RISK FACTORS:
* Human papilloma virus infection
* Smoking
* Immunosuppression
* Chlamydia infection
* Diet
* Oral contraceptives (birth control pills)
* Intrauterine device use
* Multiple full-term pregnancies
* Young age at the first full-term pregnancy
* Poverty
* Diethylstilbestrol (DES)
* Family history of cervical cancer
PREVENTION
Testing (screening)
* Regular Pap test
* Pelvic exam
* Condoms and HPV
* Don’t smoke
* Get vaccinated
Gardasil, Cervarix
Guidelines for early detection:
All women should begin cervical testing at age 21.
Age 30 (Pap test + HPV test q 5 years) until age 65.
High risk of cervical cancer: need to be screened more often and follow the recommendations of their doctors. Women underwent Total hysterectomy: should stop screening Women who have been vaccinated against HPV should still follow these guidelines Accurate pap tests
Not on menstrual period.
No douche
No sexual intercourse
Pap test results
* Conventional cytology
* Liquid-based cytology
Bethesda System
The general categories are:
Negative for intraepithelial lesion or malignancy,
Epithelial cell abnormalities, and
Other malignant neoplasms.
* Squamous intraepithelial lesions (SILs)
* Squamous cell carcinoma
* Adenocarcinoma
* Atypical glandular cells
* Atypical squamous cells
The HPV DNA test
SIGNS AND SYMPTOMS OF CERVICAL CANCER:
* Women with early cervical cancers and pre-cancers usually have no symptoms. * Symptoms often do not begin until the cancer becomes invasive and grows into nearby tissue. * Abnormal vaginal bleeding
* Menopausal bleeding
* Spotting between periods
* longer or heavier than usual
* Bleeding after douching or after a pelvic exam may also occur. * Vaginal discharges
* Dyspareunia
ASSESSEMNT:
* Medical history and physical exam
* Colposcopy
* Cervical biopsies
* Colposcopic biopsy
* Endocervical curettage
* Cone biopsy
* LEEP
* Cold knife cone biopsy
* biopsy results are reported: different from the Bethesda System – CIN1, CIN2, CIN3
– Cystoscopy, proctoscopy, and examination under anesthesia
IMAGING STUDIES:
* Chest x-ray
* Computed tomography
* CT-guided needle biopsy Magnetic resonance imaging
* Intravenous urography
* Positron emission tomography
SURGERY
* CRYOSURGERY
* LASER SURGERY
* CONIZATION
* HYSTERECTOMY
abdominal hysterectomy
vaginal hysterectomy
laparoscopic hysterectomy
robotic-assisted surgery
* RADICAL HYSTERECTOMY
* TRACHELECTOMY
* PELVIC EXENTERATION
* PELVIC LYMPH NODE DISSECTION
RADIATION THERAPY
* External beam radiation therapy
* 6 to 7 weeks
* Cisplatin
* Brachytherapy
* tandem and ovoid treatment
* 2 main types of treatment (low-dose rate and high-dose rate brachytherapy) * Side effects:
Tiredness
upset stomach
loose bowels
nausea and vomiting
anemia
leukopenia
* Feeling sunburned
ANTI-CANCER DRUGS
* cisplatin, paclitaxel (Taxol®),
* topotecan, ifosfamide (Ifex®), and 5-fluorouracil (5-FU). * side effects of chemotherapy might include:
Nausea and vomiting
Loss of appetite
Loss of hair
Mouth sores
An increased chance of infection Bleeding or bruising after minor cuts or injuries SOB, Fatigue
Chemoradiation
* CONCURRENT CHEMORADIATION
* cisplatin, 5FU
Making healthier choices
* Eating better
* Rest, fatigue, and exercise.