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What is Cervical Cancer?
Cervical cancer is a disease in which cancerous cells form in the tissues of the cervix. Human papillomavirus (HPV) infection is the major risk factor for getting cervical cancer. There are usually no noticeable signs of early cervical cancer, but it can be detected early with annual check-ups (Pap smear screening by a gynecologist). Possible signs of cervical cancer include vaginal bleeding and pelvic pain. Almost 12,000 American women will be diagnosed with cervical cancer this year.
Treatment Options for Cervical Cancer
When detected early, cervical cancer is initially treated with surgery to remove the cancer. In this procedure, a hysterectomy, the surgeon removes the uterus, including the cervix. Surgeons often perform hysterectomy using da Vinci® robotic-assisted laparoscopic surgery, which is minimally invasive. Other options may include laser surgery, loop excision and cone biopsy. Pathologists evaluate lymph nodes from the area to determine if the cancer has spread. Depending on the extent of the cancer, surgery may be followed by radiation therapy with or without chemotherapy. Women with locally advanced tumors may receive concurrent chemoradiation as part of their treatment.
Fox Chase Cancer Center's radiation therapists use innovative methods to deliver radiation to patients with cervical cancer. This includes external beam radiation therapy, such as Intensity Modulated Radiation Therapy (IMRT), which accurately and precisely delivers high doses of radiation to the tumor; or internal radiation therapy (the use of radioactive implants, otherwise known as high-dose rate therapy) such as brachytherapy, which allows outpatient treatment.
For women who want to retain their ability to have children, surgeons try to use advanced laparascopic and vaginal surgical techniques that leave the uterus intact.
Our multispecialty team of gynecological oncologists at Fox Chase Cancer Center can help reduce the symptoms and increase survival for women whose cancer has spread into other organs, such as the lungs or liver, through a combination of chemotherapy and radiation therapy.
Prevention of Cervical Cancer
There are several risk factors that contribute to cervical cancer, including HPV (human papillomavirus) infection, sexual history (which causes HPV infections), reproductive history (more than 7 deliveries), long-term use of oral contraceptives, smoking and diet. HPV infection is the primary risk factor for cervical cancer. Recently, a new vaccine was introduced that can prevent HPV infection - which is exciting news for women.
There are over 100 types of HPV which infect the cervix — approximately one third of these are transmitted from one person to another through sexual contact. About half of these are linked to cervical cancer. While lifetime risk of HPV infection is common (over 80%), the vast majority of infections resolve spontaneously without any risk of cancer. The women at highest risk are those who have many sexual partners and who begin having intercourse at an early age. Only a few women develop persistent infections that can lead to pre-cancerous changes in the cervix. If untreated, pre-cancerous changes can develop into invasive cervical cancer over a period of time.
Currently, there is one HPV vaccine, Gardasil™, recommended for girls between the ages of 9-26 who have not contracted an HPV.
Read news release
June 8, 2006 »
A second vaccine, Cervarix™, is in clinical trials and may be available in 2009. The vaccines are available through primary physician offices.
Routine gynecologic screening with Pap smears remains an essential component of monitoring for pre-cancerous conditions and invasive cervical cancer. If detected early, most of these conditions can be cured. It is important to note that the availability of new HPV vaccines has not changed the need for routine screening to prevent deaths from cervical cancer in our population.
In studies, the vaccines were 100% effective in preventing cervical pre-cancers and genital warts caused by HPV. The vaccine is expected to last 4 1/2 years, so a booster vaccine may be given to extend the effects of the vaccine.