Cervical Cancer
What is
cervical cancer?
What are the risk factors for developing cervical
cancer?
What are the symptoms of cervical cancer?
What if abnormal cells are seen on my Pap smear?
What kind of attention do each type of cell
abnormalities require?
What are the treatments for cervical cancer?
Also
See:
Pap Smear
Cancer
Colposcopy
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What is cervical cancer?
Cancer of the
cervix, a very common kind of cancer in women, is a disease in which
cancer (malignant) cells are found in the tissues of the cervix. The
cervix is the opening of the uterus (womb). It connects the uterus to the
vagina (the birth canal). Cancer of the cervix usually grows slowly over a
period of time. Before cancer cells are found on the cervix, the tissues
of the cervix go through changes in which abnormal cells begin to appear
(a condition called dysplasia). Later, cancer starts to grow and spread
more deeply into the cervix and to surrounding areas.
What are the
risk factors for developing cervical cancer?
According to the
National Cancer Institute, strong risk factors include early age at first
intercourse, a history of multiple sexual partners, genital human
papillomavirus infection (HPV) or other sexually transmitted disease
(STD), and the presence or history of other genital tract abnormalities.
Women age 60 and above are at greater risk for cervical cancer than are
women in other age groups because these older women are less willing or
able to seek medical care for early screening. One reason that many of
these women do not get screened for cervical cancer is that they often
don't view themselves as being at risk. Other risk factors include active
or passive ("second-hand") smoking, poor nutrition, and a current or past
sexual partner with risk factors for STDs, or HIV/AIDS.
What are the
symptoms of cervical cancer?
There are no real
symptoms of the early stages of cervical cancer. That is why is it is so
important that your doctor does a series of tests regularly to look for
it. The first of these is a Pap smear, which is done by using a piece of
cotton, a brush, or a small wooden stick to gently scrape the outside of
the cervix to pick up some cells that can be examined under a microscope.
You may feel some pressure, but you usually do not feel pain. Most
cervical cancers can be caught early with regular screening. (Connect to
the Internet link for "Pap Smear" listed at the top of this FAQ for more
information.)
What
if abnormal cells are seen on my Pap smear?
Results from five to
10% of Pap smears performed each year on women in the United States are
reported as abnormal. Abnormal cell types include:
-
ASCUS-atypical
squamous cells of undetermined significance. Squamous cells are the thin
flat cells that form the surface of the cervix.
-
LSIL-low-grade
(early changes in the size, shape, and number of cells) squamous
intraepithelial lesion. The word lesion refers to an area of abnormal
tissue; intraepithelial means that the abnormal cells are present only
in the surface layer of cells.
-
HSIL-high-grade
squamous intraepithelial lesion. High-grade means that there are a large
number of precancerous cells that look very different from normal cells.
ASCUS and LSIL are
considered mild abnormalities. HSIL is more severe and has a higher
likelihood of progressing to invasive cancer.
If the Pap test
abnormality is unclear or minor, the doctor may repeat the test to ensure
accuracy. If the Pap test shows a significant abnormality, the doctor may
then perform a test called a colposcopy. For this test, the doctor uses a
magnifying instrument to view the tissue surrounding the vagina and cervix
to check for any abnormalities. A Schiller test may also be performed. For
this test, the doctor coats the cervix with an iodine solution. Healthy
cells turn brown and abnormal cells turn white or yellow. Both of these
procedures can be done in the doctor's office. Finally, the doctor may
also remove a small amount of cervical tissue for examination. This
procedure is called a biopsy and is the only sure way to know whether the
abnormal cells indicate cancer.
What kind of attention do each type of cell abnormalities require?
All doctors agree
that women who show HSIL cells on their Pap tests should receive a
colposcopy and, if necessary, a biopsy. However, there is no agreement
among doctors about how to manage women who show ASCUS or LSIL cells. Most
doctors either perform immediate colposcopy and, if necessary, biopsy, as
for women with high grade lesions. Since low-grade cell changes in many
women tend to go back to normal on their own, other doctors choose to wait
and repeat the Pap smear every four to six months, then perform colposcopy
if the abnormality is still present.
The National Cancer
Institute is conducting a study called the ASCUS/LSIL Triage Study to help
doctors determine how to best manage these two abnormal cell types in
women. So far, results show that it is helpful for women with ASCUS cells
to also be tested for HPV to see if their abnormalities need immediate
attention. The study found that many women with ASCUS cells who tested
positive for HPV had precancer, or rarely, cancer. A negative HPV test
provided strong reassurance that precancer or cancer was not present.
What are the
treatments for cervical cancer?
Treatments for
cancer of the cervix depend on the stage of disease, the size of the
tumor, and a woman's age, overall physical condition, and desire to have
children. Treatment for cervical cancer during pregnancy may be delayed,
depending on the stage of the cancer and how many months of pregnancy
remain. There are three kinds of treatment for women with cancer of the
cervix:
1.
surgery -
removing the cancer in an operation;
2.
radiation therapy - using high-dose x-rays or other high-energy
rays to kill cancer cells
3.
chemotherapy
- using drugs to kill cancer cells.
The National Cancer
Institute recommends that doctors should strongly consider giving
chemotherapy at the same time as radiation therapy for women with invasive
cervical cancer. Five major studies showed that chemotherapy that includes
the drug cisplatin, when given at the same time as radiation therapy,
prolongs survival in women with this disease. Up to now, surgery or
radiation alone has been considered standard treatment for this form of
cancer.
from
The Office On Women's Health - US Department of Health and Human Services
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