CERVICAL CANCER

Mrs. Riya Joy

DEFINITION

Cervical cancer is a malignant

tumour deriving from cells of the

"cervix uteri", which is the lower

part of uterus.

Begins in the lining of the cervix

Cells change from normal to pre-

cancer (dysplasia) and then to

cancer

Cervix

Lower part of the uterus

Connects the body of the uterus to the vagina

Cervical Cancer- incidence

Affects 16/ 100000 women

14-24% of all female cancer

CAUSES

Human papilloma virusInfection with the common human papillomavirus (HPV) is a cause of approximately 90% of all cervical cancers. About half of the sexually transmitted HPVs are associated with cervical cancer.

Sexual HistoryA woman has a higher-than-

average risk of developing cervical cancer if she:

Has had multiple sexual partnersBegan having sexual relations

before the age of 18Has a partner who has had

sexual contact with a woman with cervical cancer

RISK FACTORS

HIV infectionChlamydia infectionLow socioeconomic status SmokingSeveral pregnanciesGiving birth at a very young ageLong-term use of the

contraceptive pillFamily history

SIGN AND SYMPTOMS

Intermenstrual Bleeding

Bleeding after sexual intercourse or a pelvic

exam

longer and are heavier menstrual periods

Bleeding after menopause

Increased vaginal discharge: offensive

Pelvic pain, back pain and leg pain

Bladder symptoms: frequency, dysuria,

haematuria, fistula

Rectal symptoms: diarrhoea, bleeding, fistula

Diagnosis

PAP SMEAR

HPV DNA test

COLPOSCOPY

CERVICAL BIOPSY

CYSTOSCOPY, CHEST X RAY, IVP,

PROCTOSCOPY (for staging)

CT scan

MRI

PAP SMEAR

Routine screening for cervical abnormalities

Like the Pap test, the HPV DNA test involves collecting cells from the cervix for lab testing.

HPV DNA test

COLPOSCOPY

A visual examination of the surface of the cervix using

a colposcope- an instrument with

magnifying lenses and a light.

If abnormalities are seen, a tissue sample (biopsy) may be taken and sent for evaluation.

Biopsy

STAGES OF CERVICAL CANCER

Stage 0: cancer insitu Stage I. Cancer is confined to the cervix. Stage II. Cancer at this stage includes the

cervix and uterus, but hasn't spread to the pelvic wall or the lower portion of the vagina.

Stage III. Cancer at this stage has moved beyond the cervix and uterus to the pelvic wall or the lower portion of the vagina.

Stage IV. At this stage, cancer has spread to nearby organs, such as the bladder or rectum, or it has spread to other areas of the body, such as the lungs, liver or bones.

MEDICAL MANAGEMENT

Chemotherapy

Chemotherapy is the use of chemicals

(medication) to destroy cancer cells. Cytotoxic

medication prevents cancer cells from dividing

and growing (Cisplatin)

Radiotherapy

For patients with advanced cervical cancer

radiation combined cisplatin-based

chemotherapy is the most effective treatment

SURGICAL MANAGEMENT

Laser surgery - a narrow beam of

intense light destroys cancerous and

precancerous cells.

LEEP (loop electrical excision

procedure) - a wire loop which has an

electric current cuts through tissue

removing cells from the mouth of the

cervix.

Cryosurgery

Hysterectomy

Simple hysterectomy

Removal of the body of the uterus

and cervix.

Radical hysterectomy and pelvic

lymph node dissection

Removal of entire uterus,

surrounding tissue, upper part of the

vagina, and lymph nodes

PREVENTION

HPV vaccine Safe sex Cervical screening: pap smear

Have few sexual partners Delay first sexual intercourse

Don't smoke

THANK YOU….