Transcript Facts and Information About Cervical Cancer

Facts and Information
About
Cervical Cancer
By
Courtney Johnson and Mike Adkins
What is Cervical Cancer
Cancer that forms in tissues of the cervix (the
organ connecting the uterus and vagina). It is
usually a slow-growing cancer that may not have
symptoms but can be found with regular Pap tests.
The cervix is the lower part of the uterus (womb),
which opens into the vagina.
The Cervix
The cervix is part of a woman's reproductive
system. It is the lower, narrow part of the uterus
(womb). The uterus is a hollow, pear-shaped organ
in the lower abdomen. The cervix connects the
uterus to the vagina. The vagina leads to the
outside of the body.
The Cervix
The cervical canal is a passageway through which
blood flows from the uterus through the canal into
the vagina during a menstrual period. During
pregnancy, the cervix is tightly closed to help keep
the baby inside the uterus. During childbirth, the
cervix dilates (opens) to allow the baby to pass
through the vaginal canal.
Symptoms of Cervical cancer
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Abnormal bleeding
Unusual heavy discharge
Pelvic pain
Pain during urination
Bleeding between regular menstrual periods,
after sexual intercourse, douching, or pelvic
exam
How common is cervical cancer?
• Worldwide, cervical cancer is the second-mostcommon type of cancer that strikes women.
• Cervical cancer is the 14th most common cause
of new cancers diagnosed among women.
• About 11,150 women in the United States
developed cervical cancer and about 3,870 will die
from it this year.
How common is cervical cancer?
• Most common in women younger than 50
• Rarely in women younger than 20
• About 20% of women over 65 are diagnosed
• Cervical cancer occurs more frequently in
Hispanic women
What contributes to cervical
cancer?
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Human papillomavirus (HPV)
Low socioeconomic status
Smoking
Human Immunodeficiency virus (HIV)
Chlamydia infection
Diet
Birth control pills
Family history of cervical cancer
Understanding Cancer
• Cancer begins in cells, the building blocks that
make up tissues. Tissues make up the organs of
the body.
• Normally, cells grow and divide to form new cells
as the body needs them. When cells grow old,
they die, and new cells take their place.
Understanding Cancer
• Sometimes, this orderly process goes wrong.
New cells form when the body does not need
them, and old cells do not die when they should.
These extra cells can form a mass of tissue
called a growth or tumor.
• Tumors can be benign or malignant.
Benign Tumors
• Benign tumors are rarely life-threatening.
• Generally, benign tumors can be removed, and
they usually do not grow back.
Benign Tumors
• Cells from benign tumors do not invade the
tissues around them.
• Cells from benign tumors do not spread to other
parts of the body.
• Polyps, cysts, and genital warts are types of
benign growths on the cervix.
Malignant Tumors
• Are generally more serious than benign tumors
and may be life-threatening.
• Malignant tumors often can be removed. But
sometimes they grow back.
Malignant Tumors
• Cells from malignant tumors can invade and
damage nearby tissues and organs.
• Cells from malignant tumors can spread
(metastasize) to other parts of the body.
Malignant Tumors
• Cancer cells spread by breaking away from the
original (primary) tumor and entering the
bloodstream or lymphatic system.
• The cells invade other organs and form new
tumors that damage these organs. The spread
of cancer is called metastasis.
Human papillomavirus (HPV)
• Genital HPV infections are very common,
affecting up to 80 percent of women by the age of
50.
• HPV by itself is not a disease. Most infections go
away or are suppressed by the body, without
causing any symptoms or health effects.
Human papillomavirus (HPV)
• There is no treatment for HPV itself, only for
abnormal cells that may form if an infection
becomes long-lasting.
• There is currently no HPV test for men, and it is
impossible to know from whom you got the
infection or when.
Human papillomavirus (HPV)
• Medical research suggests that after you get a
particular type of HPV, you become immune to it
and cannot be re-infected with that same type
again.
Human papillomavirus (HPV)
Types
About 30 types of HPV are spread only through
direct genital contact. These "genital" types of HPV
are either “high-risk” or “low-risk”
Human papillomavirus (HPV)
Types
1) "high-risk" – which means they can cause
certain kinds of cancer (most commonly, cervical
cancer) if the infection persists
Human papillomavirus (HPV)
Types
2) "low-risk" – which means they are not
associated with cancer, but can cause genital
warts. Unless you develop one of these problems,
the only way to know whether you have HPV is by
being tested.
Human papillomavirus (HPV)
Symptoms
HPV cause visible genital warts. In women, these
growths may develop inside the vagina, where
they are hard to detect or can also develop on the
lips of the vagina or around the anus.
Human papillomavirus (HPV)
Symptoms
In men, they usually appear on the penis,
the scrotum or around the anus. Very rarely,
growths can be found in the mouth or the
throat.
Human papillomavirus (HPV)
Symptoms
Depending on the type of HPV, some women have
infections that cause abnormal cell growth
(dysplasia) on the female cervix. A woman may
only find out she has HPV when her annual Pap
smear results indicate abnormal cervical cell
changes.
Abnormal cell growth
Healthy Cervix
HPV statistics
• Approximately 5.5 million people are newly
infected with genital HPV each year and about
20 million people are currently infected.
• Some studies estimate that 50% to 75% of the
sexually active population are exposed to at
least 1 strain of HPV, although most people don't
develop symptoms.
HPV statistics
• At least 50 percent of sexually active men and
women acquire a genital HPV infection at some
point in their lives. By age 50, at least 80 percent
of women will have been infected with genital
HPV infection.
HPV statistics
• Every women that contracts HPV will not
develop cervical cancer
• More common in uncircumcised men
• Condoms can reduce spread of HPV by 70%
Preventing HPV
• Abstinence. Avoiding skin-to-skin contact with
someone with an HPV infection.
• Using a latex condom during sexual intercourse
may provide some protection.
• Lifelong mutual monogamy
• Vaccines and Education
HVP vaccination
• The approved vaccine against human papilloma
virus (HPV) may have substantial benefits
beyond preventing infections that might lead to
cervical cancer and genital warts. New research
shows it also protects against abnormalities that
can lead to vaginal, vulvar, and anal cancers.
HVP vaccination
• The vaccine only worked in women and girls
who were not already infected with HPV.
Gardasil (2006) or Cervarix (2009) are routinely
given to 11- and 12-year-old girls, and allowed
for girls as young as 9.
HVP vaccination
• Vaccinating girls before they become sexually
active and have a chance to catch HPV gives
them the best chance of being protected by the
vaccine.
PAP Testing
• The Pap test (sometimes called a Pap smear) is
a way to examine cells collected from the cervix
(the lower, narrow end of the uterus). The main
purpose of the Pap test is to detect cancer or
abnormal cells that may lead to cancer. It can
also find noncancerous conditions, such as
infection and inflammation.
How often should a woman have
a Pap test?
• Current general guidelines recommend that
women have a Pap test at least once every year,
beginning about three years after they have
sexual intercourse, but no later than age 21.
• It is safe to wait 3 years, because cervical
cancer usually develops slowly.
How often should a woman have
a Pap test?
• This is continued to the age of 30.
• Age 30 to 65, every three years
When is Pap test no longer
required?
• Women ages 65 to 70 who have had at least
three normal Pap tests and no abnormal Pap
tests in the last 10 years may decide, after
talking with their clinician, to stop having Pap
tests.
When is Pap test no longer
required?
• Women who have had a hysterectomy (surgery
to remove the uterus and cervix) do not need to
have a Pap test, unless the surgery was done as
a treatment for precancer or cancer.
Treatment for cervical cancer
• A number of treatments are used to fight cervical
cancer. In some cases, a combination of
therapies may be recommended
• You will meet one-on-one with physicians and
practitioners to discuss and choose the
treatment options that will work best for you.
Treatment for cervical cancer
• Your options for conventional, cervical cancer
treatment may include the following:
• Chemotherapy
• Radiation therapy (e.g., external beam radiation,
High-Dose Rate (HDR) brachytherapy)
• Surgery
• Immunotherapy/biotherapy
Treatment for cervical cancer
• Treatment also depends on the stage. If only the
surface of the cervix is involved, doctors can
often completely remove the cancer by removing
part of the cervix using the loop electrosurgical
excision procedure, a laser, or a cold knife.
Treatment for cervical cancer
• Or cryotherapy may be used to destroy the
cancer by freezing it.
• If the cancer has begun to spread within the
pelvic area, hysterectomy plus removal of
surrounding tissues, ligaments, and lymph
nodes (radical hysterectomy) is necessary.
Treatment for cervical cancer
• When the cancer has spread extensively or
recurs, chemotherapy is sometimes
recommended. However, chemotherapy reduces
the cancer's size and controls its spread in only
25 to 30% of women treated, and this effect is
usually temporary.
Diet
Incorporate foods into your diet that help clear the
HPV virus from your body. The HPV virus causes
cancer by the inflammation caused by persistent
infection. Phytochemicals and vitamins that have
been shown to hasten clearance in reputable
studies and foods that contain them include:
Diet
Lutein - spinach, kale, turnips, mustard and collard
greens
Vitamin C - oranges, grapefruit, peaches
Vitamin A - carrots, sweet potatoes, pumpkins,
spinach
Lycopene - tomato products (especially sauces),
watermelon
Prognosis
• Prognosis depends on the stage of the cancer
• With treatment, 80 to 90% of women with stage I
cancer and 50 to 65% of those with stage II
cancer are alive 5 years after diagnosis.
Prognosis
• Only 25 to 35% of women with stage III cancer
and 15% or fewer of those with stage IV cancer
are alive after 5 years.
QUESTIONS ?
Resources
1. The FUTURE II Study Group (2007) Quadrivalent Vaccine against
HPV to Prevent High-Grade Cervical Lesions Published in the May
10, New England Journal of Medicine. 356, 9: 1915- 1927.
2. Quadrivalent Vaccine against Human Papillomavirus to Prevent
Anogenital Diseases Published in the May 10, 2007 New England
Journal of Medicine (Vol. 356, No. 19: 1928-1943). First author:
Suzanne M. Garland, MD, Royal Women's Hospital and the
University of Melbourne, Melbourne, Australia.
3. Case–Control Study of Human Papillomavirus and Oropharyngeal
Cancer Published in the May 10, 2007 New England Journal of
Medicine (Vol. 356, No. 19: 1944-1956). First author: Gypsyamber
D'Souza, PhD, Johns Hopkins Bloomberg School of Public Health.
Resources
4. Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human
papillomavirus type 16 vaccine. New England Journal of Medicine
2002; 347(21):1645–1651.
5. Koutsky M. (2002). Do condoms prevent genital HPV infection,
external genital warts, or cervical neoplasia? American Sexually
Transmitted Diseases Association. 29:725-35.
6. Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human
papillomavirus type 16 vaccine. New England Journal of Medicine
2002; 347:1645-51.
7. Harper DM, Franco EL, Wheeler C, et al. Efficacy of a bivalent L1
virus-like particle vaccine in prevention of infection with human
papillomavirus types 16 and 18 in young women: a randomized
controlled trial. Lancet 2004; 364:1757-65.
Resources
8. Villa, LL, Costa, RL, Petta, CA, et al. (2005). Prophylactic
quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1
virus-like particle vaccine in young women: a randomized doubleblind placebo-controlled multicentre phase II efficacy trial. Lancet
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9. http://www.cdc.gov
10. Pagliusi, SR, Teresa Aguado, M. (2004). Efficacy and other
milestones for human papillomavirus vaccine introduction. Vaccine
23:569-78.
11. Cervical Cancer Prevention: HPV Diet. Posted by Lynne Eldridge
MD at 6/22/2007 4:00 AM Retrieved June 20, 2008, from
http://blog.avoidcancernow.com/2007/06/21/cervical-cancerprevention-hpv-diet.aspx
Resources
12. National Cancer Institute. (2008). Cervical Cancer Retrieved June
20, 2008, from http://www.cancer.gov/cancertopics/types/cervical
13. American Cancer Society, Inc. (2008). Detailed guide: cervical
cancer. Retrieved June 9. 2008, from
http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_i
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