CLOSE WINDOW [X]
Savitha Shama M.D. is board certified in Internal Medicine. She completed her residency training at the Grady Memorial Hospital under the Morehouse Internal medicine residency program. She is a graduate of Govt. Medical College, Mysore, India. Dr Shama practices at the Georgia Clinic in Norcross, GA. She can be reached at 770-449-0990 or at  docshama@yahoo.com.
Cervical Cancer- Prevention & Treatment

Dr Savitha Shama stresses the importance of regular Pap smear tests in the prevention and early diagnosis of cervical cancer. 

Ladies, if you are having second thoughts about getting your regular Pap smear tests, you should read this…
There has been a remarkable 75% reduction in the occurrence and deaths from cervical cancer in developed countries over the past 50 years. In contrast, cervical cancer is the second leading cause of death in developing countries. In case if you have started to wonder why such disparity, it is largely due to widespread institution of cervical cancer prevention programs in developed countries, which are essentially non existent in many developing countries. And 60% of women who do get diagnosed with cervical cancer in developed countries have never been screened or not screened over the preceding 5 years.

What is Cervical cancer?
The cervix is a small, thimble-shaped structure, located at the uppermost part of the vagina. It is part of the uterus and serves as its entrance. Cervical cancer begins with abnormal microscopic changes to cells in the cervix epithelium, the surface skin layer of the cervix. If changes continue to occur, cells may become cancerous and grow out of control. Fortunately, cervical cancer tends to grow slowly. It may remain in noninvasive stage, confined to the cervical covering, for two to ten years. This gives ample opportunity to detect abnormalities at pre-cancerous stages and improve survival dramatically.

Causes
The cause of cervical cancer is unknown, but infection with certain types of human papilloma virus (HPV) has been strongly associated with a woman’s risk of developing cervical cancer. Cigarette smoking may also contribute to cervical cancer. Other risk factors include early onset of sexual activity, multiple sexual partners and multiple births among others.

Symptoms
Early cervical cancer is frequently asymptomatic, underscoring the importance of screening. The most common symptoms at presentation are: Abnormal vaginal bleeding, bleeding after intercourse, non-itchy foul smelling vaginal discharge. These symptoms, however are not unique to cervical cancer and may occur with many disorders of female reproductive tract. Pelvic pain, lower back pain, bowel or urinary symptoms, appetite loss, weight loss and anemia are uncommon and suggest advanced disease.

Diagnosis
Diagnosis of cervical cancer usually begins with a pelvic exam, using a speculum, an instrument used to inspect the cervix and vagina, and to help perform a Pap test. The Pap test is a quick, painless procedure in which the doctor gently brushes the surface lining and the canal of cervix to obtain a sample of mucus and cells. The cells are then sent to a laboratory for examination. If the Pap test indicates abnormal cells, a gynecologist may consider further testing with a colposcope. A colposcope is a special instrument containing a magnifying lens that makes the cervix appear larger. A vinegar solution is then applied to the cervix and vagina so that abnormal areas temporarily turn white. Areas that turn white will direct the gynecologist where best to obtain a biopsy. Also biopsy is obtained if the cervix looks visibly abnormal. The biopsy is used to confirm dysphasia or the presence of cancerous cells.

Expected Duration
If the condition is caught before cells become cancerous then treatment plans may focus on eliminating the abnormal cells. Minor abnormalities, which may resolve spontaneously, are often followed by colposcopy and possible biopsy every three to six months. Severe abnormalities are usually treated by excision, removal or laser vaporization techniques; follow-up colposcopy examination should be performed on a regular and frequent basis to ensure that abnormalities do not occur.
In the earliest stages of cancer, treatment may involve surgery alone. In later, more advanced stages, treatment may involve extensive pelvic surgery, by itself or in combination with radiation therapy and chemotherapy. Radiation and chemotherapy may take several weeks to a few months to complete.

Prevention
* Limit the number of sexual partners to reduce possible exposure to human papilloma virus (HPV) and other sexually transmitted diseases or human immunodeficiency virus (HIV).
* Stop smoking
* Use a diaphragm or condom to protect the cervix during intercourse.
Prevention and early detection dramatically increase the survival rate. If cervical cancer is discovered and treated early, 99 women in 100 survive the disease. If the disease is not diagnosed until it reaches the most advanced stage, only 7 in 100 will survive.

So dear ladies, if you are 18 and older or under 18 and sexually active, get your regular annual pelvic exam and Pap test to screen for cervical cancer.

*Disclaimer: The contents are meant for informative, educational purposes only. Formal recommendations can only be made by physicians involved in your care. Please check with your physician before acting on any part of this article. 

CLOSE WINDOW [X]