When a woman is diagnosed with cervical cancer, she needs to undergo several other tests, which are done for determining the staging of the disease. Pregnant women are made to undergo only the diagnostic procedures that are safe for the developing fetus. If the cancer is still in its early stage during the diagnosis, the treatment for the condition is delayed until the woman gives birth. Delay of cervical cancer treatment is also common if the disease gets diagnosed during the final pregnancy trimester. If a woman is diagnosed with cervical cancer a few days before the date of delivery, the doctor often suggests her to get a C (Cesarean) section done. There are also instances when the cancerous tissues of early stage cervical cancer has been destroyed using techniques like ;laser therapy, which are not known to cause any harm to the cervix or uterus.

If a pregnant woman is diagnosed with advanced cervical cancer during her first trimester, she may be suggested to get her pregnancy terminated. However, the decision depends entire on the expecting woman. She is allowed to take the decision after discussing with her loved ones. Diagnosis of advanced stage of cervical cancer during the 2nd or 3rd trimester can force the physician to recommend early Cesarean sections, which is accompanied by hysterectomy (the surgical procedure used for removing the uterus). The hysterectomy other than removing the uterus might also involve removal of the cervix and affected parts of the woman’s vagina.

A pregnant woman diagnosed with cervical cancer other than receiving proper treatments also requires mental conditioning. She must go for psychological counseling for facing the situation bravely.

Squamous Cell Carcinomas:
This is the most common cervical cancer type. It accounts for 80-90% of all the cervical cancer cases. The squamous cells will appear to be thin and flat in structure when examined under microscopes. Cervix can be segmented into two parts: the endocervix (the inner part of cervix) and the exocervix (the outer part of cervix). Usually, cells affected by squamous cell carcinoma are located in the region that joins the endocervix with the exocervix.

Adenocarcinoma:
Glandular cell is another cell type present in our cervix. These cells secrete mucus in the vagina. The term adenocarcinoma refers to the cervical cancer type, in which the glandular cells of the cervix become cancerous. The glandular cells are situated within the endocervix. Adenocarcinoma is accounting for around 10-20% of all the cervical cancer cases. In the last 2 to 3 decades the number of cases of adenocarcinoma has increased significantly.

Adenosquamous Carcinoma:
It is the most rare cervical cancer type among the three. The other medical term used for adenosquamous carcinomas is mix-cell carcinomas. If checked under the microscope, it can be seen that the cells affected by this cervical cancer type comprises of both glandular cells and squamous cells.

Stage 0:
This is the stage when the cervical cancer just starts to develop; the stage is marked by abnormal transformations known as dysplasia, which occur within the cervical lining. Diagnosis of stage 0 of cervical cancer usually occurs during the routine Pap Smear. In this stage, the cancer does not invade the patient’s lymph nodes.

Stage 1:
Stage 1 cervical cancer is characterized by invasion of the cancer into the cervix’s deeper tissues; however, in this stage also the cancer stays confined within the cervix. Patients in stage 1 of cervical cancer do not experience any symptom indicating the spreading of cancer cells in distant organs or the lymph nodes. Stage 1 cervical cancer can again be segmented into 2 sub stage; stage IA and stage IB. In stage IA of cervical cancer, the cancer reaches the cervix’s deeper tissues; but this spreading of the disease can only be viewed through a microscope. In stage IB of cervical cancer, the spreading of the cancer might be visible to the eyes; in this stage the cancer invaded the cervix by over 7mm across and 5mm inside.

Stage 2:
According to theories of medical science, in its stage 2, cervical cancer spreads beyond cervix and reaches the adjacent structures. However, the cancer in this stage still does not invade the patient’s vagina or pelvic wall. Stage 2 of cervical cancer does not include any involvement of the lymph nodes. Like stage 1, stage 2 cervical cancer also has 2 sub stages, stage IIA and Stage IIB. In Stage IIA, the cancer spreads to the vagina’s upper part; however, the parametria i.e. the tissues around the cervix still stay unaffected. In stage IIB, the cancer invades the upper vagina as well as the parametria.

Diagnosis:-

In a process of diagnosis of a cervical cancer, in a initial stage, the  patient may be advised to go for a colposcpoy. It is basically a protected assessment of the cervix area.  After this procedure, the physician may go for a biopsy test in the laboratory. They usually collect a small tissue from the cervix area as a sample and go for a test. Usually, the laboratory test demonstrate the abnormal growth of cancer cells in the cervix. If this test says that the patient has cervical cancer , she will also need to go for a Computer tomography  or CT Scan and MRI scan. The physicians also do an ultrasound scan for the cervix to find the cancer cell growth. Currently, the medical experts are working on positron emission tomography or PET-CT scanning process to diagnose the medical case. A Pap smear test is also done by collecting cells from vaginal surface.

Treatments for Cervical Cancer:-

As the patient is diagnosed with cervical cancer, the healing process generally starts with chemotherapy drugs. Theses drugs have been proven as significantly affective for a number of cancer patients. This treatment is done to destroy the cancer cells and stop the cell growth inside the uterus.  The medication is also given through injection. The other treatment of cervical cancer is Radiation therapy or radiotherapy; here the powerful radiation is thrown on the affective part to destroy the cancer cells. The radiation therapy can give more effective result if it is included with chemotherapy drugs as directed by the physician. There are cases where the cancer has not spread in the outer cells of the cervix. In such cases, it is said that the patient has Microinvasive disease. Here, the physical experts adopt a small operative method to remove the cancerous cells. The other treatment is known as laser therapy. Nowadays, this treatment has become very famous among a number of patients. Here the medical experts use a large-loop excision of the transformation zone or LLETZ to take away the abnormal area. The cancer, which is in the final stage, is treated through a surgery. The patient also needs to go through radiotherapy. The surgery is also known as radical hysterectomy.

How can you prevent?

The first step towards the prevention of a cervical cancer is adopting a safe sex method and trying to prevent any occurrence of HPV. The National Health Services has in initiated a Cervical Cancer Screening program to treat those patients who are in the precancerous stage. The Cervical Screening is a process to test the inner parts of the cervix. The inhabitants of UK are diagnosed with this health status within a gap of five years. The HPV Vaccine will be another imitative to fight an occurrence of cancer. A research has said that the HPV Vaccine can save an occurrence of cervical cancer for at least ten to twenty years. In the countries like the UK, almost all the girls who are in the age of twelve to thirteen years receive the HPV vaccine. A women who is diagnosed with the cancer symptoms, can face a big shock of life. The family members should give a profound support to the patient and give an extra love and affection.

The useful nutrients:-

The patient, who is suffering with cervical cancer, should have a diet full of useful nutrients. She should have all needed fruits and vegetables in a proper amount. The intake of high level of vegetables helps the body to reduce the cancer risk for fifty-five percent. Medical experts say that papaya consumption can be very useful to treat HPV infections. The other resource is Vitamin A. If an women body suffers with the deficiency of Vitamin A , can have a risk of having HPV infections. In addition, the intake of doses of Vitamin C, E, Folic Acid and Vitamin K is also very much supportive to prevent the infection. In a clinical trial done on a HPV Positive patient, a lower level of alpha-tocopherol was found in the blood stream, says a report. The intake of folic acid and Carotenoids are also needed to avoid infections.

Awareness:-

There is also a deep need of spreading awareness about infection of HPV and cancer in the Cervix. A report says, a research done in the year 2005 by the US National Cancer Institute found that only twenty to twenty-five percent women in America had the awareness about the disease. It is very important to spread the awareness about the cancer in the rural and urban areas.

Cervical Cancer – Part 1

What is a Cervical cancer?

The health condition of cervical cancer is actually a malignant neoplasm that can be found in the cervix uteri and other parts of the cervical area. The area of cervix is a very thin but important part inside the uterus. Uterus is an area , where  a baby grows during a pregnancy. The location of the cervix is connected with the top part of the vagina. Medical experts say that the cervical cancers are generally the squamous cell carcinomas and it happens in the flattened epithelial cells or sqauamous, which covers the cervix.  The very common type of cancer is the Adenocarcinoma. This type of cells arise glandular epithelial cells. In some cases, the cancer can also happen in other segments of cervix; however, this is not that common. The cancer can be there in the bleedings from the vagina and as the cancer reaches in the advanced stage, the symptoms can be seen.

Causes of Cervical Cancer:-

The exact cause of a cervical cancer is still unknown to the scientists. There are many grounds that can lead to a cervical cancer in women. It can be a sexual History, any affect of lifestyle. The main thing that results in this stage of cancer is the infection of  HPV or Human papillomavirus. The HPV infection has been in the top of cause list of cervical cancer. The virus affects the inner and outer parts of genital tract. Medical experts say that there are almost forty-five types of HPV Virus. The virus of HPV has some certain categories, which can spread through the contact of one person with another, especially, through sexual behavior. Some of warts that occur inside the vagina also causes the occurrence of cervical cancer. If a patient has a habit of frequent smoking, the women who start having sex in very early age, the people who have many sex partners, have a high risk of the infection. The person who has a very weak immune system and an attempt to unsafe sex or other source of infection will also have the risk. Usually, the human beings are affected two segments of a cervical cancer first is the squamous cell cancer and the other one is adenocarcinoma. There are also cases where the patient gets both the infections together.

Cervical Cancer symptoms and signs:-

The women who suffer with this cancer can suffer with irregular bleeding from the vagina; it can be during the menstruation or after the attempts of sexual activity. The bleeding can also happen in  a post menopausal condition. The women suffering with the symptom can also face trouble in the urination process, it can be a pain or burning sensation. The women will have trouble during sex. She can also have swellings in the intestines.  An advanced stage will also lead severe infections in the heart, bladder, abdomen and kidney.

Cervical Cancer – Part 2

Cervical cancer garners the second slot in the list for being the most pervasive form of cancer among females globally and estimated to cause 328000 deaths in 2010.

During a large-scaled trial examining information dating back 6 decades from 10574 invasive cervical cancer cases across thirty-eight nations, a global group of researchers inspected what forms of HPV were contributory to majority of the worldwide occurrences of cervical cancer.

The study helmed by Silvia de Sanjose appeared in the latest edition of ‘Lancet’ found that 8 forms of HPV – 35, 58, 52, 31, 33, 45, 18 and 16 – as per ascending order of regularity have been found to be accountable for over ninety percent of cervical cancer cases.

GlaxoSmithKline makes the vaccination Cervarix whereas Gardasil manufactured by Merck & Co. shields women from HPV forms sixteen and eighteen; via cross-shielding, partly even from HPV forms thirty-one and forty-five.

Several well-off nations have commenced vaccination programmes wherein such jabs are administered to girl populaces prior to them becoming sexual active, however the vaccinations are usually quite expensive & unreachable for majority of the individuals residing in underprivileged nations.

According to Sanjose from Catalan Inst. of Oncology, Barcelona the trial outcomes reinforce the justification for cervical cancer deterrence via usage of existent vaccinations & could assist in the expansion of 2nd generation vaccinations for shielding from several forms of HPV.

About eighty percent of the global cervical cancer cases presently crop up in third world nations & the condition arises due to elevated risk & sexually-transmittable forms of human papillomavirus.

From the over 118 varied forms of HPV whose identification has been made, around forty communicate a disease to the lower urinary & reproductive tract & twelve types are found to be cancer-causative, the study scientists explicated.

During their trial, that entailed cancer cases across N. American, European, C.S. American, African, Asian regions, the scientists additionally detected numerous atypical HPV forms like 67, 61, 69, 26, 82, 91 and 30 that could additionally be causal to cervical cancer however accounting for merely 1% of cases globally.

This trial has been pegged as a formidable endeavour which may be the standard for all times.

The outcomes of the trial apparently back futuristic courses for cervical cancer screenings & form-specific triage and institute the potential global effect of present HPV vaccinations & setting main concerns for the subsequent generation vaccinations.

Immunization for HPV (human papillomavirus), is advised for all women up to twenty-six years of age and even for girls of nine years of age. The latest study headed by author Dr. Ana Cecilia Rodriguez stated that the study was conducted for ascertaining if women in the older age band could be shielded alongside observing outline of HPV infection as women grew older.

The study did a follow-up of over nine thousand women from Costa Rica in the age group of nineteen to 97 years and screened them for cancer-causing HPV infections and originators to cervical cancer.

The study that was lately released online in The Journal of the National Cancer Institute showed that the rate of lately identified infections plummeted as women aged – to 13.5% among women forty-two years and more, from thirty-five percent among women in ages 18-25 years. New-fangled infections were observed to usually subside in analogous manner among both older and younger females with no need for treatment.

Dr. Rodriguez expounded that despite cervical cancer having far greater prevalence among older-aged women as compared to women in the younger age group; it has been observed to develop decade or more time periods following the preliminary infection with a cancer-causing virus.

Dr. Rodriguez from the Inceinsa Foundation, a fitness and nutrition organization, whose effort was backed by the NIH (National Institutes of Health) in the U.S. stated that as the HPV vaccine could solely avert infections, and since such women were not contracting infections to that vast an extent, hence likely gains from the HPV inoculation in women from the older age group was quite circumscribed.

The Human Papilloma Virus

The finding that the HPV or Human Papillomavirus virus causes cervical cancer has opened novel avenues in its prevention and treatment. There seems to be a strong association between the occurrence of cervical cancer and the commonness of HPV infection in the populace. Above hundred HPV types has been detected, nearly forty are found to affect the genital region and at least fifteen are deemed oncogenic; 2 other types cause majority of the cases of genital warts.

HPV linked Diseases

Globally, HPV is the most commonly occurring sexually transmitted infection that affects nearly 50-80% women that are sexually active at least once during their life span. Women could usually get infected with HPV in their teen years, twenties or early thirties; however the vast majority clears the virus innately. The progression from HPV infection to cervical cancer is an atypical and gradual progression; nearly five to ten per cent of women infected with oncogenic HPV eventually develop continual infections; these women are at heightened risk of developed high-grade, pre-malignant lesions and if untreated leads to cervical cancer. Usually, it could take about two decades or more for the infections to progress to cancer; hence as a consequence, the incidence of cervical cancer starts to increase after 35-40years of age and does not peak till a woman reaches her fifties or sixties.

HPV vaccine

A vaccine that averts HPV-associated cervical disease –and hence cervical cancer –potentially offers immense benefits. The below stated are the varied cervical cancer vaccination.

• Prophylactic Vaccine
  Prophylactic immunisation offer a potentially economical, logistically simplistic and immensely effectual approach to reducing impediments due to cervical cancer. But, it is not likely to offer any benefits to women who are already infected with HIV-linked diseases.
• Therapeutic Vaccine
  A therapeutic vaccine could be helpful to women that already have the HPV infection. Employed alone or merged with standard treatments, a therapeutic vaccine could aid in averting low-grade ailment from progression and lead to regression of existent lesions; it could additionally have the potential to curb the spread of metastatic cancer and avert relapse of cervical cancer. For maximum efficacy, therapeutic HPV vaccines must elicit cell-intervened immunity as antibodies fail to reach and eradicate the virus once it has been integrated into host cells.
• Chimeric Vaccine
  The most effectual HPV vaccine approach calls for a vaccine that has both prophylactic and therapeutic properties that are present in the chimeric vaccine that has the capacity to prevent novel HPV infections and clearing existent infections. This vaccine could be administered to both sexually inexperienced youngsters and older aged women that have already been infected with HPV. It has a likelihood of having a swifter impact on cervical cancer rates as compared to the purely prophylactic vaccine.
• First-generation VLP Vaccine
  Gardasil (Merck and Co.) and Cervarix (GlaxoSmithKline) are the presently obtainable first-generation VLP vaccinations essentially targeting HPV strains 16 and 18. This is chiefly due to the reason that they are reason behind 70% of squamous cell cervical cancers and an approximate 35% of low grade squamous intraepithelial lesions globally.
  A latest study indicates that HPV 16 and 18 could be accounting for nearly 85% of adenocarcinomas. Epidemiological information indicates that a bivalent vaccine against HPV 16 and 18 could avert an approximate 71% of cervical cancers globally.
  Gardasil additionally targets HPV strains 6 and 11 that lead to 90% of all anogenital warts in both sexes. Judging by the fact that younger aged girls in ages of ten to fifteen years have a comparatively higher immunogenic response as compared to older aged adolescents, vaccine manufacturers are suggesting inoculations at ages of 10-12 years in Europe and North America, where several teens start becoming sexually active early on. In other parts of the world, strong presence of cultural norms govern sexual behaviourisms that could postpone the age of first sexual intercourse till late adolescent year or till after marriage, it could be ideal to inoculate both sexes at a rather later age. Irrespective of the age of first immunisation, inoculation programs must consider the requirement of booster doses.
  Men don main roles in spreading HPV as they do in the case of other sexually transmitted diseases, that indicate that inoculating men could be important for producing herd immunity, even though cervical cancer are known to affect solely the female gender.
• Protein and Peptide Vaccine
  These rely on genetic engineering practices for producing antigenic sections that are capable of evoking an immune response with increased safety and lesser side effects than a whole organism. As they evoke weaker immune responses as compared to the whole pathogen, hence several inoculations are needed for producing long-lasting immunity.
• Recombinant live vector Vaccine
  These vaccines merge the benefits derived from subunit vaccines and live attenuated ones. As they express solely selected HPV genes, hence are rather safe. They are increasingly immunogenic producing long-lasting safeguard with a single vaccination. The disadvantage is that it could be unsafe for immune- compromised individuals.
• DNA Vaccine
  Naked DNA is amongst the latest strategies to vaccine development. Their advantages are that they elicit both cell and antibody-mediated immunity thus inducing long-standing immunity. These could also be stored at room temperatures and have longer shelf life.
• Plant-based Vaccine
  Genes derived from human pathogens are introduced into a range of plants employing genetic engineering. Such transgenic plants then start producing and accumulating disease antigens in their tissues. Optionally, the gene sequences for a required antigen are inserted into either a bacterium or a virus that usually cause infection among plants. When bacterium or virus infection affects adult plants, they manufacture and amass the required proteins. In case edible plants are employed, their fruits and vegetables could have immense potential to function as edible vaccines.

Cervical cancer is one of the most prevalent forms of cancer that affects women globally and a key reason behind cancer-linked fatalities. Hence, the researchers have endeavoured to investigate if these genetic alterations could provide additional information to the clinical data derived from standard assessment means, and be employed for identifying patients that require further treatment. Past studies have revealed that there were several genetic variations in the cancer cells of those affected with cervical cancer; however their significance in the disease proliferation and treatment immunity is yet to be thoroughly delved.

Heidi Lyng, head author of the study observed more than 140 patients who had been detected with cervical cancer and underwent treatment at the Norwegian Radium Hospital. Employing screening techniques covering all genes in the human genome, the researchers cited that their main discovery was the collection of biological processes which are found to be the traits of cancer related to the growth and pasting of particular genes. Furthermore, they detected new loci related to immunity against chemotherapy and radiotherapy, and illustrated the genes entailed in this process.

This research signifies a significant move in deciphering how cervical cancer develops, however the authors accentuated the fact that the outcomes need to be authenticated in independent patient groups prior to considering their usage in clinical decision-making.

The Cervarix vaccine (Manufacturer – GlaxoSmithKline) is aimed at combating high risk HPV strains 16 and 18 that are the offenders for nearly seventy percent of all occurring cervical cancers, and has got the green-light from the FDA to be used in girls and women in the age group of 10-25 years.

HPV is a set of more than hundred related virus forms that could be transmitted via skin contact – inclusive of intercourse –vaginal or anal and could even be transmitted at the time of oral sexual contact. HPV leads to the appearance of genital warts, although several infected individuals could be asymptomatic. Several women contract HPV; however, in majority of the cases, it subsides without being treated. But, among few women it could linger and probably lead to cervical cancer.

In the present year, more than eleven thousand women in the United States could be detected having cervical cancer and nearly four thousand women would face fatality due to the disease. Nearly all the cases (more than ninety-nine percent) of the cervical cancers are linked to HPV. For lowering the chances of contracting HPV infection, doctors suggest women in the young age bracket to delay sex, follow safe sex practices (condom does not offer total safeguard from the infection) and according to the age group must get inoculated.

Gardasil (Manufacturer – Merck) has been joined by Cervarix as the new-fangled HPV vaccine having the FDA nod.

During a study conducted on more than eighteen thousand girls and women in the age of 15-25 years, Cervarix was observed to have an efficacy rate of 93% in averting pre-malignant lesions occurring due to the HPV strains 16 and 18, among those that were administered all three doses of the vaccine at the commencement of the study.

However, Cervarix was ineffective among those that previously had been infected with the HPV strains. The prevalent side effects involve pain, discomfort, reddishness and swell up noted at the jab spot; weariness; headaches; aching muscles and joints; and GI (Gastro-Intestinal distress). The vaccine is administered in a sequence of three jabs spanning over a six-monthly time period.

The certification of Cervarix makes it yet another choice in deterring cervical cancer. It is a potentially life-saving vaccine against cervical cancer and helps in reducing the necessity of going in for biopsies and invasive methods related to the obligatory follow-up arising from irregular Pap Tests.

Gardasil – the other vaccine having the FDA approval, safeguards against HPV-strains 16, 18, 6 and 11 that cause genital warts. Similar to Cervarix, it is administered three times over a span of six months. It was lately approved for use among boys and men in the age bracket of 9 to 26 years to assist in averting genital warts.

Till now these two vaccines have not been compared against each other. The Gardasil vaccine series is available at nearly 360 dollars excluding the doctor’s fee or the cost incurred for administering the injections). GlaxoSmithKline has still not revealed the cost of Cervarix.

The American Cancer Society is reassessing the information on Cervarix. ACS presently suggests that Gardasil be customarily be administered to females in the age group 11-12 and earlier as 9 years at the prudence of the doctors, and concurs that ‘catch-up’ inoculations must be offered to girls between 13-18 years. Women lying between 19-26 years need to discuss with their health care provider regarding the risk of earlier exposure to HPV and probable advantages gained from the inoculation prior to opting for any vaccination.