Carsinoma Doctor

Archive for December, 2010

Cervical cancer is a common type of cancer in women, and is a disease in which cells are cancerous (malignant) in the tissues of the cervix.

The uterus is the hollow organ, inverted pear-shaped, where a fetus grows. The neck or uterine cervix is an opening that connects the uterus to the vagina (birth canal).

Cervical cancer begins to grow slowly. Before they are cancer cells in the cervix, normal tissues of the cervix go through a process known as dysplasia, in which abnormal cells begin to appear. A Papanicolaou cytology usually find these pre-malignant cells. Later, cancer cells start to grow and spread more deeply into the cervix and surrounding areas.

Since there are usually no symptoms associated with cervical cancer usually involves a series of tests to diagnose:

*Papanicolaou cytology: is carried out using a piece of cotton, a brush or a small wooden spatula to gently scrape the outside of the cervix to collect cells. The patient may feel some pressure, which in some cases accompanied by pain.
*Biopsy. If abnormal cells are found, the doctor will remove a sample of tissue from the cervix and observed under a microscope for the presence of cancer cells. To perform a biopsy only takes a small amount of tissue can be done in the doctor’s office. Sometimes you need to extract a biopsy sample cone-shaped, larger (cone), for which it may be necessary to go to hospital.

The prognosis (chance of recovery) and choice of treatment depend on the stage of the cancer (if only in the cervix or has spread to other places) and general health status.

Treatment depends on the stage of the cancer. If the cancer is confined to the outermost layer of the cervix (carcinoma in situ), often can be removed completely removing the cancer of the cervix with a scalpel or electrosurgical excision. This treatment has the advantage of not altering the ability to bear children. But since cancer may recur, doctors advise women to have checks and Pap every 3 months during the first year and every 6 months from now. If a woman has a carcinoma in situ and do not want children, we recommend the removal of the uterus (hysterectomy).

If the cancer is in a more advanced stage, it is necessary to perform a hysterectomy plus removal of adjacent structures (radical hysterectomy) and lymph nodes. The ovaries, if they are normal and functioning properly, are not removed when women are young. Radiation therapy is very effective for the treatment of advanced cervical cancer has not spread beyond the pelvic region. Although it causes little or no immediate problem, it can cause irritation in the rectum and vagina. Injuries to the bladder and rectum can occur even later, and ovaries, in general, cease to function.

When cancer has spread beyond the pelvis, sometimes one must resort to the chemotherapy. However, only effective in 25 to 30 percent of cases treated and the effects are usually temporary.

The Pap can detect accurately and inexpensively as much as 90 percent of cervical cancers, even before symptoms appear. Consequently, the number of deaths from this disease has been reduced by over 50 percent. It is recommended that women get their first Pap smear when they start to be sexually active or after age 18 and repeat it on once a year. If results are normal for 3 consecutive years, then the test can be spaced and do it every 2 or 3 years if you do not change the habit of life. If all women had the Pap regularly, could be eliminated deaths from this cancer. However, nearly 40 percent of women in developed countries are tested regularly.

If you find a lump, ulcer or other suspicious training on the cervix during a pelvic examination, or if Pap results indicate an anomaly or cancer, must perform a biopsy (removing a tissue sample for examination under a microscope .) The tissue sample is taken during a colposcopy, which uses a viewing tube with a magnifying lens (colposcope) to examine the neck of the uterus carefully and choose the place of the biopsy. There are two types of biopsies: the punch biopsy, which removes a tiny portion of the cervix that is selected visually with the colposcope, and endocervical curettage, in which tissue is scraped from the cervical canal visually inaccessible. Both procedures are a bit painful and cause a little bleeding, but together usually provide enough tissue for the pathologist to establish a diagnosis. If it is not clear, it makes a cone, which removes a major portion of tissue. Usually, this biopsy is done by loop electrosurgical excision in one’s own doctor’s office.

Once the diagnosis is established, it must decide the size and exact location of the cancer (ie, staging is done.) The process begins with a physical examination of the pelvis and various tests (cystoscopy, chest radiography, IVP, sigmoidoscopy) to determine if cervical cancer has spread to other surrounding structures or distant parts of the body. It also can perform other tests such as CT scan, a barium enema and X-rays of bones and liver, depending on the characteristics of each case.