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This presentation is intended to help women
take an active role in their health care.
It does not replace the judgment of a health care professional in
diagnosing and treating disease. |
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The mission of the Gynecologic Cancer Foundation
(GCF) is to ensure public awareness of gynecologic cancer prevention, early
diagnosis and proper treatment. In
addition the Foundation supports research and training related to
gynecologic cancers. GCF advances
this mission by increasing public and private funds that aid in the
development and implementation of programs to meet these goals. |
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GCF gratefully acknowledges the National
Cervical Cancer Coalition (NCCC) for their support of this educational
presentation. For more information
on NCCC, call (800) 685-5531 or visit the Web site at www.nccc-online.org. |
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A list of specially trained gynecologic
oncologists practicing in your local area can be received by phone, fax or
mail |
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A directory of all GCF members practicing in the
U.S. can also be mailed upon request |
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Free educational brochures on gynecologic health |
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Confidential gynecologic (ovarian, endometrial,
cervical) and breast cancer risk assessment |
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Comprehensive women’s cancer information
including gynecologic, breast, lung and colon cancers |
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Links to other sources of cancer information |
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Cervical Cancer Screening and Prevention |
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2003 Statistics: |
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Breast 211,300 |
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Uterus (womb) 40,100 |
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Ovary 25,400 |
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Cervix 12,200 |
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Vulva 4,000 |
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Source: American Cancer Society. |
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It is a cancer of the female reproductive tract |
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It is the most common cause of cancer death in
the world where Pap tests are not available |
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It is the easiest gynecologic cancer to prevent
through screening |
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Vulva |
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Vagina |
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Cervix |
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Uterus |
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Fallopian tubes |
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Ovaries |
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Opening of the uterus (womb) into the vagina |
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Two cell types present (squamous and glandular) |
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Cervical cancers tend to occur where the two
cell types meet |
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500,000 women worldwide die of cervical cancer
annually |
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50-60 million women in the U.S. have a Pap test
each year |
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3-5 million women in the U.S. have an abnormal
result |
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12,200 new cervical cancers diagnosed in the
U.S. per year |
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4,100 deaths from cervical cancer in the U.S.
per year |
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The central cause of cervical cancer is human
papillomavirus or HPV: |
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HPV is sexually transmitted |
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The HPV detected today could have been acquired
years ago |
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There are many different types of HPV |
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Low-risk types can cause warts |
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High-risk types can cause precancer and
cancer of the cervix |
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NO! |
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In most cases HPV goes away |
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Only women with persistent HPV (where the virus
does not go away) are at risk for cervical cancer |
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Most men and women who have had sex have been
exposed to HPV |
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More than 75% of sexually active women tested
have been exposed to HPV by
age 18-22 |
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Women who have ever had sex |
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Women who have had more than one partner |
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Women whose partner (s) has had more than one
sexual partner |
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Women with other sexually transmitted diseases |
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Women who do not have Pap tests |
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Women with immune problems |
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Steroid medications |
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Transplanted organs |
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Chemotherapy |
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HIV |
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Women who smoke |
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Delay onset of sexual activity |
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Know your sexual partner |
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Do not smoke |
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Maintain a healthy diet and lifestyle |
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Practice safe sex |
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A test which collects cells from the surface of
the cervix and looks for any abnormal cells |
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Abnormal cells can be treated before cervical
cancer develops |
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When cancer is detected early, it is easier
to treat |
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A pelvic exam |
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A test for ovarian or uterine cancer |
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A biopsy |
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Three years after the onset of sexual
intercourse |
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No later than age 21 |
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Every year until age 30 |
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After age 30, if you have only had normal
results, you may have them every two to three years after discussion with
your physician and evaluation of your risk factors |
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A Pap test can
find treatable changes of the cervix (precancer) before you have a
symptom or notice a problem |
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Once a problem is symptomatic, it is
harder
to treat |
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The test is not perfect |
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Changes (abnormalities) may occur since the last
test |
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It may take many years for changes to develop or
be detected |
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Your risk changes if you have new partners |
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Schedule your Pap when you are not having a
menstrual period |
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It is best to abstain from intercourse and avoid
use of tampons or douches for two days before your Pap test |
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Feet are placed in stirrups (foot holders) |
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A speculum (thin duck-billed instrument) is
inserted into vagina to see the cervix |
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You may have brief discomfort which is usually
mild |
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You may have some spotting afterward |
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You may ask to have a copy mailed to you |
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You may call for your results |
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If you have an abnormal result, it is
extremely important to follow-up
for the recommended testing |
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Even after a normal Pap test, it is still
important to report any symptoms of abnormal vaginal bleeding, discharge or
pain to your doctor and call to be seen right away |
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If you had treatment for precancer or cancer of
the cervix, you may need a Pap test |
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If the cervix was left in place at the time of
your hysterectomy, you will still need Pap tests |
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Preventive health care is still important even
if you do not need a Pap test |
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The
American Cancer Society recommends that screening stop at age 70, if three
or more recent tests are normal, and there have been no abnormal results in
the last 10 years. |
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Liquid cytology-thin layer cytology |
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Combination of HPV test and Pap is now available
for women 30 years of age and older |
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Pap test computer reviews |
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Vaccines for HPV currently being tested |
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Evaluation of the Abnormal Pap Test
and Treatment of Precancer |
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A test sometimes used to determine if you need
further evaluation |
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Cells are collected just like a Pap test |
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It checks for high-risk HPV |
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ASC-US
management options: |
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HPV testing |
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Repeat Pap |
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Colposcopy |
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ASC-H, LSIL, HSIL, AGC, AIS, cancer |
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Colposcopy |
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Possibly endometrial biopsy for AGC |
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AIS / cancer: referral to gynecologic oncologist |
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Colposcopy: |
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Use of a magnifying instrument |
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Application of a vinegar-like solution onto the
cervix |
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See abnormalities that can’t be seen with the
naked eye |
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Feels like getting a Pap test, but lasts longer |
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Biopsy: |
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Removal of a small piece of tissue from the
cervix |
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May feel like getting a Pap test or like a
menstrual cramp that lasts a few seconds |
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Mildly abnormal (CIN I) |
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observation preferred |
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More abnormal (CIN II) |
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treatment |
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Precancer (CIN III) |
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treatment |
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Cancer |
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Gynecologic oncology consultation |
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LEEP |
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Laser |
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Cryotherapy |
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Cone Biopsy |
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In special circumstances a hysterectomy may be
recommended |
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Estimates of cure range from 73-90% with a
single treatment |
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The risk for invasive cancer following treatment
is about 1% |
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Therefore, you still need to have regular Pap
tests |
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Minimal, if any, impact on fertility |
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Take Control - Protect Yourself |
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1) Ask your doctor about an appropriate Pap test
screening interval for you |
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2) Make sure that you get a Pap test at the
recommended time |
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3) Find out how and when you will learn about
the results of your Pap test |
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4) Follow-up! Don’t assume that no news is
good news |
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5) Do not smoke |
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Abnormal bleeding |
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Between periods |
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With intercourse |
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After menopause |
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Unusual vaginal discharge |
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Other symptoms |
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Leg pain |
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Pelvic pain |
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Bleeding from the rectum or bladder |
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Some women have no symptoms |
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Find a gynecologic oncologist |
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Call 1-800-444-4441 |
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Discuss treatment options |
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Conization |
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Hysterectomy |
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Radical hysterectomy |
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Radiation with chemotherapy |
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Ask about clinical trials (Gynecologic Oncology
Group) |
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Other considerations |
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Preserve your fertility |
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Preserve your ovaries |
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Conization: |
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Removes a cone-shaped piece of tissue |
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Often allows for diagnosis and treatment |
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Performed with local anesthesia in the office or
under general anesthesia in the operating room |
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Treatment option for early stage cancer |
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Not the same as the usual hysterectomy |
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Surgical removal of the uterus, cervix and upper
vagina with the surrounding tissues |
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Lymph nodes are removed |
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Removal of the ovaries is not required |
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Standard of care for advanced cancer |
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Treatment requires: |
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External radiation |
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Internal radiation |
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Low dose chemotherapy given at the same time |
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Restoring wellness is a gradual process |
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Some women find strength from: |
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Friends and family |
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Support groups |
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Spiritual work |
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Counseling |
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Exercise |
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The challenges and the journey are different for
each woman with cervical cancer |
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Tell her it doesn’t hurt |
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Offer her a ride |
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Offer help with child care |
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Help her get an appointment |
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Help her find the right health care provider |
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Empower her with information: Tell your friend
about the importance of health prevention |
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Bobbie Gostout, M.D., Editor |
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Wendy Brewster, M.D. |
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Karen Carlson |
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Thomas Cox, M.D. |
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Juan Felix, M.D. |
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Hollis Forster |
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Christine Holschneider, M.D. |
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Beth Karlan, M.D. |
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Alan Kaye |
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Hershel Lawson, M.D. |
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Suzy Lockwood, R.N., M.S.N., Ph.D. |
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Saralyn Mark, M.D. |
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F.J. Montz, M.D., K.M. (1955-2002) |
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Mitchell Morris, M.D. |
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Karl Podratz, M.D., Ph.D. |
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Karen Riordan |
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Debbie Saslow, Ph.D. |
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Evelyn Schulman |
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Alice Spinelli, M.S.N., A.R.N.P. |
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Joan Walker, M.D. |
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Leslie Walton, M.D. |
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Thomas Wright, Jr., M.D. |
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This
educational effort was undertaken by the Gynecologic Cancer Foundation with
support from the National Cervical Cancer Coalition (NCCC). GCF gratefully acknowledges and thanks
NCCC for its efforts related to cervical cancer public outreach. |
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For more information: |
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National Cervical Cancer Coalition |
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16501 Sherman Way |
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Suite #110 |
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Van Nuys, CA 91406 |
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Toll Free Hotline (800) 685-5531 |
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Phone: (818) 909-3849 |
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Fax: (818) 780-8199 |
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Email: info@nccc-online.org |
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Web site: www.nccc-online.org |
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Notes