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#Robbins Kumar Basic Pathology First
loriraxubu · 1 year
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Sparsh gupta pathology latest edition pdf
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collegebookstore · 3 years
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ficojasulan · 2 years
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Cervical Cancer
Intro
Cervical Cancer
Cervical cancer is a cancer from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early no symptoms are seen. Later symptoms may include abnormal vaginal bleeding, pelvic pain, or pain during sexual intercourse.
Cervical cancer typically develops from precancerous changes over 10 to 20 years. About 90% of cervical cancer cases are squamous cell carcinomas, 10% are adenocarcinoma, and a small number are other types. Diagnosis is typically by cervical screening followed by a biopsy. Medical imaging is then done to determine whether or not the cancer has spread.
HPV vaccines protect against between two and seven high-risk strains of this family of viruses. Regular Pap smears are also used as a mechanism to detect cancer. Other methods of prevention include: having few or no sexual partners and the use of condoms. Cervical cancer screening using the Pap smear or acetic acid can identify precancerous changes which when treated can prevent the development of cancer. Treatment of cervical cancer may consist of some combination of surgery, chemotherapy, and radiotherapy.
Causes
HPV
Smoking
Oral contraceptives
Multiple Pregnancies
Stages
1A, 1B, 2A, 2B, 3B, 4A, 4B.
Treatment
Microinvasive cancer (stage 1A) may be treated by hysterectomy (removal of the whole uterus including part of the vagina). For stage 1A2, the lymph nodes are removed, as well. Alternatives include local surgical procedures such as a loop electrical excision procedure or cone biopsy. For 1A1 disease, a cone biopsy (cervical conization) is also used.
If a cone biopsy does not produce clear margins, one more possible treatment option for women who want to preserve their fertility is a trachelectomy. This attempts to remove the cancer while preserving the ovaries and uterus. It is a viable option for those in stage 1 cervical cancer which has not spread. Due to the possible risk of cancer spread to the lymph nodes in stage 1b cancers and some stage 1a cancers, the surgeon may also need to remove some lymph nodes from around the uterus for evaluation.
A radical trachelectomy can be performed abdominally or vaginally. A radical abdominal trachelectomy with lymphadenectomy complications are uncommon. Recurrence in the residual cervix is very rare if the cancer has been cleared with the trachelectomy.
Early stages (IB1 and IIA less than 4 cm) can be treated with radical hysterectomy with removal of the lymph nodes or radiation therapy. Radiation therapy is given as external beam radiotherapy to the pelvis and brachytherapy (internal radiation). Women treated with surgery who have high-risk features found on pathologic examination are given radiation therapy with or without chemotherapy to reduce the risk of relapse.
Larger early-stage tumors (1B2 and 2A) may be treated with radiation therapy and cisplatin-based chemotherapy, hysterectomy (which then usually requires adjuvant radiation therapy), or cisplatin chemotherapy followed by hysterectomy.
Advanced-stage tumors (2B-4A) are treated with radiation therapy and cisplatin-based chemotherapy. Hycamtin and cisplatin, for women with late-stage (4B) cervical cancer treatment. Combination treatment has significant risk of neutropenia, anemia, and thrombocytopenia side effects.
References
“Cervical Cancer Treatment (PDQ®)”. NCI. 2014-03-14. Retrieved 24 June 2014.
“Defining Cancer”. National Cancer Institute.
Tarney, CM; Han, J (2014). “Postcoital bleeding: a review on etiology, diagnosis, and management.”. Obstetrics and Gynecology International.
Kumar V, Abbas AK, Fausto N, Mitchell RN (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier.
Kufe, Donald (2009). Holland-Frei cancer medicine. (8th ed.). New York: McGraw-Hill Medical.
World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 5.12.
Dunne, EF; Park, IU (Dec 2013). “HPV and HPV-associated diseases.”. Infectious Disease Clinics of North America. 27 (4): 765–78.
“Cervical Cancer Treatment (PDQ®)”. National Cancer Institute. 2014-03-14.
“FDA approves Gardasil 9 for prevention of certain cancers caused by five additional types of HPV”. U.S. Food and Drug Administration. 10 December 2014.
“Human Papillomavirus (HPV) Vaccines”. National Cancer Institute. 2011-12-29.
Tran, NP; Hung, CF; Roden, R; Wu, TC (2014). “Control of HPV infection and related cancer through vaccination.”. Recent Results in Cancer Research. 193: 149–71.
“Cervical Cancer Prevention (PDQ®)”. National Cancer Institute. 2014-02-27.
World Health Organization (February 2014). “Fact sheet No. 297: Cancer”.
“SEER Stat Fact Sheets: Cervix Uteri Cancer”. NCI.
World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 1.1.
Baalbergen, Astrid; Veenstra, Yerney; Stalpers, Lukas; Baalbergen, Astrid (2013). “Primary surgery versus primary radiotherapy with or without chemotherapy for early adenocarcinoma of the uterine cervix”. Reviews.
Erstad, Shannon (2007-01-12). “Cone biopsy (conization) for abnormal cervical cell changes”.
Jones WB, Mercer GO, Lewis JL, Rubin SC, Hoskins WJ (1993). “Early invasive carcinoma of the cervix”. Gynecol. Oncol. 51 (1): 26–32.
Dolson, Laura (2001). “Trachelectomy”.
Burnett AF (2006). “Radical trachelectomy with laparoscopic lymphadenectomy: review of oncologic and obstetrical outcomes”. Curr. Opin. Obstet. Gynecol. 18 (1): 8–13.
Cibula D, Ungár L, Svárovský J, Zivný J, Freitag P (2005). “[Abdominal radical trachelectomy–technique and experience]”. Ceska Gynekol (in Czech). 70 (2): 117–22.
Plante M, Renaud MC, Hoskins IA, Roy M (2005). “Vaginal radical trachelectomy: a valuable fertility-preserving option in the management of early-stage cervical cancer. A series of 50 pregnancies and review of the literature”. Gynecol. Oncol. 98 (1): 3–10.
Roy M, Plante M, Renaud MC, Têtu B (1996). “Vaginal radical hysterectomy versus abdominal radical hysterectomy in the treatment of early-stage cervical cancer”. Gynecol. Oncol. 62 (3): 336–9.
Dargent D, Martin X, Sacchetoni A, Mathevet P (2000). “Laparoscopic vaginal radical trachelectomy: a treatment to preserve the fertility of cervical carcinoma patients”. Cancer. 88 (8): 1877–82.
Schlaerth JB, Spirtos NM, Schlaerth AC (2003). “Radical trachelectomy and pelvic lymphadenectomy with uterine preservation in the treatment of cervical cancer”. Am. J. Obstet. Gynecol. 188 (1): 29–34.
Waggoner, Steven E (2003). “Cervical Cancer”. The Lancet. 361 (9376):
“FDA Approves First Drug Treatment for Late-Stage Cervical Cancer”. U.S. Food and Drug Administration. 2006-06-15.
Sardain, H; Lavoue, V; Redpath, M; Bertheuil, N; Foucher, F; Levêque, J (August 2015). “Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review.”. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 41 (8): 975–85.
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collegebookstore · 4 years
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