Shopping Cart
Your Cart is Empty
Quantity:
Subtotal
Taxes
Shipping
Total
There was an error with PayPalClick here to try again

News from CaSfA's Director
News from CaSfA's Director
Blog
What's New In Cervical Cancer
Posted on March 22, 2017 at 1:38 PM |
In a recent Facebook webchat,
Dr. Ursula Matulonis, medical director of Gynecologic Oncology in
Dana-Farber’s Susan F. Smith Center for Women’s Cancers,
and Dr. Colleen Feltmate , director of minimally invasive surgery in
Gynecologic Oncology at Brigham and Women’s Hospital, discussed what is new in
Cervical Cancer. You
can access the webchat at: http://blog.dana-farber.org/insight/2017/01/what-you-should-know-about-cervical-cancer-webchat/?utm_source=newsletter&utm_medium=email&utm_content=What%20you%20should%20know%20about%20cervical%20cancer&utm_campaign=spotlight Here are my notes: About 13,000 women are diagnosed with cervical cancer each
year in the US Screening for cervical cancer: ·
Is a bit of controversial ·
Can be confusing even for doctors. ·
Should include screening for Human Papilloma
Virus (HPV), especially for age 30 and over ·
All agree women should see gynecologist by the
time become sexually active ·
Now using HPV and pap test in combination for
screening women over 30 yo. Where do you find out about screening? ASCCP (American Society for Colposcopy and Cervical
Pathology web site (http://www.asccp.org/asccp-guidelines) guides doctors and patients with
practical algorithms Risk factors for cervical cancer: ·
HPV-sexually transmitted through direct contact. ·
Increased sexual partners—increases risk of HPV ·
Smoking ·
Immunosuppression—don’t clear the virus well ·
Skipping pap smears/no access to medical care
for pap smears—one of biggest factors is not having pap smear for five or more years Vaccination for HPV: ·
As young as 9-11 up to age 26 ·
Important to get before exposure (sex activity) ·
Boys and girls should be vaccinated ·
Anal, throat, and oral cancer—risk for women and
also risk for men ·
Three shot series—some immunity to HPV if do
partial series, but need to complete all for it to work best [when I was looking for more information, I
found the CDC is now recommending two doses, 6-12 months apart. If a child received the second dose within 6
months of the first, then a third dose should be given. Here’s the link with info: https://www.cdc.gov/hpv/parents/vaccine.html ] Many women will have precancerous changes on their pap
smear—it is a screening test, meant to
pick up any abnormalities ·
If abnormal pap, next step is colposcopy
(procedure that uses a binocular-like tool to get a closer look at the
cervix). ·
Depending on result of colposcopy, may biopsy to
test if pre or cancer ·
Often if cervical cancer is picked up early can
do limited excision ·
If your pap smear shows precancerous changes,
you can get medical care with general gynecologist ·
Sometimes gyn will refer to oncologic gynecologist Cervical cancer Almost 100% cervical cancer is driven by HPV Two types of cervical cancer: squamous cell carcinomas—begin
in the flat cells of the cervix; and Adenocarcinomas – begin in the glandular
cells of the cervix. Some argue
adenocarcinoma can be more virulent and come back more often. Others argue they are the same. Another type is combination of both, but this type is very rare HPV types 16 & 18 cause the vast majority of cervical
cancers. Initial HPV vaccine covered
these types only. Now the vaccine protects against 7 types-covers about 99%
cervical cancer causing HPV. [Again, this
is a bit off from the CDC info: “All three licensed HPV vaccines
protect against types 16 and 18, which cause the majority of cervical cancers
across racial/ethnic groups (67% of the cervical cancers among whites, 68%
among blacks, and 64% among Hispanics). The 9-valent HPV vaccine protects
against seven HPV types that cause about 80% of cervical cancer among all
racial/ethnic groups in the United States.”
From https://www.cdc.gov/hpv/parents/questions-answers.html
] When cervical cancer is first diagnosed: Staging of Cancer- Imaging techniques may be
ordered—CT/MRI/PET scans Is having children a concern?—may change approach of
treatment Is the cancer a visible or a microscopic lesion? Minimally invasive surgery—has come along way Stage 1—in past did a radical abdominal hysterectomy—removed
uterus, cervix, much of vagina. Had a
lot of surgical complications, long recovery and no longer able to have
children. Now if don’t want children
will do a laparoscopic hysterectomy—less bleeding, less pain and less late side
effects. Patients can even go home the next
day. And in younger women, doctors are doing
less surgery so that many can still have children. [Radical trachelectomy—removes
cervix, top 1-2cm of vagina and surrounding tissue, but leaves uterus]. Research continues to look at ways to map the
cancer so only take out the cancer, and leave behind healthy tissue. In later stages, cancer may be in the lymph nodes and pelvis.
If surgery isn’t curative—chemo and radiation may be needed Quality of life: Side effects of treatment—trouble with intercourse due to
changes in tissue—Multidisciplinary approach is most beneficial (used at Dana
Farber): Includes biofeedback techniques, sometimes local estrogen
creams, dilators, and counseling. Racial disparity a big concern with cervical cancer. Rate of
cervical cancer in African Americans is almost double that of Caucasians--probably
due to limited access to medical care among African Americans. Audience Questions: Is there any age when a woman can stop cervical cancer
screening? If a woman has had normal pap smears, has no evidence of HPV
infection, and has had the same sex partner, probably can stop screening after
age 65. However, women and men are
living longer and longer, and often having new partners later in life. In this case, screening is still necessary
after age 65 [According to the American
Cancer Society, more than 15% of cervical cancers are diagnosed in women over
65.https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html ]. When should someone seek a second opinion? Consider it before any major intervention or surgery If anything a doctor does or says doesn’t feel right to you It is always reasonable to decide between medical practitioners—no
reasonable doctor should feel slighted when patient gets a second opinion Where is the field going? Looking into molecular mechanisms driving cervical disease Immunotherapy may play a larger role in the future A trial is now being conducted at Dana Farber looking at using
a vaccine to treat HPV-16 in patients with HPV 16 anal and oral cancer [https://clinicaltrials.gov/ct2/show/NCT02865135?term=HPV+and+anal+cancer&rank=2
] Another trial is looking at using a HPV vaccine in patients
who are at high risk for cancer recurrence. |
Categories: cervical cancer
Post a Comment
Oops!
The words you entered did not match the given text. Please try again.
0 Comments
Loading...
/
Oops!
Oops, you forgot something.