Cervical Cancer

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Cervical Cancer: 

Cervical Cancer Dr. Rizwana Syed M.S Ob Gyn

Introduction : 

Introduction

What is the Cervix: 

What is the Cervix Opening of the uterus (womb) into the vagina

How common is cervical Ca.: 

How common is cervical Ca . 500,000 women worldwide die of cervical cancer annually 12,200 new cervical cancers diagnosed in the U.S. per year 4,100 deaths from cervical cancer in the U.S. per year Most cervical cancer can be prevented

Cervical Cancer: 

It is a cancer of the female reproductive tract It is the most common cause of cancer death in the world where Pap tests are not available It is the easiest gynecologic cancer to prevent through screening Types Two cell types present ( squamous and glandular ) Cervical cancers tend to occur where the two cell types meet Cervical Cancer

What causes cervical cancer?: 

The central cause of cervical cancer is a virus. This virus is called HPV (human papillomavirus ). human papillomavirus or HPV: HPV is sexually transmitted The HPV detected today could have been acquired years ago What causes cervical cancer?

If I have HPV, does it mean I will get cancer?: 

NO! In most cases HPV goes away Only women with persistent HPV (where the virus does not go away) are at risk for cervical cancer How common Is HPV? Most men and women who have had sex have been exposed to HPV More than 75% of sexually active women tested have been exposed to HPV by age 18-22 If I have HPV, does it mean I will get cancer?

Who is at risk?: 

Any women who ever had sexual intercourse Who is at risk?

Sexual activity that increases the risk for infection with HPV and for cervical cancer includes: : 

Having multiple sexual partners or having sex with a promiscuous partner History of sexually transmitted disease (STD) Sexual intercourse at a young age (before age 18) Not using condoms with new partners Sexual partner's previous partner had cervical cancer or abnormal cervical cells. Sexual partner has or had cancer of the penis. Women who smoke Sexual activity that increases the risk for infection with HPV and for cervical cancer includes:

Other Risk Factors : 

Age Race Poor diet, and other infections. Abnormal Pap smear. Previous genital or vaginal cancer. Cigarette smoking. Immune defenses are low (e.g., transplants, taking immunosuppressive drugs, or AIDS. Mother took DES when pregnant with the patient. Other Risk Factors

Symptoms: 

Symptoms Abnormal vaginal bleeding (e.g., spotting after sexual intercourse, bleeding between menstrual periods, increased menstrual bleeding). Abnormal (yellow, odorous) vaginal discharge , often of a yellow or green color and foul smelling. Low back pain Cervical Pain, noted when a tampon, finger or penis is inserted into the vagina. Painful sexual intercourse Painful urination is seen with advancing disease Some women have no symptoms at all.

Stages: 

Stages

Diagnosis: 

Diagnosis PAP SMEAR COLPOSCOPY CERVICAL BIOPSY

PAP SMEAR: 

PAP SMEAR

COLPOSCOPY: 

COLPOSCOPY A visual examination of the surface of the cervix using a colposcope- an instrument with magnifying lenses and a light . If abnormalities are seen, a tissue sample (biopsy) may be taken and sent for evaluation.

Biopsy: 

May feel like getting a Pap test or like a menstrual cramp that lasts a few seconds Biopsy

Screening: PAP SMEAR: 

Screening: PAP SMEAR Three years after the onset of sexual intercourse No later than age 21 How often do I need a Pap test? When do I need my first Pap test? Every year until age 30 After age 30, if you have only had normal results, you may have them every two to three years after discussion with your physician and evaluation of your risk factors

It is the easiest gynecologic cancer to prevent through screening I feel fine, so why do I need a Pap test? A Pap test can find treatable changes of the cervix ( precancer ) before you have a symptom or notice a problem Once a problem is symptomatic, it is harder to treat Why do I need to keep getting tested? Changes (abnormalities) may occur since the last test It may take many years for changes to develop or be detected Your risk changes if you have new partners

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What is the best time to have a Pap test? Schedule your Pap when you are not having a menstrual period It is best to abstain from intercourse and avoid use of tampons or douches for two days before your Pap test If you have an abnormal result, it is extremely important to follow-up for the recommended testing Even after a normal Pap test, it is still important to report any symptoms of abnormal vaginal bleeding, discharge or pain to your doctor and call to be seen right away

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Is there an age when I can stop having Pap tests? The American Cancer Society recommends that screening stop at age 70, if three or more recent tests are normal, and there have been no abnormal results in the last 10 years.

Prevention: 

Prevention

HPV Vaccine: 

Who should be vaccinated and when? To be most effective, the HPV vaccine should be given before a female has any type of sexual contact with another person. It is given in a series of 3 doses within 6 months. Here are the recommendations for each age group: girls ages 11 to 12 The vaccine should be given to girls ages 11 to 12 and as early as age 9. girls ages 13 to 18 Girls ages 13 to 18 who have not yet started the vaccine series or who have started but have not completed the series should be vaccinated. young women ages 19 to 26 Some authorities recommend vaccination of women ages 19 to 26, but the American Cancer Society experts believed that there was not enough evidence of the benefit to recommend vaccinating all women in this age group. It is recommended that women ages 19 to 26 talk to their doctors about whether to get the vaccine based on their risk of previous HPV exposure and potential benefit from the vaccine HPV Vaccine

HPV Vaccine: 

What are the benefits of the vaccine? The vaccine will prevent the 2 types of HPV that cause most cervical cancers (about 70%) and the 2 types of HPV that cause most genital warts (about 90%), but only in women who have not already been exposed to these types of HPV. It also helps prevent vulvar and vaginal cancers related to these 2 types of HPV. The vaccine will not prevent HPV in women who have already had these HPV types. People who get vaccinated will still need Pap tests because the vaccine will not prevent all types of HPV that can cause cervical cancer. HPV Vaccine

How do I lower my risk?: 

Delay onset of sexual activity Know your sexual partner Do not smoke Maintain a healthy diet and lifestyle Practice safe sex How do I lower my risk? Get your Pap test

Treatment: 

Treatment Surgery (hysterectomy) Radiation Therapy External Radiation Chemotherapy

Myths: 

HPV is Uncommon Cervical Cancer Only Occurs in Developing Countries Mostly Promiscuous Women Get Cervical Cancer If You Have HPV, You Will Develop Cervical Cancer Condoms Provide 100% Protection Against HPV Older Women Don't Need Pap Smears I'm too young to worry about cervical cancer I had the HPV vaccine, so I don't need to use condoms during sex…. Myths

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Thank You drrizwanasyed@hotmail.com