Jan. 9, 2003 – January is Cervical Cancer Awareness month, and this Cancer Information Service column presents information from the National Cancer Institutes publication: "What You Need to Know About Cancer of the Cervix."
Each year, about 15,000 women in the United States learn they have cancer of the cervix. If all women had pelvic exams and Pap tests regularly, most precancerous conditions would be detected and treated before cancer develops. Precancerous changes of the cervix usually do not cause pain.
What are precancerous conditions?
Scientist believe that some abnormal changes in cells on the cervix are the first step in a series of slow changes that can lead to cancer years later. That is, some abnormal changes are precancerous; they may become cancerous with time.
There are different terms that doctors use to refer to abnormal changes. One term is squamous intraepithelial lesion, or SIL. The word "lesion" refers to the area of abnormal tissue; "intraepithelial" means that the abnormal cells are present only in the surface layer of cells.
What are the symptoms of cervical cancer?
Symptoms usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue. The most common symptom is abnormal bleeding — bleeding between periods or bleeding after menopause.
However, these symptoms may be caused by cancer or by other health problems. Only a physician can tell for sure. It is important for a woman to see her doctor if she is having any of these symptoms.
How is cancer of the cervix diagnosed?
After a pelvic exam or Pap test, the doctor is able to detect abnormal changes in the cervix. There are several diagnosis options that a doctor may use to determine whether a patient has cervical cancer, including colposcopy, biopsy, loop electrosurgical excision procedure (LEEP), endocervical curettage (ECC), conization, or dilatation and curettage (D and C). All these procedures can be done in a doctor's office or at the hospital.
What are the treatment options for cervical cancer?
The choice of treatment for cervical cancer depends on the location and size of the tumor, the stage (extent) of the disease, the woman's age and general health, and other factors.
Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. Before starting treatment, the patient may want a second pathologist to review the diagnosis and another specialist to review the treatment plan.
Most often methods of treatment for cervical cancer involve surgery and radiation therapy. Sometimes, chemotherapy or biological therapy is used. Often patients are treated by a team of specialists. The team may include gynecologic oncologists and radiation oncologists. The doctors may decide to use one treatment method or a combination of methods. Some patients take part in clinical trials (research study) using new treatment methods.
Most women with cervical cancer want to learn all they can about their disease and treatment choices so they can take an active part in decisions about their medical care.
Here are some questions a woman with cervical cancer may want to ask her doctor before her treatment begins:
– What is the stage (extent) of my disease?
– What are my treatment choices? Which do you recommend? Why?
– What are the chances that the treatment will be successful?
– Would participation in a clinical trial be appropriate for me?
– What are the risks and possible side effects of treatment?
– How long will treatment last?
– Will it affect my normal activity?
– What is the treatment likely to cost?
– What is likely to happen without treatment?
– How often will I need to have checkups?
Patients should not feel they need to ask all of their questions or remember all of the answers at one time.
What is nutrition like for cancer patients during treatment?
Some patients find it hard to eat well during cancer treatment. They may lose their appetite. The common side effects of treatment, such as nausea, vomiting or mouth sore, can make eating difficult. For some patients, foods taste different. Also, people may not feel like eating when they are tired or uncomfortable.
Eating well during cancer treatment means getting enough calories and protein to help prevent weigh loss and to regain strength. Patients who eat well often feel better and have more energy. In addition, they may be better able to handle the side effects of treatment.
What type of follow-up care is needed after cervical cancer treatment?
Regular follow-up exams — including a pelvic exam, a Pap test and other laboratory tests — are very important for any woman who has been treated for a precancerous condition or cancer of the cervix. The doctor will perform these tests and exams frequently for several years to check for any signs that the condition has returned.
Cancer treatment may cause side effects many years later. For this reason, patients should continue to have regular checkups and should report any health problems that appear.
For more information, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), or visit the CIS Web site.
The telephone service is available in the Virgin Islands from 10 a.m. to 5:30 p.m. Monday through Friday. Calls are confidential and free.
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