Cervical cancer Flashcards
where does cervical cancer happen?
because cervix is an opening to the uterus, the wall of the cervix is where the malignancy happens
etiology & risks of cervical cancer?
- HPV infection (human papilloma virus)
- Hx of STDs
- multiple sex partners, early age sex
- smoking (organ specific carcinogens)
Human papilloma virus
- more than 100 strains
- approx 40 are sexually transmitted
- strain 6 & 11 cause 90% of genital warts
- strain 16 & 18 responsible for approx 70% of cervical cancer
strain 6 & 11 of HPV
cause 90% of genital warts
strain 16 & 18 of HPV
responsible for approx 70% of cervical cancer
what are some things that can be done in protection for cervical cancer?
- gardasil: 3 shots, 0, 2, 6 months protection for approx 6 yrs
- pap smear (papnicolaou test): smear of cervix, look at epithelial cells in lab if squamous cells normal-negative, if shows squamous cells dysplasia-precancerous squamous cell malignancy 3 different scoring for positives (CIN)
Patho of cervical cancer
- squamous cell origin
- initial dysplasia (precancerous legion)
- then carcinoma in situ (in epithelial layer), progresses in cone shape (large to small)
- later invasive CA (deeper layers)
- several years between precancerous & invasive stage
- CIN (levels of cervical intraepithelial neoplasia)
- mets via lymphatics
what is CIN
levels of cervical intraepthelial neoplasia
CIN 1, CIN 2, CIN 3
cervical cancer has what kind of cell origin?
squamous cell origin
Diagnosing cervical cancer
- PAP smear (for screening & diagnosis)
- colpsocopy (scope cervix & vagina - view cervix to determine location & extent of location)
manifestations of cervical cancer
- vaginal discharge(not purulent, not heavy)
- metorrhagia (bleeding between menses- abnormal, in women that are post menopausal any vaginal bleeding is abnormal)
- more frequent menses
- pelvic/back pain
treatment of cervical cancer
- all cases surgical excision (cervix relatively accessible) found early -excision (some examples of sx: laser surgery, cryosurgery-freezing, probe that has very low temp and causes necrosis
- if pick up later, invasive- radiation and surgery
- more advanced- radical hysterectomy
- conization: surgical instrument that extracts cone shaped tissue
- LEEP (loop electrosurgical excision procedure) - common for CIN 1&3 (want to remove all)
when is LEEP commonly used (loop electorsurgical excision procedure)
common for CIN 1 & 3, because want to remove all of cancer
how many levels of CIN (cervical intraepithelial neoplasia) is there?
three
CIN 1 (cervical intraepithelial neoplasia)
-mild dysplasia, LSIL (low grade squamous intraepithelial lesion)