I chose to do my research paper on Cervical Cancer. I did this because this is the disease that took the life of my fiances mother. It has been to my understanding that this would mean she is at a higher risk for this disease. I have put together five questions that I would like to research on the topic to give myself a further understanding of the potential dangers of Cervical Cancer. These questions are: What is Cervical Cancer? What causes Cervical Cancer? How do we Diagnose Cervical Cancer? What are the stages of Cervical Cancer?
How do we treat Cervical Cancer? I believe if I answer these questions I will have at least some piece of mind. What is cervical cancer? The cervix of the uterus is the ninth most common site of cancers affecting women. As compared with all the cancers of the reproductive organs of women, it rates third, after uterine cancer and ovarian cancer. (Medical and Health Encyclopedia, 2000, pp. 435-436) The cervix is the lower part of the uterus . The body of the uterus is where a baby grows. The cervix connects the body of the uterus to the vagina.
The part of the cervix closest to the body of the uterus is called the endocervix. The part next to the vagina is the exocervix. The 2 main types of cells covering the cervix are squamous cells and glandular cells. The place where these 2 cell types meet is called the transformation zone. Most cervical cancers start in the transformation zone. Also most cervical cancers begin in the cells lining the cervix. These cells do not suddenly change into cancer. Instead, the normal cells of the cervix first gradually develop pre-cancerous changes that turn into cancer.
Doctors use several terms to describe these pre-cancerous changes, including cervical intraepithelial neoplasia (CIN), squamous intraepithelial lesion (SIL), and dysplasia. Cervical cancers and cervical pre-cancers are classified by how they look under a microscope. There are 2 main types of cervical cancers: squamous cell carcinoma and adenocarcinoma. About 80% to 90% of cervical cancers are squamous cell carcinomas. These cancers are from the squamous cells that cover the surface of the exocervix. Under the microscope, this type of cancer is made up of cells that are like squamous cells.
Squamous cell carcinomas most often begin where the exocervix joins the endocervix. Most of the remaining cervical cancers are adenocarcinomas. Although cervical cancers start from cells with pre-cancerous changes (pre-cancers), only some of the women with pre-cancers of the cervix will develop cancer. The change from cervical pre-cancer to cervical cancer usually takes several years, but it can happen in less than a year. For most women, pre-cancerous cells will go away without any treatment. Still, in some women pre-cancers turn into true (invasive) cancers.
Treating all pre-cancers can prevent almost all true cancers. Pre-cancerous changes are separated into different categories based on how the cells of the cervix look under a microscope. Although almost all cervical cancers are either squamous cell carcinomas or adenocarcinomas, other types of cancer also can develop in the cervix. These other types, such as melanoma, sarcoma, and lymphoma, occur more commonly in other parts of the body. (What Is Cervical Cancer, 2010) What causes Cervical Cancer? A viral infection called the human papillomavirus (HPV) causes about 70-90% of all cervical cancers.
HPV describes a group of viruses that includes more than 100 different types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of both men and women. However, most people who have healthy immune systems experience no symptoms of the virus. Currently, there is no cure for HPV. When a woman is exposed to HPV, her immune system usually prevents the virus from doing any serious harm. But in a small number of women, the virus survives for years. Eventually, the virus can lead to the conversion of normal cells on the surface of the cervix into cancerous cells.
At first, the cells may only show signs of a viral infection. Eventually, however, the cells may develop precancerous changes. This is known as cervical intraepithelial neoplasia. Typically, the precancerous changes clear on their own. In some cases, however, cervical intraepithelial neoplasia eventually progresses to invasive cervical cancer. (Pruthi ,2009) How do we Diagnose Cervical Cancer? Most often, cervical cancer is first detected with a Pap test that is performed as part of a regular pelvic examination. The vagina is spread with a metal or plastic instrument called a speculum.
A swab is used to remove mucous and cells from the cervix. This sample is sent to a laboratory for microscopic examination. The Pap test is a screening tool rather than a diagnostic tool. It is very efficient at detecting cervical abnormalities. The Bethesda System commonly is used to report Pap test results. A negative test means that no abnormalities are present in the cervical tissue. A positive Pap test describes abnormal cervical cells as low-grade or high-grade SIL, depending on the extent of dysplasia. About 5-10% of Pap tests show at least mild abnormalities.
However, a number of factors other than cervical cancer can cause abnormalities, including inflammation from bacteria or yeast infections. A few months after the infection is treated, the Pap test is repeated. Following an abnormal Pap test, a colposcopy is usually performed. The physician uses a magnifying scope to view the surface of the cervix. The cervix may be coated with an iodine solution that causes normal cells to turn brown and abnormal cells to turn white or yellow. This is called a Schiller test. If any abnormal areas are observed, a colposcopic biopsy may be performed.
A biopsy is the removal of a small piece of tissue for microscopic examination by a pathologist. Other types of cervical biopsies may be performed. An endocervical curettage is a biopsy in which a narrow instrument called a curette is used to scrape tissue from inside the opening of the cervix. A cone biopsy, or conization, is used to remove a cone-shaped piece of tissue from the cervix. In a cold knife cone biopsy, a surgical scalpel or laser is used to remove the tissue. A loop electrosurgical excision procedure (LEEP) is a cone biopsy using a wire that is heated by an electrical current.
Cone biopsies can be used to determine whether abnormal cells have invaded below the surface of the cervix. They also can be used to treat many precancers and very early cancers. Biopsies may be performed with a local or general anesthetic. They may cause cramping and bleeding. (Gale Encyclopedia of Cancer, 2005) What are the stages of Cervical Cancer? The stages of Cervical cancer are many. They start at a stage 0 which is a non invasive cancer and would be considered a minimal threat if caught in this stage. The cancer in stage 0 has not spread through the Cervix, nor to the rest of the tissues of the body.
The final stage is a stage known as recurrent which means after you have already gone through treatment, the cancer returns again to the Cervix. The following is a very helpful chart I found listing the various stages: * Stage 0: Carcinoma in situ; non-invasive cancer that is confined to the layer of cells lining the cervix. * Stage I: Cancer that has spread into the connective tissue of the cervix but is confined to the uterus. * Stage IA: Very small cancerous area that is visible only with a microscope. * Stage IA1: Invasion area is less than 3 mm (0. 13 in) deep and 7 mm (0. 33 in) wide.
* Stage IA2: Invasion area is 3–5 mm (0. 13-0. 2 in) deep and less than 7 mm (0. 33 in) wide. * Stage IB: Cancer can be seen without a microscope or is deeper than 5 mm (0. 2 in) or wider than 7 mm (0. 33 in). * Stage IB1: Cancer is no larger than 4 cm (1. 6 in). * Stage IB2: Stage IB cancer is larger than 4 cm (1. 6 in). * Stage II: Cancer has spread from the cervix but is confined to the pelvic region. * Stage IIA: Cancer has spread to the upper region of the vagina, but not to the lower one-third of the vagina. * Stage IIB: Cancer has spread to the parametrial tissue adjacent to the cervix.
* Stage III: Cancer has spread to the lower one-third of the vagina or to the wall of the pelvis and may be blocking the ureters. * Stage IIIA: Cancer has spread to the lower vagina but not to the pelvic wall. * Stage IIIB: Cancer has spread to the pelvic wall and/or is blocking the flow of urine through the ureters to the bladder. * Stage IV: Cancer has spread to other parts of the body. * Stage IVA: Cancer has spread to the bladder or rectum. * Stage IVB: Cancer has spread to distant organs such as the lungs. * Recurrent: Following treatment, cancer has returned to the cervix or some other part of the body.
(Gale Encyclopedia of Cancer, 2005) How do we treat Cervical Cancer? A simple hysterectomy is used to treat some stages O and IA cervical cancers. Usually only the uterus is removed, although occasionally the fallopian tubes and ovaries are removed as well. The tissues adjoining the uterus, including the vagina, remain intact. The uterus may be removed either through the abdomen or the vagina. In a radical hysterectomy, the uterus and adjoining tissues, including the ovaries, the upper region (1 in) of the vagina near the cervix, and the pelvic lymph nodes, are all removed.
A radical hysterectomy usually involves abdominal surgery. However it can be performed vaginally, in combination with a laparoscopic pelvic lymph node dissection. With laparoscopy, a tube is inserted through a very small surgical incision for the removal of the lymph nodes. These operations are used to treat stages IA2, IB, and IIA cervical cancers, particularly in young women. Following a hysterectomy, the tissue is examined to see if the cancer has spread and requires additional radiation treatment.
Women who have had hysterectomies cannot become pregnant, but complications from a hysterectomy are rare. If cervical cancer recurs following treatment, a pelvic exenteration (extensive surgery) may be performed. This includes a radical hysterectomy, with the additional removal of the bladder, rectum, part of the colon, and/or all of the vagina. Such operations require the creation of new openings for the urine and feces. A new vagina may be created surgically. Often the clitoris and other outer genitals are left intact. Recovery from a pelvic exenteration may take 6 months to 2 years.
This treatment is successful with 40-50% of recurrent cervical cancers that are confined to the pelvis. If the recurrent cancer has spread to other organs, radiation or chemotherapy may be used to alleviate some of the symptoms. Radiation therapy, which involves the use of high-dosage X rays or other high-energy waves to kill cancer cells, often is used for treating stages IB, IIA, and IIB cervical cancers, or in combination with surgery. With external-beam radiation therapy, the rays are focused on the pelvic area from a source outside the body.
With implant or internal radiation therapy, a pellet of radioactive material is placed internally, near the tumor. Alternatively, thin needles may be used to insert the radioactive material directly into the tumor. Chemotherapy, the use of one or more drugs to kill cancer cells, is used to treat disease that has spread beyond the cervix. Most often it is used following surgery or radiation treatment. Stages IIB, III, IV, and recurrent cervical cancers usually are treated with a combination of external and internal radiation and chemotherapy.
The common drugs used for cervical cancer are cisplatin, ifosfamide, and fluorouracil. These may be injected or taken by mouth. The National Cancer Institute recommends that chemotherapy with cisplatin be considered for all women receiving radiation therapy for cervical cancer. (Cervical Cancer Treatment, 2010) So in conclusion, I am a lot less worried about my family and their likelihood of being diagnosed with Cervical cancer. From what I have learned from doing this paper, as long as they are tested regularly (via. Pap tests) any cancer that would present itself would be found in early stages.
This would mean, though not preferable, that if needed it could be removed through mildly invasive procedures. I have learned quite a bit from writing this paper and think I am more aware for having done it.
References Cervical Cancer Diagnosis and Treatment. (2009, July 20).Retrieved August 2, 2010, from Center for Disease Control and Prevention Web site: http://www. cdc. gov/cancer/cervical/basic_info/diagnosis_treatment. htm Cervical Cancer Treatment. (n. d. ). Retrieved August 2, 2010, from The National Cancer Institute Web site: http://www. cancer.gov/cancertopics/pdq/treatment/cervical/healthprofessional Gale Encyclopedia of Cancer. (2005).
Thomson Gale. Retrieved from http://www. answers. com/topic/cervical-cancer Medical and Health Encyclopedia (Deluxe ed. ). (2000). (pp. 435-436). Chicago, IL: Furguson Publishing Company. Pruthi, S. , M. D. (2009, January 17). How Does HPV Cause Cervical Cancer? Retrieved August 1, 2010, from Mayo Clinic Web site: http://www. mayoclinic. com/health/cervical-cancer/AN00386 Society Web site: http://www. cancer. org/Cancer/CervicalCancer/DetailedGuide/cervical-cancer-wha.