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Tuesday, September 10, 2013

Cervical Cancer

Posted by Chantel Martiromo, Article By Kyle J. Norton 

Cervical Cancer
Cervix is the lower part of uterus that opens at the top of the vagina. Cervix acts an transition area for vaginal lining (squamous epithelium) change to uterus type (columnar epithelium) through the transitional area (squamous columnar epithelium) to host the development of the fetus. Cervical cancer is malignant neoplasm of the cervix uteri or cervical area caused by abnormal cells growth with alternation of cells DNA.

Pre-cervical cancer
Precervical cancer is the early stage of abnormal cell changes in the cervical tissue, if left untreated, it can develop into true invasive cervical cancer caused by factors connected to male seminal fluid. A vaccine, Gardasil used to prevent pre-cervical cancer from the infection of two types of HPV was approved by the U.S. Food and Drug Administration in 2006. It is for your benefits to take this vaccine if you are sexual active with several partners.

A. Symptoms

There is no specific symptom presented in pre-cervical cancer. It is usually discovered during annual pap test or cervical smear test.

B. Causes and risk factors
1. Age
The average age of pre-cervical cancer can occur as young as age in mid-thirty.
2. Sexual active
Pre-cervical cancer occurs in sexual active women with several partners due the risk of sexual transmitting diseases.
3. Smoking
Researchers found that smoking increases the risk of cervical cancer as a result of carcinogen effect of the inner lining of the cervix.
4. Virus
a. Human papillomavirus
Human papillomavirus (HPV) can be transmitted by seminal fluid carries the virus without even notice by the male partner, since it does not cause any symptoms and problem. cause of infection of most HPV in women are temporary and have little long-term significant effect, but it can develop to pre-cervical cancer if the infection persists. In some cases, if left untreated, it can progress to invasive cervical cancer.
b. Genital herpes
About 45 million Americans are infected with the genital herpes virus, with approximately one million new infections each year. Genital herpes is genital infection by herpes simplex virus and can cause the change of the cells of the cervix, leading to pre-cervical cancer.
5. Early age of sexual intercourse
Early age of sexual intercourse increases the risk of pre-cervical cancer due to the risk of getting sexual transmitting diseases.
6. Etc

C. Diagnosis
1. Pap test or cervical smear test
The Pap test or cervical smear test is a screening test used in gynecology to exam for any changes of cervical cells to detect abnormal cell growth hat can cause pre-cancer and cervical cancer, by using a speculum to gather cells from the outer opening of the cervix. For best results, pap test should not occur when a woman is menstruating as it may interfere with the result.

2. Colposcopy
If the pap test or cervical smear test results are abnormal, (most of the time it is caused by inflammation or a vaginal infection, not pre-cervical cancer) your doctor might want to take a closer exam at your cervix to determine the cause of your abnormal pap smear results with a medical instrument, colposcope to view your cervix and sample is taken in the susceptible area for examination after applying acetic acid washes away mucus to allow abnormal areas to be seen more easily. Sometimes, it is necessary to use color filters to examine the capillaries of the squamocolumnar junction.

D. Treatments
D.1. Mild pre cervical cancer
1. If you have only mild changes, either you may need a colposcopy or another pap test in 6 months, because these mild change of abnormal cells can go back to normal by themselves.
2. Laser ablation
2.1. Laser ablation is performed as out patient in hospital most of the time, it is a type of treatment with the use of laser to burn off the abnormal cells with local anesthesia. It can be done in a few minutes.
2.2. Side effects
a. Redness and tenderness of the skin
b. Infection
c. Numbness
d. Pain
e. Blood clot
f. Etc.

3. Cold coagulation
3.1. The same purpose as above to remove the abnormal cells in the cervix without affecting the normal cells by using a hot probe to burn away the abnormal cells with local anesthesia. The treatment is also done in hospital as out patient and finished in a short time.
3.2. Side effects
a. Cramps and pain
b. Discharge
c. Bleeding
d. Tiredness
e. Etc.

4. Cryotherapy, cryosurgery or cryoablation (freezing)
4. 1. Instead of using hot probe to burn away the infected area in the cervix, crytherapy
uses a cold probe to freeze away and destroy abnormal cells with local anesthesia.
4.2. Side effects
a. Bleeding
b. fluid accumulation
c. Numbness
d. Cramps and pain
e. Etc.


5. Diathermy or electrocautery
5.1. Diathermy is a treatment with a use of an high-frequency electromagnetic current to destroy the abnormal cells in the cervix with local anesthesia. It is done as out patient in the hospital and finished in a short time.

5.2. Side effects
a. Skin effect
b. Bleeding
c. Cramps and pain
d. An increased menstrual flow
e. Etc.

6. Hysterectomy6.1. If you are past your menopause or have finished having children, your doctor may suggest removing the whole uterus.
6.2. Side effects
a. Fatigue
b. Cramp and pain
c. Nausea and vomiting
d. Constipation
e. Bleeding
f. Etc.

7. Etc.

D.2. Moderate or severe cervical cancer
1. Cryosurgery
See above.

2. Conization
Conization is a type of treatment with the uses of medical instrument of the loop electrosurgical excision procedure (LEEP) or large loop excision of the transformation zone (LLETZ) surgically removed cone shaped areas of abnormal tissue with general anesthesia. It is normally done in hospital as outpatient.

3. Etc.


Invasive cervical cancer
An advanced stages of cervical cancer as the cancerous cells have spread from the surface of the cervix to tissue deeper in the cervix or to distant parts of the body.

A. Symptoms
1. Abnormal bleeding
2. Unusual heavy discharge
3. Pain and bleeding during sexual intercourse
4. Pelvic cramps and pain
5. Pain during urination
6. Bleeding between period
7. Etc.

B. Causes and risk factors
See above

C. Stage of invasive cervical cancer
1. Stage 0
Cervical caner is classified as Stage 0. if the cancerous cell have not penetrated in deeper tissue but remain in the surface of the cervical lining.
2. Stage I
In stage I, The cancerous are no longer in the surface but have invaded into deep cervical lining
a. Stage IA1
The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1: The spreading is not ≤ 3mm(1/8 inch) deep and ≤ 7mm (1/4 inch) wide.
a.2. Stage IA2: The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and ≤ 7 mm (about 1/4 inch) wide.
b. Stage IB: The cancer in this stage have invaded the connective tissue of the cervix, ≥ 5mm (1/5 inch).
b.1. Stage IB1: Cancer is ≥ 4 cm large (1 3/4 inches).
b.2. Stage IB2: Cancer is ≥ 4 cm (1 3/4 inches) but ≤ 5cm (2 inches)
3. Stage II
In stage II, the cancer cells have spread to distant tissues, but is still within the pelvic area.
a. Stage IIA: Cancer has spread to the 2/3 of upper part of the vagina.
b. Stage IIB: In this stage, cancer has spread to tissue near the cervix. This tissue is called parametrial tissue of the cervix.
4. Stage III
In this stage, cancer cells have spread to entire vagina and penetrate deep into the pelvic wall.
a. Stage IIIA: Cancer has spread to the entire vagina and contained in the area.
b. Stage IIIB: Cancer has spread deep into to the pelvic wall and interfered with the flow of urine to the bladder.
5. Stage IV
In stage IV is the most advance stage of cervical cancer as cancer cells have spread to the distant parts of the body
a. Stage IVA:
In this stage, cancer cells have spread to the nearby organs and tissue but closed to the cervix , including bladder or rectum.
b. Stage IVB:
In this stage, cancer cells have spread to distant areas of the body, including the lungs, kidney, etc.


D. Types of invasive cervical cancer
D.1 Squamous cell carcinomas
Squamous cells are the thin, flat cells that line the bottom of the cervix. Abnormal growth of squamous cells accounted for 80 to 90% of invasive cervical cancer. Squamous cell carcinomas is defined as a cancer of which the squamous cells in the cervix have divided and replication in uncontrolled matter due to DNA alternation caused by virus or other factors.

D. 2. Adenocarcinoma
Glandular cells that line the upper portion of the cervix. Abnormal growth of glandular epithelial cells are accounted 10 to 20 percent of invasive cervical cancers. Adenocarcinoma is defined as a cancer a cancer of which the glandular epithelium cells in the cervix have divided and replication in uncontrolled matter due to DNA alternation caused by virus or other factors.

F. Preventions and Treatments
A. Preventions
A.1. How to avoid
1. Vaccine
Gardasil, is approved for females between nine and 26 years of age in Canada to prevent infection of two types of HPV and by the U.S. Food and Drug Administration in 2006.
Symptoms include
1.1. Pain in the area of the injection
1.2. Swelling in the area of the injection
1.3. Redness in the area of the injection
1.4. Fever
1.5. Nausea
1.6 Dizziness
1.7. Diarrhea
1.8. Vomiting
1.9. Cough
1.10. Etc.
But most people have no symptom after injection
2. If you are sexual active use condom to protect against sexual transmitting infection cause of cervical cancer.
3. Stop smoking to reduce the carcinogen effect
4. Annual pap test or cervical smear test to catch abnormal cell growth early
5. Limited numbers of sexual partners
6. Etc.

A.2. Nutritional supplements
1. Antioxidants For more detial of antioxidants, please visit http://the-anti-aging-guide.blogspot.com/2011_04_01_archive.html
Antioxidants have been proven in many studies to be effective in preventing the alternation of DNA in cell division and replication caused by oxidation.In fact, people eating diets high in antioxidant-rich foods are less likely to develop cancer.

2. Beta-carotene
Beta-carotene in foods beside is the precursor of vitamin A is a powerful free radical scavenging antioxidant helped to reduce the risk of cell mutation caused by free radical affects, but also enhances immune system in fighting against virus causes of cervical cancer.
Deficiency of beta-carotene can cause to develop cancerous or precancerous cervical lesions.

3. Folate
Researchers found that folate enhances normal cellular changes seen in cervical dysplasia due to deficiency of folate, by reducing the risk of altered homocysteine.

4. Omega 3 fatty acid
Omega-3 fatty acids decrease inflammation by balancing the Omega 3 and 6 fatty acid that cause inflammation due to over production of certain prostaglandins hormone family. Recent study found that omega-3 from fish inhibited the growth of cancerous cervical cells caused by HPV virus.

5. Coenzyme Q10
Coenzyme Q10 enhances energy production by promoting the process of the production of ATP then serving as fuel for the cells and acts an antioxidant to prevent the generation of free radicals during this process, thus reducing the risk of cervical cancers.

6. Etc.

Treatment with invasive cervical cancers depends on the stage of above

B. Types of treatments
B.1. Conventional medicine
1. Surgery
Most patients with invasive or non invasive cervical cancer are required surgery. While non invasive cancer patients are not needed further treatment, invasive cancer patients usual needed to combine other treatments, such as radiation therapy. Types of surgery include those of above.
a. Trachelectomy
Trachelectomy or cervicectomy is a surgery to remove the cervix, but preserve the uterine, if infertility is the concern of younger women with early stage of cervical cancer
b. Hysterectomy or radical trachelectomy
Since removal of uterus causes patients' inability to bear children, so the surgery is normally recommended for past menopause or have finished having children women or no other treatment option is available due to advance of the diseases.


2. Radiation therapy
By using high-energy x-rays or other types of radiation, radiation therapy kills breast cancer cells and keep them from growing or regrowing. If the cancer is small in size, cancer can be cured. If the cancer is large, radiation therapy can be used to control local bad symptoms.
a. External beam irradiation
In External beam therapy (EBT), a beam of high-energy x-rays or or other types of radiation is directed to a patient's tumor externally depending to the stage of the cancer.
b. Brachytherapy
By placing a small quantity radioactive seeds or sources by a medical instrument into uterus or vagina, before using high-energy x-rays or other types of radiation to kill cancerous cells without causing radiation affects in the nearby healthy tissues.
c. Side effects
c.1. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation.
c.6. Etc.

3. Chemotherapy
a. Chemotherapy is most use to treat with advance stage of cervical cancer combined with radio therapy, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells. Chemotherapy medicine includes platinum drugs and Taxol.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.

Treatment options depending to the stageA. Stage 0
Cervical caner is classified as Stage 0. if the cancerous cell have not penetrated in deeper tissue but remain in the surface of the cervical lining.

B. Stage I
B. 1. Treatment options for stage IA1 may include:
1. Conization
2.Trachelectomy
3. Brachytherapy
4. Etc.

B. 2. Stage IA2.
Treatment options for stage IA2 may include:
1. Hysterectomy
2. External beam radiation therapy and brachytherapy
3. Trachelectomy (removal cervix only) if pregnancy is a concern

B.3. Stage IB1.
Treatment options for stage IB1 may include
1. Hysterectomy
2. Internal and external radiation therapy (brachytherapy)
3. Radical trachelectomy

B.4. Stage IB2. Treatment options for stage 1B2 may include
1. Hysterectomy
2. Chemotherapy
3. Radiation therapy

C. Stage II
C.1. Stage IIA.
Treatment options for stage IIA may include
1. Internal and external radiation therapy
2, Radiation therapy
3. Chemotherapy
4. Radical hysterectomy

C.2. Stage IIB.
Treatment options for stage IIB may include
1. Combined internal and external radiation therapy along with
2. Chemotherapy with cisplatin

D. Stage III.
Treatment options for stage IIIA and stage IIIB may include
1. Combined internal and external radiation therapy plus
2. Chemotherapy

E. Stage IV
E.1. Stage IVA.
Treatment options for stage IVA may include
1. Combined internal and external radiation therapy plus
2. Chemotherapy

E.2. Stage IVB.
Stage IVB cancer is generally not considered curable. Treatment options may include:
1. Radiation therapy to relieve symptoms
2. Chemotherapy with cisplatin and combination with another drugs


B.2. With Herbs
1. Reishi Mushroom
Reishi mushroom is a species of fungal, genus Ganoderma, beloning to family Ganodermataceae, it is also known as Ling Zhi in traditional Chinese medicine and highly regarded for its cancer protective action. It has been used as anti-inflammatory, antioxidative agent in TCM and researcher found that reishi mushroom promotes the body's natural cancer killer cells T lymphocytes to slow the growth of cervical cancer cells.


2. Aloe Extract
Aloe vera is a genus Aloe, belonging to the family Xanthorrhoeaceae originated in the Sudan. Emodin extract from the aloe vera not only has an antioxidant and anti-inflammatory properties but also inhibits cell proliferation by triggering apoptosis, a self-destruct mechanism in cancer cells

3. Astragalus extract
Astragalus is herb, genus of Astragalus, belonging to the legume family Fabaceae. In rat study, researcher found that astragalus extract possess cytostatic properties in inhibiting tumor growth and delay chemical-induced hepatocarcinogenesis.


4. Green tea catechin extract.
Green tea has been consumed over thousands of year in human history, it is made solely with the leaves of Camellia sinensis that have undergone minimal oxidation. Polyphenols, a powerful antioxidant found in green tea reduces the risk of cancer caused by alternation of cells DNA by scavenging free radicals before oxidation can start. It also contains substance-epigallocatechin-3-gallate which has been shown to exhibit cervical cancer-preventive activities in animal research, according to a 2009 study published in the Arizona Cancer Center website.


5. Turmeric curcumin
Turmeric (Curcuma longa), a member of the ginger family, is used in a traditional Indian as curry spice. According to a study published in the book "Herbal Medicine, Healing, and Cancer" written by Donald Yance and Arlene Valentine, turmeric seems to reduce the growth of cervical cancer, by inhibiting the forming of free radicals.

6. Etc.


B.3. With Chinese herbs
1. Dang Qui
Dang Qui, also known as Chinese angelica root, has been used in TCM for over thousands of year and is considered a queen herb for women reproductive enhancer. Researcher found that Dang Qui contains anti oxidation property by getting rid of free radicals before it can cause mutation of cells. In vitro, researchers found that extracts of dang qui exhibits antitumor, anti-tuberculosis (TB), neuroprotective, and hemotopoeitic effects.

2. Huang Qi
Huang Qi is also known as astragalus. The sweet herb has been used in TCM to
improve endurance, protect the liver and regulate blood sugar by enhancing the functions of lung and spleen channels. In rat study, researcher found that astragalus extracts possess cytostatic properties by inhibiting tumor growth and delaying chemical-induced hepatocarcinogenesis

3. Ren Shen
Ren Shen, also known as Panax ginseng. The sweet, warm aromatic herb has been used in TCM as anti-cancer, anti aging, anti stress agent and to improve cardiac function including short of breath, palpitation, instant sweating, dropping of blood pressure, etc, by enhancing the functions of lung and spleen channels. In vitro study, researcher found that Ginsenosides extracted from Panax ginseng demonstrated anticancer effects.

4. Chai HuChai Hu
Chai Hu is also known as bupleurum. The bitter and cold herb has been used in TCM as anti inflammatory, anti tumor, anti bacterial and anti viral agent and to relieve pain, improve immune system, reduce heat, etc. by enhancing the functions of liver, gall bladder, pericardium and triple burner channels. Saikosaponins, substances found in Chai Hu, in vitro studies were found to enhance the cytotoxicity, a self-destruct mechanism in cancer cells.

5. Qing Dai
Qig Dai is also known as Natural Indigo. the salty and cold herb has bben used in TCM as anti inflammatory agent and to treat Chronic Myeloid Leukemia (CML), eczema, children epilepsy, etc. by enhancing the function of liver, lung and stomach channels. It is used in combination with other herbs to treat cancer.

6. Etc.

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