Cardiovascular

What Is Cervical Cancer? What Causes Cervical Cancer?

the sample is collected in much the same way as a conventional smear. However, instead of smearing the sample onto a microscope slide, the head of the brush where the sample cells are caught is broken off and placed in a small glass vial which contains preservative fluid - sometimes it can be rinsed directly into the preservative fluid. In the laboratory it is spun and treated to remove mucus, pus and other materials. A random sample of the remaining cells is taken. A thin layer of the cells is placed on a microscope slide and examined. The test is not designed for diagnosing cancer. It is designed to check the health of the cervix and to detect early changes in the cells, which could develop into cancer in the future. The best time to have the test is in the middle of the menstrual cycle - between periods. If the test results show abnormal cells in the cervix the doctor will refer the patient to a gynecologist. In the UK the patient may also be referred to a nurse colposcopist. *HPV DNA test - also known as just "HPV test". This test determines whether the patient is infected with any of the HPV types that are most likely to cause cervical cancer. This involves collecting cells from the cervix for lab testing. The test can detect high risk HPV strains in cell DNA before any cervix cell abnormalities appear. A British study found that the combination of HPV testing with regular liquid-based cytology (LBC) screening does not improve the detection of cervical cancer compared with LBC screening alone. An eight-year trial involving more than 130,000 women published in The New England Journal of Medicine found that that in low-re settings a single round of HPV testing significantly reduces the numbers of advanced cervical cancers and deaths, compared with Pap (cytology) testing. If the patient experiences signs and symptoms of cervical cancer, or if the Pap test revealed abnormal cells, the patient may undergo additional tests: *Biopsy - a small piece of tissue will be taken. The patient will be anesthetized for this. *Colposcopy - this is performed in the doctor"s office. A speculum is placed to hold the vagina open and the gynecologist looks at the cervix through a colposcope - a lighted magnifying instrument specifically designed for examining the tissues of the vagina and the cervix. If the doctor is still unable to see the abnormal area clearly a cone biopsy or LETTZ may be done. *Cone biopsy - a small cone-shaped section of the abnormal tissue is taken from the cervix for examination under a microscope. The patient is usually under local anesthetic; sometimes general anesthetic is used. The biopsy may indicate whether the abnormal cells are CIN 1, 2 or 3, or whether deeper levels of the cervix are affected. *LLETZ - a diathermy (wire loop with an electric current) is used to remove abnormal tissue. The tissue is sent to the lab to be checked. This is a common treatment for CIN. *Blood tests - a blood test will reveal the number of blood cells, as well as identifying any liver or kidney problems. *Chest x-ray - this is to determine the health of the patient"s lungs and heart. *Examination under anesthetic (EUA) - this allows the doctor to examine the vagina and cervix more thoroughly. The patient is under a general anesthetic. The doctor may also check the bladder with a cystoscope, or/and the colon and rectum with a procto-sigmoidoscope to determine whether the cancer has spread. During this whole procedure the doctor may take a biopsy of the bladder, colon/rectum and the lining of the uterus. *CT (computerized tomography) scan - a CT scanner emits a series of narrow beams through the human body as it moves through an arc, unlike an X-ray machine which sends just one radiation beam. The final picture is far more detailed than an X-ray one. Inside the CT scanner there is an X-ray detector which can see hundreds of different levels of density. It can see tissues inside a solid organ. This data is transmitted to a computer, which builds up a 3-D cross-sectional picture of the part of the body and displays it on the screen. The doctor will have a much better idea of the size and position of the cancer. The patient will have to have a barium drink beforehand. The barium appears white on the scan. Just before the scan a tampon may be placed into the vagina, and a barium liquid may be placed into the rectum. The whole scan takes from 10 to 30 minutes. *MRI (magnetic resonance imaging scan) - an MRI does not use X-rays; it uses magnets and radio waves to build up cross-sectional images of the targeted part of the body. The patient lies very still on a couch inside a long tube which enters a doughnut-like machine. As the machine can become noise patients will usually be given earphones so that they can listen to music - some may even let you bring your own tunes. All metal items should be removed beforehand because the MRI machine is a powerful magnet. If you have any metal in your body, such as a pacemaker or surgical clips you cannot have an MRI scan. By using high-MRI with a special vaginal coil, a technique to measure the movement of water within tissue, researchers may be able to identify cervical cancer in its early stages, researchers at Cancer Research UK Clinical Magnetic Resonance Research Group reported. *Pelvic ultrasound - this is a device that uses high frequency sound waves which create an image on a monitor of the target area. The patient will be asked to drink plenty of fluids beforehand so that the bladder is full and a clear picture can be viewed. A transvaginal ultrasound device may be inserted into the vagina, or an external device may be placed next to the stomach. Pretreatment MRI and PET/CT for cervical cancer may direct more women to optimal therapy choices and spare many women potential long-term morbidity and complications of trimodality therapy (surgery followed by chemoradiation), according to a study performed at the Institute for Technology Assessment in Boston. What are the stages of cervical cancer? After carrying out the various tests the doctor will determine the stage of the cancer. The stage of a cancer refers to how far it has spread. Determining the stage of the cancer is important because it is the main factor in deciding on treatment options. Cancers have various staging systems. In cervical cancer, stages are numbered from 0 to 4. If you have CIN it means you have abnormal cells, it is not the same as cervical cancer and the stages below do not apply, except for perhaps stage 0. *Stage 0 - Carcinoma in situ (stage 0) Even though there are only abnormal cells on the surface layer of the cervix and this is not considered to be part of the cervical cancer staging system, many doctors will call this Stage 0. It is not an invasive cancer; the cells have not left the area where they started to grow. This is the same as CIN 3. *Stage 1 cervical cancer The cancer is only in the cervix (the neck of the uterus, womb). This stage is divided into: *Stage 1A - cancer is microscopic; it can only be viewed through a microscope. This stage is divided into two: 1A1 - cancer has grown into less than 3 mm of the cervical tissue, and is less than 7mm wide. 1A2 - cancer has grown 3-5mm into cervical tissue, and is less than 7mm wide. *Stage 1B - cancer is larger and is usually visible with the naked eye, but is confined to the cervical tissue and has not spread. This stage is divided into two: 1B1 - cancer is no larger than 4cm. 1B2 - cancer is larger than 4cm. This stage of cervical cancer is generally treated with surgery or radiotherapy. For patients at Stage 1B2 a combination of chemotherapy and radiotherapy may be recommended sometimes. *Stage 2 cervical cancer The cancer includes the cervix and uterus, but has not yet spread into the pelvic wall or lower portions of the vagina. It is divided into two stages: *Stage 2A - the cancer has reached the top of the vagina. *Stage 2B - the cancer has reached tissue around the cervix. Treatment for Stage 2A usually consists of surgery or radiotherapy, and sometimes both. Treatment for Stage 2B invariably consists of a combination of radiotherapy and chemotherapy. *Stage 3 cervical cancer The cancer has spread beyond the cervix and uterus and has reached the surrounding structures of the pelvic area, the lower portion of the vagina, and the pelvic wall (muscles and ligaments that line the pelvis). The cancer growth may have blocked the ureter (the tube that carries urine from the kidneys to the bladder). It is divided into two stages: *Stage 3A - the cancer has reached the lower third of the vagina, but not the pelvic wall. *Stage 3B - the cancer has grown through the pelvic wall, or is blocking one ureter or both of them. The most common treatment option for this stage is a combination of chemotherapy and radiotherapy. *Stage 4 cervical cancer Advanced cancer; the cancer has spread to nearby organs, such as the bladder or rectum, or it has spread further into other parts of the body, such as the liver, lungs or bones. This is divided into two stages: *Stage 4A - the cancer has reached the bladder or rectum (nearby organs). *Stage 4B - the cancer has spread further, possibly including the lungs, liver or bones. What are the treatment options for cervical cancer? It is important to ask questions about any aspects of your treatment that you are not sure about, or anything that worries you. Talking about the benefits and disadvantages of various options with an expert, such as a gynecologist, gynecological nurse or your GP (general practitioner, primary care physician) will help you understand the process. Some people find it useful to write down a list of questions, while others appreciate the company and support of a relative or close friend when they go to the doctor. Cancer treatments can sometimes be complex and bewildering and not that straightforward for lay people to figure out. Doctors and

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