CERVICAL CANCER – HPV – HPV Vaccine

The cervix is the lowest part of the uterus where it meets the vagina. Cervical cancer usually develops slowly over years. The normal cells laying the cervix are changing gradually, first turning into precancerous lesions and, if left untreated, into cancer cells. Today, various names are given to precancerous conditions: cervical intraepithelial neoplasia (CIN), squamous intraepithelial lesion (SIL), or dysplasia. In some patients, the cancer is limited to the cervix, and in some advanced cases, it can spread to the surrounding and distant organs.

Cervical cancer is one of the most common cancer types in women and is among the leading causes of death in many countries. Although it is so common, its incidence has decreased by 70% all over the world due to the fact that screening tests (smear test) can be performed easily. Thanks to the Pap smear test, thousands of new cases can be diagnosed each year.

Risk factors for cervical cancer:

  • Sexual intercourse at an early age
  • Polygamy
  • Smoking
  • Poor hygiene
  • AIDS
  • human papilloma virus (HPV)

Since cervical cancer in early stage and CIN are usually asymptomatic, screening with Pap smear is very important. With the smear test, the cells in the cervix are removed without any pain using a simple brush and examined under a microscope. In some cases, the cervix is examined with colposcopy (a device that functions as a magnifying glass), and if necessary, biopsy, LEEP or conization can be applied.

In order to detect the cervical cancer in the early stage, it is recommended to take a smear test once a year from every woman who has started sexual intercourse.

Since the relationship between cervical cancer and HPV is demonstrated directly, less contact with HPV will reduce the risk of infection, and therefore the risk of precancerous lesions and cancer. For this purpose, monogamy, usage of condom and HPV vaccination are important. HPV is a very contagious and common virus that can cause cervical cancer and genital warts. Vaccination can protect from approximately 70% of HPV types. Although the age of vaccination is not yet fully clarified, its use is recommended between the ages of 12 and 26. HPV vaccine is used in 3 doses within 6 months.

Treatment of cervical cancer is related to the severity and extent of the disease. Surgery, radiotherapy and chemotherapy can be applied. Early stage cervical cancers can be easily treated with laparoscopic surgery.

ENDOMETRIAL CANCER

Endometrial cancer is the most common type of gynecological cancer in women. Most of the endometrial cancers can be detected in the early stages while the cancer cells are limited to the uterine wall. Thus, many patients regain their health with early treatment. Seventy five percent of endometrial cancer is seen in menopausal women and 25% in premenopausal women.

Risk factors for endometrial cancer:

  • exposure to high dose of unopposed estrogen hormone
  • obesity
  • nulliparity
  • hypertension
  • diabetes mellitus
  • late menopause
  • usage of tamoxifen

Most patients with endometrial cancer present with abnormal bleeding symptoms in the early period. Vaginal bleeding should be a warning in menopausal patients. Women in the menopausal period are recommended to regularly go to gynecology controls and have their uterine wall thickness measured by ultrasonography. For diagnosis, a simple curettage is done to the uterus and the tissues taken are sent to pathology.

Endometrial cancer is a type of cancer that is mainly classified by surgery. The treatment is surgery, except for the patients with systemic diseases that cannot undergo surgery or those who desire pregnancy. This surgical procedure includes hysterectomy (removal of the uterus), removal of the ovaries and often lymph nodes, which can be performed laparoscopically in many cases.

OVARIAN CANCER

Ovarian cancer is the most common cause of death among gynecological cancers. Most patients are diagnosed between the ages of 40 to 60.

Risk factors for ovarian cancer:

  • never being pregnant
  • history of infertility
  • positive family history of ovarian cancer

As the symptoms are uncertain in the early stages of the disease and do not attract the attention of the patient, early diagnosis of ovarian cancer is difficult. Routine gynecological examination and ultrasonography, and if necessary, some blood tests (Ca-125) are recommended to patients. The definitive diagnosis is determined by the surgical procedure and pathology result.

Surgical staging is essential for the diagnosis and treatment of ovarian cancer. Chemotherapy is used in many cases after surgery.

Especially patients with a family history of ovarian cancer should go to routine controls. Ultrasonography and Ca-125 tests should be investigated.