Stages of Cervical Cancer: Stage 0 describes cancer cells found only on the surface of the cervix. More invasive cancers are separated into four stages. Stage I is when the cancer has not spread beyond the cervix. Stage II means the tumor has spread to the upper part of the vagina. A Stage III tumor extends to the lower part of the vagina and may block urine flow. In Stage IV, the tumor has reached the bladder or rectum, or cancer cells have spread to other parts of the body and formed new tumors.
Worldwide, cervical cancer is second most common and the fifth deadliest cancer in women. It affects about 16 per 100,000 women per year and kills about 9 per 100,000 per year. Approximately 80% of cervical cancers occur in developing countries Worldwide, in 2008, it was estimated that there were 473,000 cases of cervical cancer, and 253,500 1) ___ per year.
TODAY, NO WOMAN SHOULD DIE OF CERVICAL CANCER.
Young people should be given the HPV vaccine before they become sexually active. Regular PAP smears will reveal pre-cancerous changes in plenty of time to prevent cancer.
Cervical cancer is a malignant neoplasm arising from cells originating in the cervix uteri. One of the most common symptoms of cervical cancer is abnormal vaginal bleeding, but in some cases there may be no obvious 2) ___ until the cancer has progressed to an advanced stage. Treatment usually consists of surgery (including local excision) in early stages, and chemotherapy and/or radiotherapy in more advanced stages of the disease. Cancer screening using the Pap 3) ___can identify precancerous and potentially precancerous changes in cervical cells and tissue. Treatment of high-grade changes can prevent the development of cancer in many victims. In developed countries, the widespread use of cervical screening programs has dramatically reduced the incidence of invasive cervical cancer.
HPV or 4) ___ ___ ___ infection appears to be a necessary factor in the development of almost all cases (90+%) of cervical cancer. HPV vaccines effective against the two strains of this large family of viruses that currently cause approximately 70% of cases of cervical cancer have been licensed in the U.S, Canada, Australia, and the EU. Since the vaccines only cover some of the cancer-causing (“high-risk”) types of HPV, women should seek regular Pap smear screening, even after vaccination.
The cervix is the narrow portion of the 5) ___. Most cervical cancers are squamous cell carcinomas, arising in the squamous (flattened) epithelial cells that line the cervix. Adenocarcinoma, arising in glandular epithelial cells is the second most common type. Very rarely, cancer can arise in other types of cells in the cervix. The early stages of cervical cancer may be completely asymptomatic. Vaginal 6) ___, contact bleeding, or (rarely) a vaginal mass may indicate the presence of malignancy. Also, moderate pain during intercourse and vaginal discharge are symptoms of cervical cancer. In advanced disease, metastases may be present in the abdomen, lungs or elsewhere. Symptoms of advanced cervical cancer may include: loss of 7) ___, weight loss, fatigue, pelvic pain, back pain, leg pain, swollen legs, heavy bleeding, bone fractures, and/or (rarely) leakage of urine or feces (rarely). Infection with some types of human papilloma virus (HPV) is the greatest risk factor for cervical 8) ___, followed by smoking. Other risk factors include human immunodeficiency virus. Not all of the causes of cervical cancer are known, however, and several other contributing factors have been implicated.
Cervical cancer occurs when abnormal 9) ___ on the cervix grow out of control. Cervical cancer can often be successfully treated when it’s found early. It is usually found at a very early stage through a Pap test. Most cervical cancer is caused by a virus called human papillomavirus, or HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital 10) ___, but other types may not cause any symptoms. Human papillomavirus is the cause of 70% of cervical cancer globally.
You can have HPV for years and not know it. It stays in your 11) ___ and can lead to cervical cancer years after you were infected. This is why it is important for you to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer. Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:
- Bleeding from the vagina that is not normal, or a change in your menstrual cycle that you can’t explain.
- Bleeding when something comes in contact with your cervix, such as during sex or when you put in a diaphragm.
- Pain during intercourse.
- Vaginal discharge that is tinged with blood.
As part of a regular pelvic 12) ___, one should have a Pap test. During a Pap test, the doctor scrapes a small sample of cells from the surface of the cervix to look for cell changes. If a Pap test shows abnormal cell changes, your doctor may do other tests to look for precancerous or cancer cells on your cervix. Your doctor may also do a Pap test and take a sample of tissue (biopsy) if you have symptoms of cervical cancer, such as bleeding after intercourse. While the pap smear is an effective screening test, confirmation of the diagnosis of cervical cancer or pre-cancer requires a biopsy of the cervix.
The widespread introduction of 13) ___ screening by the Pap test or Pap smear for cervical cancer has been credited with dramatically reducing the incidence and mortality of cervical cancer in developed countries. Pap smear screening every 3-5 years with appropriate follow-up can reduce cervical cancer incidence by up to 80%. Abnormal results may suggest the presence of pre-cancerous changes allowing examination and possible preventive treatment. If precancerous disease or cervical cancer is detected early, it can be monitored or treated relatively noninvasively, with little impairment of fertility.
Cervical cancer screening is typically recommended starting at age 21. Recommendations for how often a Pap smear should be done vary from once a year to once every five years, in the absence of abnormal results. Guidelines vary on how long to continue screening, but well screened women who have not had abnormal smears can stop screening about age 60 to 70. The treatment for most stages of cervical cancer includes:
- Surgery, such as a hysterectomy and removal of pelvic lymph nodes with or without removal of both ovaries and fallopian tubes.
- Radiation therapy.
Depending on how much the cancer has grown, you may have one or more treatments. And you may have a combination of treatments. If you have a hysterectomy, you won’t be able to have children. But a 14) ___ isn’t always needed, especially when cancer is found very early.
The Pap test is the best way to find cervical cell changes that can lead to cervical cancer. Regular Pap tests almost always show these cell changes before they turn into cancer. It’s important to follow up with your doctor after any abnormal 15) ___ test result so you can treat abnormal cell changes. This may help prevent cervical cancer. If you are age 26 or younger, you can get the HPV vaccine, which protects against two types of HPV that cause cervical cancer. There are two HPV vaccines (Gardasil and Cervarix) which reduce the risk of cancerous or precancerous changes of the cervix and perineum by about 93%. HPV vaccines are typically given to women age 9 to 26 as the vaccine is only effective if given before infection occurs. The vaccines have been shown to be effective for at least 4 to 6 years, and it is believed they will be effective for longer; however, the duration of effectiveness and whether a booster will be needed is unknown. The high cost of this vaccine has been a cause for concern. Several countries have considered (or are considering) programs to fund HPV vaccination.
ANSWERS: 1) deaths; 2) symptoms; 3) smear; 4) Human papilloma virus; 5) uterus; 6) bleeding; 7) appetite; 8) cancer; 9) cells; 10) warts; 11) body; 12) exam; 13) cervical; 14) hysterectomy; 15) Pap