\n

When confined to the cervix in the invasive stage, the five-year survival rate for cancer is over 90%.<\/p>\n

Treatment includes:
\n\u2022\u00a0\u00a0 \u00a0Hysterectomy.\u00a0 Surgery is usually recommended for younger women because one of both ovaries can be preserved for estrogen production to maintain bone strength and avoid osteoporosis.\u00a0 A SIMPLE HYSTERECTOMY \u2013 removing the cancer, the cervix and the uterus – is usually the option when there is an invasion of less than 3 millimeters into the cervix.\u00a0 A RADICAL HYSTERECTOMY \u2013 cervix, uterus, part of the vagina and lymph nodes (glands) in the area \u2013 is the standard surgical treatment when there\u2019s an invasion of greater than 3mm into the cervix, and no evidence of tumor on the pelvic walls.<\/p>\n

\u2022\u00a0\u00a0 \u00a0Radical trachelectomy. Women with early-stage cervical cancer may preserve their fertility with this surgical procedure.\u00a0 In this, the cervix and lower part of the uterus are removed.\u00a0 Enough of the latter is left so that a pregnancy can be carried.\u00a0 Pelvic lymph nodes are also removed to determine whether cancer has spread.<\/p>\n

\u2022\u00a0\u00a0 \u00a0Radiation. High-energy rays shrink tumors by killing cancer cells.\u00a0 Cancer cells are rendered unable to reproduce.\u00a0 Premenopausal women will become menopausal because the radiation destroys their ovarian function.<\/p>\n

\u2022\u00a0\u00a0 \u00a0Chemotherapy.\u00a0 Drugs enhance the effects of radiation in treating cancer.<\/p>\n

Some women with early-stage cancer are treated with simple hysterectomy or radical trachelectomy alone.\u00a0 Women with more advanced cancer and those with high risk of recurrence are given radical hysterectomy, combined radiation and chemotherapy, or a combination of these modalities.<\/p>\n

CAN I PREVENT CERVICAL CANCER?<\/strong><\/p>\n

Yes. HPV transmission is not prevented by condom use because the virus can be transmitted by skin-to-skin contact with any infected part of the body.\u00a0 However condoms protect against other STI\u2019S that could weaken your immune system.<\/p>\n

The best ways to prevent cancer of the cervix are to:<\/p>\n

\u2022\u00a0\u00a0 \u00a0Delay fist intercourse
\n\u2022\u00a0\u00a0 \u00a0Have fewer sexual partners
\n\u2022\u00a0\u00a0 \u00a0Don\u2019t smoke<\/p>\n

PAP TEST GUIDELINES<\/strong><\/p>\n

By now you know the PAP test is crucial.\u00a0 Current guidelines suggest.<\/p>\n

\u2022\u00a0\u00a0 \u00a0An initial PAP test three years after you begin having sexual intercourse, or at age 21, whichever comes first.
\n\u2022\u00a0\u00a0 \u00a0From age 21 to 29, a regular test each year or a liquid based test every two years.
\n\u2022\u00a0\u00a0 \u00a0From age 30 to 69. \u2013 If you have had 3 normal test in a row \u2013 a regular PAP test every two years or a liquid based test every three years.<\/p>\n

From age 70 onwards, you may stop having tests if you\u2019ve had three or more normal ones in a row and no abnormal results in the last 10 years.<\/p>\n

Space does not permit me to discuss how we stage cervical cancer.\u00a0 Drop me a note or ask any question, and I\u2019ll tell you, or maybe we\u2019ll talk about cervical cancer from another angle some other time.<\/p>\n

See you next week.<\/p>\n","protected":false},"excerpt":{"rendered":"INTRODUCTION Cancer of the cervix is one of the most common cancers that affects not only the woman\u2019s reproductive system, but the woman as a whole.\u00a0 A variety of strains of the human papilloma virus (HPV), a sexually transmitted infection…","protected":false},"author":15,"featured_media":30986,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_cbd_carousel_blocks":"[]","footnotes":""},"categories":[49],"tags":[],"class_list":["post-30985","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-talk"],"acf":[],"yoast_head":"\nHEALTH TALK: Cancer of the cervix - Dominica News Online<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dominicanewsonline.com\/news\/homepage\/columns\/health-talk\/health-talk-cancer-of-the-cervix\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HEALTH TALK: Cancer of the cervix - 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