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Cervical and Uterine Cancer
The opening to the uterus (womb) is a short muscular tube known as the cervix.The cervix is visible to the doctor during a pelvic (speculum) examination. Cancer of the uterus and cervix were at one time the most common causes of cancer related death in women. Due to increased education, and the widespread use of the PAP smear, there has been a steady decline in cervical cancer deaths. The statistical estimates of cervical cancer cases for 1993 encompass 13,500 total cases, with an estimated 4,400 deaths attributable to cervical cancer. If cervical and uterine cancer are considered together, the 1993 estimates increase to 44,500 total cancer cases, with an estimated 10,100 deaths attributable to either cervical or uterine cancer.
RISK FACTORS FOR UTERINE CANCER
1. MOST CASES OCCUR IN WOMEN BETWEEN THE AGES OF 55-65
2. HISTORY FOR INFERTILITY
3. HISTORY FOR FAILURE TO OVULATE
4. LATE MENOPAUSE
5. OBESITY
6. PROLONGED ESTROGEN THERAPY AFTER MENOPAUSE (usually given for undesirable symptoms of menopause or osteoporosis)
7. HISTORY FOR ABNORMAL UTERINE BLEEDING.
RISK FACTORS FOR CERVICAL CANCER
1. LOWER SOCIOECONOMIC GROUPS
2. HISTORY OF INFECTION WITH HUMAN PAPILLOMA VIRUS (HPV) (acquired through sexual contact)
3. HISTORY OF EARLY ONSET OF SEXUAL ACTIVITY
4. HISTORY FOR MULTIPLE SEXUAL PARTNERS
A symptom common to uterine cancer is vaginal bleeding AFTER the onset of menopause (more than 6 months after the complete cessation of your periods). Post-coital bleeding is perhaps the only symptom of early cervical cancer. Regular evaluation and a yearly PAP smear are most important in the detection of cervical and uterine cancers. The PAP smear is a simple, painless test, where the examiner brushes off the surface of the cervix with a wooden spatula (similar to a popsicle stick). The cells from this specimen are analyzed under a microscope for the possible presence of cancer cells. The American Cancer Society recommends annual PAP test and pelvic examination for all females who have been sexually active or have reached age 18. After a women has had three or more consecutive annual examinations, the PAP test may be performed less frequently at the discretion of her physician. The American Cancer Society also recommends an endometrial (uterine) tissue sample at menopause for females at high risk for endometrial cancer. Treatment of cervical cancer depends on PAP smear findings. Many women in their 30's can have abnormal PAP results that indicate a precancerous condition (carcinoma in situ). In this case, treatment is by localized removal of the tissue by laser, electrocautery, or cryosurgery. Some cases may be followed by radiation therapy to the area, to ensure that any abnormal cells that may have spread to adjacent structures have been destroyed. Older females, and those who are menopausal, may elect to have a hysterectomy (removal of the uterus and cervix). More advanced forms of the disease, involving distant spread, generally receive some combination of surgery, chemotherapy, and radiation therapy. A nutritious diet is an important part of any cancer therapy. Uterine cancer is usually treated surgically with removal of the uterus and fallopian tubes. The ovaries may be removed, depending on the patient's age. Chemotherapy is often used in combination with surgery. If diagnosed early, the 5 year survival rate (those patients that will live at least 5 years after the time of diagnosis) is approximately 81% for cervical cancer and 88% for uterine cancer.
An OB-GYN physician or Gynecological Oncologist are the experts in the treatment of this problem.
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