Sunday, August 30, 2009

HPV vaccines cannot treat women who are already infected

A new study suggests that cervical cancer vaccines for human papillomavirus (HPV) do not reduce or eliminate preexisting infections.

Study researcher Allan Hildesheim at the National Cancer Institute says that, based on this research, the best approach is to vaccinate girls and women before they initiate any sexual activity.

The CDC recommends that girls should be vaccinated around 11 to 12 years of age, most of whom would not have already become sexually active. According to Hildesheim, for women who have already become sexually active, cervical cancer screening is a better preventative measure than vaccination.
The study showed that the body can clear many HPV infections on its own, but that vaccinating does not increase the clearance rate in infected women.

The CDC recommends the vaccines for women up to age 26. Recommendations that women should receive regular Pap smears remain unchanged.
Article source : http://www.thecancerblog.com/category/cervical-cancer/

Variety of Pap virus is consistent across continents, vaccines should be effective around the world

The distribution of the different types of human papilloma virus that cause cervical cancer are consistent across the world, according to a new study from the University of North Carolina at Chapel Hill.

This means that the vaccines that are currently available to protect against the two most prevalent types of HPV could prevent about 70 percent of invasive cervical cancer cases not just in the U.S, but around the world.

The researchers report that HPV16 is the most common and HPV18 is the second-most common typie in all continents. Gardasil by Merck protects against both of these types as does a similar vaccine developed by GlaxoSmithKline.

Lead study author Jennifer Smith, Ph.D cautions, "While having these vaccines represents a significant step forward, HPV-vaccinated women will need to receive clear messages that they still need to obtain their recommended Pap smears for cervical cancer prevention, given that HPV vaccines will not prevent all invasive cancer or high-grade lesions."

Cervical cancer: a disease of 'loose' women?

It's been proven that cervical cancer has a significant connection with unprotected sex and STDs, particularly HPV. So is issuing a drug proven to prevent HPV to school-age girls a way to help them protect themselves from cancer? Or is it, as the Christian Voice in Britain believes, the equivalent to calling all school-age girls promiscuous, in turn suggesting that they are not morally intelligent enough to abstain from sex until marriage?

This debate has arisen in the UK in response to a call from a group called Jo's Trust to vaccinate school-age girls against HPV with a drug called Gardasil, which has been shown to protect against HPV 100%. Stephen Green of the Christian Voice has this to say about it:

The message is one of despair, disrespect and low expectations. Anyone giving this drug to a girl is telling her: "I think you are a slag". But it is also irresponsible and will raise promiscuity, teenage pregnancy and, worst of all, infertility. Young women will be thinking they have more protection than they actually have.
Article Source : http://www.thecancerblog.com/category/cervical-cancer/

Monday, August 17, 2009

Prevalence of genital HPV - HPV Vaccine

United States

See also: HPV: Prevalence of Genital HPV

According to the Centers for Disease Control and Prevention, by the age of 50 more than 80% of American women will have contracted at least one strain of genital HPV. Both men and women can be carriers of HPV. HPV is the most common sexually transmitted infection in the US. A large percentage of the American population is infected with genital HPV because HPV is highly communicable. As a result, American public health experts recommend widespread HPV vaccination.

Only a small percentage of women with HPV develop cervical cancer. Each year, between 250,000 and 1 million American women are diagnosed with cervical dysplasia, which is caused by HPV and is a potential precursor to cervical cancer. About 11,000 American women are diagnosed with cervical cancer every year, and about 3,700 die per year of the disease. Most cancers occur in those who have not had Pap smears within the previous five years.


HPV-induced cancers

There are 19 "high-risk" HPV types that can lead to the development of cervical cancer or other genital/anal cancers; some forms of HPV, particularly type 16, have been found to be associated with a form of throat cancer.[28] Studies have found that human papillomavirus (HPV) infection is responsible for virtually all cases of cervical cancer.

Condoms protect against HPV, but do not completely prevent transmission. College freshmen women who used condoms consistently had a 37.8% per patient-year incidence of genital HPV, compared to an incidence of 89.3% among those who did not.

No data is kept by the U.S. government on genital wart infection rates,[33] however it is estimated that 20 million people are presently infected with genital warts, and there are six million new cases of genital warts every year in the United States.


Worldwide

Worldwide, cervical cancer is the fifth most deadly cancer in women. There are an estimated 470,000 new cases of cervical cancer, and 233,000 deaths per year.


Vaccination and public health

Gardasil is available poster for a university health clinicAccording to the American National Cancer Institute, "Widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds, if all women were to take the vaccine and if protection turns out to be long-term. In addition, the vaccines can reduce the need for medical care, biopsies, and invasive procedures associated with the follow-up from abnormal Pap tests, thus helping to reduce health care costs and anxieties related to abnormal Pap tests and follow-up procedures."

Current preventive vaccines protect against the two HPV types that cause about 70% of cervical cancers worldwide. Because of the distribution of HPV types associated with cervical cancer, the vaccines are likely to be most effective in Asia, Europe, and North America. Vaccines that protect against more of the types common in cancers would prevent more cancers, and be less subject to regional variation.

Only 41% of women with cervical cancer in the developing world are able to access medical treatment for their illness. Therefore, prevention of HPV by vaccination may be a more effective way of lowering the disease burden in developing countries than cervical screening.[citation needed] However, individuals in many resource-limited nations, Kenya for example, are unable to afford the vaccine.


Vaccine target populations

Gardasil and Cervarix are preventative vaccines and do not have efficacy for treating active HPV infection. They are recommended for women who are 9 to 25 years old who have yet to contract HPV. However, since it is unlikely that a woman will have already contracted all four viruses, and because HPV is primarily sexually transmitted, the U.S. Centers for Disease Control and Prevention has recommended vaccination for women up to 26 years of age.

When Gardasil was first introduced, it was recommended as a prevention for cervical cancer for women that were 25 years old or younger. New evidence suggests that all Human Papillomavirus (HPV) vaccines are effective in preventing cervical cancer for women up to 45 years of age.

In November 2007, Merck presented new data on Gardasil. In an investigational study, their HPV vaccine reduced incidence of HPV and 18-related persistent infection and disease in women through age 45. The study evaluated women who had not contracted at least one of the HPV types targeted by the vaccine by the end of the three-dose vaccination series. Merck planned to submit this data before the end of 2007 to the U.S. Food and Drug Administration (FDA), and to seek an indication for Gardasil for women through age 45.


Vaccination during pregnancy

In the Gardasil clinical trials, 1,115 pregnant women received the HPV vaccine. Overall, the proportions of pregnancies with an adverse outcome were comparable in subjects who received Gardasil and subjects who received placebo. However, the clinical trials had a relatively small sample size. Currently the vaccine is not recommended for pregnant women.The long-term effects of the vaccine on fertility are not known, but no effects are anticipated.


Vaccination of males

Gardasil can also be used in males to reduce their risk of genital warts and precancerous lesions caused by HPV. The reduction in precancerous lesions is expected to reduce the rates of penile and anal cancers in men. Since penile and anal cancers are much less common than cervical cancer, HPV vaccination of young men is likely to be much less cost-effective than for young women. From a public health point of view, vaccinating men as well as women might be useful if it decreased the virus pool within the population. Gardasil is in particular demand among gay men, who are at significantly increased risk for genital warts, penile cancer, and anal cancer.

As with females, the vaccine must be administered before infection with the HPV types covered by the vaccine occurs. Vaccination before adolescence makes it more likely that the recipient has not been exposed to HPV.

In the UK, HPV vaccines are licensed for boys aged 9–15. Merck, the maker of Gardasil, is expected to ask the U.S. Food and Drug Administration (FDA) for permission to market the vaccine in the United States for boys and men ages 9–26. The vaccine is already available in the United States and can be used off label for the vaccination of males.


Mechanism of action

The latest generation of preventive HPV vaccines is based on hollow virus-like particles (VLPs) assembled from recombinant HPV coat proteins. The vaccines target the two most common high-risk HPVs, types 16 and 18. Together, these two HPV types currently cause about 70 percent of all cervical cancer. Gardasil also targets HPV types 6 and 11, which together currently cause about 90 percent of all cases of genital warts.

Gardasil and Cervarix are designed to elicit virus-neutralizing antibody responses that prevent initial infection with the HPV types represented in the vaccine. The vaccines have been shown to offer 100 percent protection against the development of cervical pre-cancers and genital warts caused by the HPV types in the vaccine, with few or no side effects. The protective effects of the vaccine are expected to last a minimum of 4.5 years after the initial vaccination.

While the study period was not long enough for cervical cancer to develop, the prevention of these cervical precancerous lesions (or dysplasias) is believed highly likely to result in the prevention of those cancers.

Although a 2006 study suggests that the vaccines may offer limited protection against a few HPV types that are closely related to HPVs there are other high-risk HPV types are not affected by the vaccines. Ongoing research is focused on the development of HPV vaccines that will offer protection against a broader range of HPV types.[47] There is also substantial research interest in the development of therapeutic vaccines, which seek to elicit immune responses against established HPV infections and HPV-induced cancers.


Vaccine implementation

Main article: vaccination policy

In developed countries, the widespread use of cervical "Pap smear" screening programs has reduced the incidence of invasive cervical cancer by 50% or more. Current preventive vaccines reduce, but do not eliminate the chance of getting cervical cancer. Therefore, experts recommend that women combine the benefits of both programs by seeking regular Pap smear screening, even after vaccination.

HPV vaccine

Human papillomavirus (HPV) vaccine is a vaccine that prevents infection with certain species of human papillomavirus associated with the development of cervical cancer, genital warts, and some less common cancers (e.g., anal, vulvar, vaginal,penile.

Two HPV vaccines are currently on the market: Gardasil and Cervarix. Both vaccines protect against two of the HPV types that can contribute to the development of cervical cancer, and some other genital cancers; Gardasil also protects against two of the HPV types that cause genital warts.

Public health officials in Australia, Canada, Europe and United States recommend vaccination of young women against HPV to prevent cervical cancer and genital warts, and to reduce the number of painful and costly treatments for cervical dysplasia, which is caused by HPV. Worldwide, HPV is the most common sexually transmitted infection in adults. For example, more than 80% of American women will have contracted at least one strain of HPV by age fifty.

Although most women infected with genital HPV will not have complications from the virus, worldwide there are an estimated 470,000 new cases of cervical cancer that result in 233,000 deaths per year. About eighty percent of deaths from cervical cancer occur in poor countries. In the United States, most of the approximately 11,000 cervical cancers found annually occur in women who have never had a Pap smear, or not had one in the previous five years.

Since the vaccine only covers some high-risk types of HPV, experts still recommend regular Pap smear screening even after vaccination.

Gardasil has been shown to also be effective in males, though it has not yet been approved by the FDA to be marketed as such.

Safety

Gardasil is a 3 dose (injection) vaccine. There have been 24 million doses distributed in the United States, and there have been 13,758 Vaccine Adverse Event Reporting System (VAERS) reports following the vaccination. Ninety-three percent were reports of events considered to be non-serious (e.g., fainting, pain and swelling at the injection site (arm), headache, nausea and fever), and 7% were considered to be serious (death, permanent disability, life-threatening illness and hospitalization). There is no proven causal link between the vaccine and serious adverse effects - all reports are related by time only. That is, they are only related because the effect happened some time after the vaccination.

There have been 39 deaths among women who took the vaccine reported to the CDC. Six are currently under investigation, and seven are unconfirmed because of a lack of patient identification information. None of the other 26 confirmed deaths were linked to the vaccine. Guillain-Barré Syndrome (GBS), a rare disorder that causes muscle weakness, has been reported after vaccination with Gardasil. There is no evidence suggesting that Gardasil causes or raises the risk of GBS. Additionally, there have been rare reports of blood clots forming in the heart, lungs and legs. Most of those who suffered blood clots were already at risk from other factors, such as taking oral contraceptives.

Based on all of the information they have today, CDC continues to recommend Gardasil vaccination for the prevention of 4 types of HPV. Merck, the manufacturer of Gardasil, will continue to test women who have received the vaccine to determine the vaccine's efficacy over a lifetime

7 Questions to Ask When Diagnosed with Cervical Cancer

1. The Cervical Cancer Stage

After cervical cancer has been confirmed, several tests are then done to determine what stage the cancer is in. The stage categorizes how far the disease has spread. There are five stages, beginning at stage 0.
Cervical Cancer Stages

2. Treatment Options

Treatment options vary from woman to woman. Doctors take the stage of cervical cancer and general health of the patient into consideration when developing treatment options. There are some instances where there may be a few different choices in the type of treatment you will undergo, and the doctor may strongly recommend one course of treatment.

3. Suggested Treatment

If your doctor has suggested a treatment plan for you, ask why it is favored over other treatment methods. You may also want to ask the success rate of the recommended treatment method in women with similar cases of cervical cancer.

If your doctor recommends surgery, you should inquire about how frequently he or she performs the surgery and compare this to other specialists' numbers.

4. Treatment Side Effects/Effect on Daily Living

Before beginning any cancer treatment, it is important to know how it will affect your quality of life and daily living activities. Issues like caring for children, going to work, and maintaining hobbies or interests are common concerns for newly diagnosed cancer patients.

5. Start of Treatment and Preparation

The doctor will let you know when he or she would like you to begin treatment. Ask if there are any ways you can prepare for treatment beforehand. For example, if you are scheduled for surgery, do you have to go to pre-op appointments for blood work or other tests? Should you follow a certain diet before beginning chemotherapy?

6. Second Opinions

It is easy for patients to feel like they are committing "patient infidelity" against their doctor when they choose to seek the opinion of another. The truth is that most doctors understand and support their patients need for a second opinion. Women who have been diagnosed with cervical cancer often seek the second opinion of a gynecologist oncologist. This is an oncologist that specializes in treating gynecological cancer, like cervical cancer.

Many insurance companies require a second opinion or review by one of their staff physicians before treatment begins.


7. Financial Costs and Insurance Coverag
e

Now that you have had all of your questions answered by the doctor, it is time to find out how you will pay for treatment. This is an extremely important issue that needs to be addressed before treatment begins.

A financial representative from the doctor's office or hospital will meet with you and discuss the cost of the recommended treatment. He or she will tell you what is/isn't covered by insurance. Medications and services not covered by insurance may be covered by state aid or grants. The financial representative will let you know how to apply for aid and grants or refer you to the hospital social worker.
Article : http://cervicalcancer.about.com/

Cervical Cancer Support Groups

Even with the support of friends and family, it is common for women who are battling cervical cancer to feel alone in their fight. It is difficult to express frustration and stress to others who haven't experienced cancer treatment or the stress of having cancer.

A cervical cancer support group is an excellent way to fill the void in support. These groups allow cervical cancer patients to bond, giving a type of support that only another person who has "been there, done that" can give.
Types of Cervical Cancer Support Groups
There are two basic types of support groups setting, local and online. Both have the benefits and vary greatly from group to group. Each group may focus on a different personal stage in cancer treatment, from the newly diagnosed to cancer survivors.

Local Support Groups: Hospitals and cancer centers often offer regularly scheduled support groups for cancer patients, their families, and survivors. Meetings are held normally held in the hospital, cancer center, local library, or conference room. The groups are often led by an oncologist, nurse, psychologist or therapist, and sometimes a cancer survivor.

You can find local support groups through:

The American Cancer Society

hospital or treatment center staff

church, synagogue, or other religious institution


Online Support Groups: Cervical cancer support is only a click away with online support groups. Forums and message boards tailored to those who are being treated for cervical cancer or those who are survivors are excellent ways to get and give support. This is especially true for women who are experiencing treatment side effects like stomach upset and fatigue, which can make it difficult to leave the home at times.

Recommended online cervical cancer support groups:

The American Cancer Society

MDAnderson Online Cancer Support

CancerCompass

Yahoo Groups
Tips for Finding the Right Support Group
It make take going to a few meetings or logging into a few support message boards before you find the support environment you are looking for. These tips will help you find an effective support group:

Find a support group led by an experienced leader (physician, therapist, clergy, or a trained survivor).

Look for a group that targets your specific needs, such as a cervical cancer support group for women going through chemotherapy or who have had hysterectomies.

Seek a group that has rules and boundaries about sharing private information that is revealed during sessions.

Find a group that you feel comfortable in. It may take a few meetings or sessions before you feel comfortable about expressing your feelings, but it is important to feel comfortable around the leader and other members

Chemotherapy for cerivical cance

Depending on the stage of cervical cancer, a doctor may prescribe chemotherapy for treatment. Chemotherapy commonly accompanies another treatment method, like surgery or radiation therapy.

What is Chemotherapy

Chemotherapy is a cancer treatment method that uses drugs to kill cancer cells. These anti-cancer drugs target cancer cells and destroy them. Unfortunately, some drugs aren't as effective in targeting cancer cells, resulting in damage to healthy cells. This is why people often lose their hair during chemotherapy.

Chemotherapy drugs are given most often intravenously (IV) or by mouth. There are several other methods of giving chemotherapy, but most drugs used to treat cervical cancer are given through IV or in a pill form.
Types of Chemotherapy Drugs Used to Treat Cervical Cancer
Several types of chemotherapy drugs are used to treat cervical cancer. Common drugs include:


carboplatin

cisplatin

paclitaxel

fluorouracil, 5-FU

cyclophosphamide

ifosfamide

Chemotherapy Side Effects

Side effects of chemotherapy vary, depending on the type of drug. Common side effects include hair loss, stomach upset, and fatigue. Medications can be prescribed to help combat side effects like nausea and fatigue. Unfortunately, no medications are available to prevent hair loss. Some chemotherapy drugs are more effective in targeting cancer cells, minimizing hair loss.
Frequency of Chemotherapy
The frequency and duration of chemotherapy depends on many factors. The oncologist will develop a treatment plan that is based on type of cancer, stage, other health factors, type of chemotherapy drug prescribed, and other treatment methods being utilized.

Some women may undergo weekly treatment session while receiving daily radiation therapy treatments. Other women may receive chemotherapy regularly for months. Again, it varies from patient to patient based on several factors.

Some women do not tolerate chemotherapy treatment well and treatment will either be slowed down, delayed, or changed to an alternate plan.
Before Beginning Chemotherapy
Chemotherapy can be an intensive treatment for some. There are several things a woman should know before beginning chemotherapy:

what chemotherapy drug is being prescribed

why that certain drug was chosen over others

the duration and frequency of treatment

side effects of medication

side effects that require immediate medical attention

how successful is the chemotherapy drug in women with similar case histories

how chemotherapy will effect daily living

over the counter medications you can take, such a pain relievers or other medications
whether you need to have someone drive you home after each chemotherapy session
what items you can bring with you, such as an iPod, handheld gaming device, etc.

Radiation Therapy for Cervical Cancer

Radiation therapy uses certain types of energy to shrink tumors or eliminate cancer cells. Radiation therapy works by damaging a cancer cell's DNA, making it unable to multiply. Although radiation therapy can damage nearby healthy cells, cancer cells are highly sensitive to radiation and typically die when treated. Healthy cells that are damaged during radiation are resilient and are able to fully recover.
Radiation therapy may be given alone, along with chemotherapy, and/or with surgery. The decision to combine radiation therapy with other types of treatment depends on the stage of cervical cancer and other factors.

Radiation therapy may be given: by itself as the sole treatment method after surgery
after or in conjunction with chemotherapy treatmentSome chemotherapy drugs, such as 5-FU and cisplatin, make cancer cells more sensitive to radiation. Both of these chemotherapy drugs are used to treat cervical cancer.

Types of Radiation Therapy Used to Treat Cervical Cancer

Two types of radiation therapy are used to treat cervical cancer: external radiation and internal radiation. One or both types of radiation treatment may be used to treat cervical cancer.

External Radiation

Also called systemic therapy, this type of radiation is given on an outpatient basis and usually given daily for 4 to 6 weeks. It uses x-ray or gamma ray energy to deliver treatment to the affected area. In women with cervical cancer, pelvic external radiation is given and is done so through the use of a machine that resembles an x-ray machine. Each treatment lasts only a few minutes and does not cause any pain.

Internal Radiation

This type of radiation therapy is also called brachytherapy. Brachytherapy uses an implant (a seed, catheter or rod) that is sealed with a radioactive substance. The implant is placed into the uterus through the vagina and treatment is delivered. Brachytherapy is done on an inpatient basis, and the patient is allowed to leave following treatment.

Side Effects of Radiation Therapy

Side effects of radiation vary from patient to patient. It all depends on how often treatment is given and at what degree. The three most commonly experienced side effects are:
Fatigue

All radiation patients experience some degree of fatigue during treatment. This is the time when a cancer patient should really utilize her support system to help with chores, errands, child care and other small tasks. Short naps throughout the day and getting uninterrupted sleep at night really make a difference in a person's energy level.


Skin Problems

The skin that has been exposed to treatment may appear red, sunburned, tan, or irritated. The skin is very sensitive and should be treated as so. Patients should avoid perfumes or scented body lotions, tight fitting clothing, and exposing the area to sun (during treatment and for at least one year after).


Loss of Appetite

Loss of appetite can lead to fatigue and nutritional deficiencies. It is very important to keep up strength during any cancer treatment, and nutrition is one of the best resources to do that.

What is Cervical Cancer?



Cervical cancer is malignant cancer of the cervix uteri or cervical area. It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stages.[1] Treatment consists of surgery (including local excision) in early stages and chemotherapy and radiotherapy in advanced stages of the disease.

Pap smear screening can identify potentially precancerous changes. Treatment of high grade changes can prevent the development of cancer. In developed countries, the widespread use of cervical screening programs has reduced the incidence of invasive cervical cancer by 50% or more.[citation needed]

Human papillomavirus (HPV) infection is a necessary factor in the development of nearly all cases of cervical cancer. HPV vaccine effective against the two strains of HPV that cause the most cervical cancer has been licensed in the U.S. and the EU. These two HPV strains together are currently responsible for approximately 70% of all cervical cancers. Since the vaccine only covers some high-risk types, women should seek regular Pap smear screening, even after vaccination.
Article Source : www.wikipedia.com

Cervical Cancer Causes

Cervical cancer begins with abnormal changes in the cervical tissue. The risk of developing these abnormal changes has been associated with certain factors, including previous infection with human papillomavirus (HPV), early sexual contact, multiple sexual partners, cigarette smoking, and taking oral contraceptives (birth control pills).

Forms of HPV, a virus whose different types cause skin warts, genital warts, and other abnormal skin and body surface disorders, have been shown to lead to many of the changes in cervical cells that may eventually lead to cancer.

* Genetic material that comes from certain forms of HPV has been found in cervical tissues that show cancerous or precancerous changes.

* In addition, women who have been diagnosed with HPV are more likely to develop a cervical cancer that has genetic material matching the strain of virus that caused the infection.

* These findings demonstrate a strong link between the virus and cervical cancer.

* Because HPV can be transmitted by sexual contact, early sexual contact and having multiple sexual partners have been identified as strong risk factors for the development of cervical lesions that may progress to cancer.

Cigarette smoking is another risk factor for the development of cervical cancer. The chemicals in cigarette smoke interact with the cells of the cervix, causing precancerous changes that may over time progress to cancer.

Oral contraceptives ("the pill") may increase the risk for cervical cancer, especially in women who use oral contraceptives for longer than 5 years.


Cervical Cancer Symptoms


As in many cancers, you may have no signs or symptoms of cervical cancer until it has progressed to a dangerous stage.

* Cervical cancer does not usually cause pain, although it may in very advanced stages.

* The most common symptom is abnormal vaginal bleeding. This is any bleeding from the vagina other than during menstruation.

* Abnormal vaginal discharge also may occur with cervical cancer.

When to Seek Medical Care

The range of conditions that can cause vaginal bleeding are diverse, range in seriousness, and vary based on your age, fertility, and medical history.

Vaginal bleeding after menopause is never normal. If you have gone through menopause and have vaginal bleeding, see your health care provider as soon as possible.

Very heavy bleeding during your period or frequent bleeding between periods warrants evaluation by your health care provider.

Bleeding after intercourse, especially after vigorous sex, does occur in some women. If this occurs only occasionally, it is probably nothing to worry about. Evaluation by your health care provider is advisable, especially if the bleeding happens repeatedly.

If you have vaginal bleeding that is associated with weakness, feeling faint or light-headed, or actual faint, go to a hospital emergency department for care.


Exams and Tests

As with all cancers, early diagnosis is key to successful treatment and cure. Treating precancerous changes that affect only the surface of a small part of the cervix is much more likely to be successful than treating invasive cancer that affects a large portion of the cervix and has spread to other tissues.

The most important progress that has been made in early detection of cervical cancer is widespread use of the Papanicolaou test (Pap smear).

* The Pap smear is done as part of a regular pelvic examination.

* Named after the pathologist who developed the test, the Pap smear is a quick, painless, and relatively inexpensive way of screening women for precancerous or cancerous changes in their cervix.

* Cells from the surface of the cervix are collected on a slide and examined. Any abnormality found on a Pap smear mandates further evaluation.

Diagnosis of cervical cancer requires that a sample of cervical tissue (called a biopsy) be taken and analyzed under a microscope.

* This tissue sample can be obtained in a number of ways.

* A cervical biopsy is usually done by a specialist in diseases of women's reproductive and sexual organs (a gynecologist).

* The biopsy is examined by a physician who specializes in diagnosing diseases by looking at cells and tissues under a microscope (a pathologist).

Colposcopy is a procedure similar to a pelvic examination.

* The examination uses a type of microscope called a colposcope to inspect the cervix. The entire area of the cervix is stained with a harmless dye to make abnormal cells easier to see.

* The colposcope magnifies the cervix by 8-10 times, allowing easier identification of any abnormal-appearing tissue that may need biopsy.

* This procedure can usually be done in your gynecologist's office.

* These abnormalities may be an early step in the slow series of changes that can lead to cancer.

Sometimes a larger biopsy is needed to fully check for invasive cervical cancer.

* The loop electrosurgical excision procedure (LEEP) technique uses an electrified loop of wire to take a sample of tissue from the cervix.

* This procedure can often be performed in your gynecologist's office.

A cone biopsy is performed in the operating room while you are under anesthesia.

* A small cone-shaped sample of your cervix is removed for examination.

* Like LEEP, cone biopsy procedures result in tissue samples in which the types of cells and how much they have spread to underlying areas can be more fully determined.

Precancerous changes

Over the years, different terms have been used to refer to abnormal changes in the cells on the surface of the cervix. These changes are now most often called squamous intraepithelial lesion (SIL). "Lesion" refers to an area of abnormal tissue; intraepithelial means that the abnormal cells are present only in the surface layer of cells. Changes in these cells can be divided into 2 categories.

* Low-grade SIL: Early, subtle changes in the size and shape of cells that form the surface of the cervix are considered low grade.

o These lesions may go away on their own, but over time, they may become more abnormal, eventually becoming a high-grade lesion.

o SIL is also called mild dysplasia or cervical intraepithelial neoplasia 1 (CIN 1).

o These early changes in the cervix most often occur in women aged 25-35 years but can appear in women of any age.

* High-grade SIL: A large number of precancerous cells, which look very different from normal cells, constitute a high-grade lesion.

o Like low-grade SIL, these precancerous changes involve only cells on the surface of the cervix.

o These lesions are also called moderate or severe dysplasia, CIN 2 or 3, or carcinoma in situ.

o They develop most often in women aged 30-40 years but can occur at any age.

Precancerous cells, even high-grade lesions, usually do not become cancerous and invade deeper layers of the cervix for many months, perhaps years.

Some laboratories may still use an older system for describing abnormalities. This system classifies changes into 1 of 5 groups, 1 being the most mild changes and 5 being the most severe.

Ask you health care provider if you do not understand the way the result of your Pap smear is reported.

Invasive cancer

If abnormal cells spread deeper into the cervix or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer. Cervical cancer occurs most often in women aged 40 years or older.

If the biopsy results show invasive cancer, a series of tests will be performed, all designed to see whether the cancer has spread and, if so, how far.

* A chest x-ray looks for spread to the lungs.

* Blood tests can indicate whether the liver is involved. A CT scan may be necessary if results are not definitive.

* Special x-rays or a CT scan can be used to look at the bladder.

* The vagina and rectum are also examined, sometimes under anesthesia.

These tests are used to "stage" the cancer.

* By finding out how far it has spread, your health care providers can make a reasonable guess about your prognosis and the kind of treatment you will need.

* Cervical cancer is staged from stage 0 (least severe) to stage IV (metastatic disease, the most severe).

* Staging is based on size and depth of the cancerous lesion, as well as degree of spread.
Article Source : Wikipedia, eziarticles.

How Often Should You Have a Pap Smear?

The frequency in which women get Pap smears is not the same for everyone. While one woman may need an annual Pap smear, another woman may only need a Pap smear every three years. How often a woman needs a Pap smear depends on several factors, like age, general health, and findings from previous Pap smears.

When to Have Your First Pap Smear

The American Cancer Society recommends that women have their first Pap smear about three years after they become sexually active or by age 21, whichever comes first. Subsequent Pap smears should occur every two years thereafter with a liquid based Pap test or annually with a conventional test.

The American College of Obstetricians and Gynecologists recommend women have an annual Pap until age 30. If you are well over twenty one and you have never had a Pap smear, it is not too late to have start having regular screenings. Having a
regular Pap smear may considerably reduce your risk of developing cervical cancer.
Thirty and Over Unless recommended by a physician, continue screenings annually or
every two to three years. Women who have had previous abnormal Pap smears, infected with HPV, or at high risk for cervical cancer may need to be screened more frequently.

At age 30, women have the option of having an HPV test along with their Pap smear. The HPV test identifies women who are infected with high risk strains of HPV that could lead to cervical cancer, if left unmonitored or untreated.Age Sixty-Five and Over At age 65 to 70, women who have had no abnormal Pap smears within the
last 10 years may discontinue having regular Pap smears. This is a decision that has to be made with a physician or other clinician. For women who have a previous history of cervical cancer, abnormal Pap smears, or are at high risk for developing cervical cancer, should continue having regular screenings.

How Often Should You Have a Pap Smear?



The frequency in which women get Pap smears is not the same for everyone. While one woman may need an annual Pap smear, another woman may only need a Pap smear every three years. How often a woman needs a Pap smear depends on several factors, like age, general health, and findings from previous Pap smears.
When to Have Your First Pap SmearThe American Cancer Society recommends that women have their first Pap smear about three years after they become sexually active or by age 21, whichever comes first. Subsequent Pap smears should occur every two
years thereafter with a liquid based Pap test or annually with a conventional test.
The American College of Obstetricians and Gynecologists recommend women have an annual Pap until age 30.

If you are well over twenty one and you have never had a Pap smear, it is not too late to have start having regular screenings. Having a regular Pap smear may considerably reduce your risk of developing cervical cancer.Thirty and Over
Unless recommended by a physician, continue screenings annually or every two to three years. Women who have had previous abnormal Pap smears, infected with HPV, or at high risk for cervical cancer may need to be screened more frequently.

At age 30, women have the option of having an HPV test along with their Pap smear. The HPV test identifies women who are infected with high risk strains of HPV that could lead to cervical cancer, if left unmonitored or untreated.Age Sixty-Five and Over At age 65 to 70, women who have had no abnormal Pap smears within the
last 10 years may discontinue having regular Pap smears. This is a decision that has to be made with a physician or other clinician. For women who have a previous history of cervical cancer, abnormal Pap smears, or are at high risk for developing cervical cancer, should continue having regular screenings.


Why Your Daughter Should be Vaccinated with the HPV Vaccine


It is a common misunderstanding that the HPV vaccine is just a vaccine to prevent a sexually transmitted disease. While the human papillomavirus (HPV) is a virus transmitted through sexual contact like other STDs, it can lead to cervical cancer, vaginal cancer, anal cancer, vulvar cancer, and genital warts. HPV's role in the development of many other types of cancer is being investigated by researchers.

In June 2006, the FDA approved the use of Gardasil, an HPV vaccine, in young women ages 9 to 26. It is currently available at many doctor's and public health clinic's offices across the United States. The vaccine has spawned much controversy, which has led to many parents being confused and unsure about whether to have their daughter vaccinated.

Parents are encouraged to make an informed decision about vaccinating their daughters with the HPV vaccine. Talking to the family pediatrician and learning more about HPV and cervical cancer are both recommended by experts to help parents make a decision.

Why Should Your Daughter Get the HPV Vaccine?

1. Gardasil greatly reduces the chances that your daughter will develop cervical cancer. Gardasil protects against two types of HPV that cause 70% of all cases of cervical cancer, thus greatly reducing the risk of developing cervical cancer later in life. About 11,070 women in the United States are diagnosed with cervical cancer each year, and an estimated 3,780 die from the disease.

Because Gardasil does not protect against all types of HPV, women who are vaccinated still need to have regular Pap smears to detect any precancerous changes. The vaccine does not replace the Pap smear and regular Pap smears are necessary for optimum cervical health.

2. Gardasil protects young girls from the two common types of HPV that can cause genital warts. Vaccinated girls are protected from the two types of HPV that are responsible for 90% of genital warts. Genital warts can appear as cauliflower-like growths that can occur on, within, and around the vagina. They also can appear as flat growths that aren't prominent and can go unnoticed. Although genital warts do not pose any immediate health risk, they can be embarrassing for many women and can cause feelings of shame.

3. Gardasil greatly reduces the risk of developing other potentially life-threatening types of cancer. Vaccinating your daughter will greatly reduce the risk of her developing precancerous and abnormal vaginal and vulvar lesions that could become cancerous. The same types of HPV that cause cervical cancer are also linked to vaginal and vulvar cancer. Although less common than cervical cancer, vaginal and vulvar cancer are serious types of cancer that can be life-threatening.


How to Prevent and Reduce Your Risk of HPV


More studies are being done to determine HPV's role in the development of other types of cancer.

HPV is spread through skin-to-skin sexual contact -- no penile penetration or exchange of bodily fluids are needed to contract the virus. The virus is extremely common and it is estimated that more than 70% of the general population is infected with HPV. In most cases, HPV does not cause serious health consequences, like cancer. But for some people, HPV can lead to cancer.
How to Prevent HPV
Currently, there are only two HPV prevention methods: abstinence and the HPV vaccine. There are other ways to help reduce your risk of developing HPV, and those methods are discussed below.

Abstinence. Not having any sexual contact is an absolute way to prevent HPV. For most adults, complete abstinence is unrealistic, so other means of prevention and risk reduction should be followed.
HPV Vaccine. Aside from abstinence, the HPV vaccine is another effective means of preventing HPV. Although it doesn't protect against all strains of HPV, it does provide protection against the four strains of HPV that are most commonly associated with cervical cancer and genital warts.

The FDA approved the use of Gardasil, the HPV vaccine, in 2006. The target age for the vaccine is age 11 through 26, but can be given as early as 9 years of age. The goal is to vaccinate girls before they become sexually active and become exposed to HPV. It protects against two strains that are known to cause cervical cancer in women and two strains that are responsible for genital warts.


How to Reduce Your Risk Of HPV


Practice Safe Sex with a Condom. It is still unclear how good condoms are at decreasing the transmission of HPV, but studies show that women whose partner wore a condom every time they engaged in sexual intercourse cut their risk of developing HPV by about 70%. However, it's important to keep in mind that HPV is not transmitted via the exchange of bodily fluids. It is transmitted though sexual skin-to-skin contact. For example, during intercourse the penis is covered by the condom, leaving other areas of the genitals exposed. These exposed areas may come in contact with the vagina, thus possibly transmitting the virus. And, of course, it's not just heterosexual contact that can transmit the virus -- it's any type of sexual contact.
Limit the Number of Sexual Partners You Have. Limiting the number of sexual partners you have during your lifetime may decrease your risk of contracting HPV. Being in a monogamous, long-term relationship with someone also will greatly reduce your risk of contracting different strains of the virus. In fact, in a monogamous relationship where one or both partners are infected with HPV, the couple helps lower the possibility of becoming infected with another strain of the virus.
Article source : http://cervicalcancer.about.com/