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Everything You Need To Know About Cervical Cancer
Cervical cancer can be hard to detect but it doesn't cause many symptoms in its early stages. Regular screening is key for prevention.
Cervical cancer is a type of cancer that starts in the cervix. The cervix is a hollow cylinder that connects the lower part of a woman's uterus to her vagina. Most cervical cancers begin in cells on the surface of the cervix.
Many women with cervical cancer don't realize they have the disease early on because it usually doesn't cause symptoms until the late stages. When symptoms do appear, they're easily mistaken for common conditions like menstrual periods and urinary tract infections (UTIs).
Typical cervical cancer symptoms are:
If you notice any of these symptoms, see your doctor for an exam. Find out how your doctor will diagnose cervical cancer.
Most cervical cancer cases are caused by the sexually transmitted human papillomavirus (HPV). This is the same virus that causes genital warts.
There are about 100 different strains of HPV. Only certain types cause cervical cancer. The two types that most commonly cause cancer are HPV-16 and HPV-18.
Being infected with a cancer-causing strain of HPV doesn't mean you'll get cervical cancer. Your immune system eliminates the vast majority of HPV infections, often within 2 years.
HPV can also cause other cancers in women and men. These include:
HPV is a very common infection. Find out what percentage of sexually active adults will get it at some point in their lifetime.
Cervical cancer is very treatable if you catch it early. The four main treatments are:
Sometimes these treatments are combined to make them more effective.
SurgeryThe purpose of surgery is to remove as much of the cancer as possible. Sometimes the doctor can remove just the area of the cervix that contains cancer cells. For cancer that's more widespread, surgery may involve removing the cervix and other organs in the pelvis.
Radiation therapyRadiation kills cancer cells using high-energy X-ray beams. It can be delivered through a machine outside the body. It can also be delivered from inside the body using a metal tube placed in the uterus or vagina.
ChemotherapyChemotherapy uses drugs to kill cancer cells throughout the body. Doctors give this treatment in cycles. You'll get chemo for a period of time. You'll then stop the treatment to give your body time to recover.
Targeted therapyBevacizumab (Avastin) is a newer drug that works in a different way from chemotherapy and radiation. It blocks the growth of new blood vessels that help the cancer grow and survive. This drug is often given together with chemotherapy.
If your doctor discovers precancerous cells in your cervix, they can be treated. See what methods stop these cells from turning into cancer.
After you've been diagnosed, your doctor will assign your cancer a stage. The stage tells whether the cancer has spread, and if so, how far it's spread. Staging your cancer can help your doctor find the right treatment for you.
Cervical cancer has four stages:
A Pap smear is a test doctors use to diagnose cervical cancer. To perform this test, your doctor collects a sample of cells from the surface of your cervix. These cells are then sent to a lab to be tested for precancerous or cancerous changes.
If these changes are found, your doctor may suggest a colposcopy, a procedure for examining your cervix. During this test, your doctor might take a biopsy, which is a sample of cervical cells.
The U.S. Preventive Services Task Force recommends the following screening schedule for women by age:
Do you need a Pap smear? Learn what to expect during a Pap test.
For cervical cancer that's caught in the early stages, when it's still confined to the cervix, the 5-year survival rate is 92 percent.
Once the cancer has spread within the pelvic area, the 5-year survival rate drops to 56 percent. If the cancer spreads to distant parts of the body, survival is just 17 percent.
Routine testing is important for improving the outlook of women with cervical cancer. When this cancer is caught early, it's very treatable.
Several different types of surgery treat cervical cancer. Which one your doctor recommends depends on how far the cancer has spread.
One of the easiest ways to prevent cervical cancer is by getting screened regularly with a Pap smear or hrHPV test. Screening picks up precancerous cells, so they can be treated before they turn into cancer.
HPV infection causes most cervical cancer cases. The infection is preventable with the vaccines Gardasil and Cervarix. Vaccination is most effective before a person becomes sexually active. Both boys and girls can be vaccinated against HPV.
Here are a few other ways you can reduce your risk of HPV and cervical cancer:
An abnormal Pap smear result indicates you have precancerous cells in your cervix. Find out what to do if your test comes back positive.
Here are some key statistics about cervical cancer.
The American Cancer Society estimates that in 2022, approximately 14,100 American women will be diagnosed with cervical cancer, and 4,280 will die from the disease. Most cases will be diagnosed in people with a cervix between the ages of 35 and 44.
Hispanic women are the most likely ethnic group to get cervical cancer in the United States. American Indians and Alaskan natives have the lowest rates.
The death rate from cervical cancer has dropped over the years. From 2002 to 2016, the number of deaths was 2.3 per 100,000 women per year. In part, this decline was due to improved screening.
It's rare to get diagnosed with cervical cancer while you're pregnant, but it can happen. Most cancers found during pregnancy are discovered at an early stage.
Treating cancer while you're pregnant can be complicated. Your doctor can help you decide on a treatment based on the stage of your cancer and how far along you're in your pregnancy.
If the cancer is at a very early stage, you may be able to wait to deliver before starting treatment. For a case of more advanced cancer where treatment requires a hysterectomy or radiation, you'll need to decide whether to continue the pregnancy.
Doctors will try to deliver your baby as soon as it can survive outside the womb.
HPV, Cervical Cancer Vaccine: 15 Facts
Gardasil, the new vaccine against human papilloma virus (HPV) -- which causes cervical cancer and genital warts -- is now available nationwide.
Here is what you need to know now about this new vaccine.
1. What is Gardasil?
Gardasil is a vaccine, licensed for use in June 2006, by the FDA. It targets four strains of human papillomavirus (HPV) -- HPV-6, 11, 16, and 18. HPV-16 and HPV-18 account for about 70% of all cervical cancers. HPV-6 and -11 cause about 90% of genital warts. HPV is also linked to anal cancer.
2. How does HPV spread?
Sexual activity spreads the virus, a very common one. It's one of the most common sexually transmitted diseases (STDs) in the country, according to the CDC, with more than 20 million people currently infected and another 6.2 million contracting the virus each year.
About half of those with HPV are aged 15 to 24. Surveys suggest 3.7% of U.S. Girls have sex by age 13, and 62.4% have had sex by the 12th grade.
3. Who should get the vaccine?
Gardasil is approved by the FDA for girls and women ages 9 to 26. The CDC and the American Academy of Pediatrics recommend that the vaccine be given routinely to girls at age 11 to 12 years old, although doctors may choose to vaccinate girls as young as 9. The CDC also recommends the vaccine for women age 13 to 26 who did not receive the vaccine at an earlier age.
However, if a girl or woman is already infected with HPV, the vaccine will not prevent that strain of HPV from causing disease. It will protect against new infections with other strains of HPV included in the vaccine.
The vaccine is also being studied in women up to age 45, although that group may be targeted for the vaccine later.
The vaccine is being studied in males, too. Men can get HPV infections and can pass the virus to their sex partners. HPV causes genital warts and is associated with rare cases of cancer of the penis. Particularly in gay men, HPV is linked to anal cancers. Merck is currently testing Gardasil in men, including gay men.
4. What is the best way to talk to my daughter about this?
Emphasize that the primary goal is to help prevent cervical cancer. If you, as a parent, are worried this will give your child a false sense of security that they can't catch a sexually transmitted infection from sexual activity, you can also emphasize that the vaccine only protects against certain strains of HPV -- not against any of the many other types of sexually transmitted infections.
5. Does Gardasil protect against all cervical cancers?
No. The vaccine does protect against the strains of HPV most likely to cause cancer. But it does not protect against all HPV strains.
However, recent reports suggest that the vaccine may give wider protection than originally thought. There is preliminary evidence it may offer some protection against other HPV strains, which cause 8% or 9% of cervical cancers.
6. How effective is the new vaccine?
Studies have shown it is 100% effective in the prevention of cervical precancers and noninvasive cervical cancers caused by HPV-16 and 18 in those not already exposed to those strains, according to Merck & Co. Inc., which makes Gardasil. Merck is a WebMD sponsor.
7. If someone is already sexually active, will this vaccine still work?
If a person has been infected with any of the four strains the vaccine protects against, the vaccine won't provide protection against that type. But it will prevent infection from the other three.
8. How long is Gardasil effective?
Research suggests the vaccine lasts at least four years. Long-term results are not yet certain. The protection might last longer.
9. Does the vaccine actually contain HPV or any live virus?
No. It has a virus-like particle, but not the actual virus.
10. Is Gardasil safe?
Clinical trial data have found it is safe.
11. What does the vaccine cost? Will insurance cover it?
The "list" price is about $120 per dose, and three doses are needed. But that is the price your doctor pays to the manufacturer. It does not include the cost of an office visit or other charges, so the cost to individuals could be higher. The federal Vaccines for Children Program will provide free vaccines to those under age 19 who qualify. More information on that program is on the CDC web site, www.Cdc.Gov. A number of insurers say they plan to cover the costs.
12. Is it available everywhere in the U.S.?
Supplies have been shipped nationwide, according to Merck, although your individual doctor's office or clinic may not have ordered it.
13. Will the new vaccine make cervical cancer screens such as the Pap test passé?
No. Screening with a Pap test is still needed, since the vaccine does not protect against all cervical cancer.
14. Is this the only vaccine for cervical cancer?
There's a second vaccine in the works: Cervarix, from GlaxoSmithKline. Cervarix targets two HPV strains, HPV-16 and HPV-18. GSK says it plans to seek FDA approval for Cervarix by the end of the year. Early studies find that this vaccine, like Gardasil, is extremely safe and effective. GlaxoSmithKline is a WebMD sponsor.
15. How common is cervical cancer and how deadly?
The American Cancer Society predicts that in 2007, there will be about 11,150 new U.S. Cases of invasive cervical cancer, and 3,670 cervical-cancer deaths.
Cervical cancer is the second most common cancer in women worldwide. There are about 500,000 new cases, and 250,000 cervical-cancer deaths each year. According to the World Health Organization, nearly 80% of cases occur in low-income countries, where cervical cancer is the most common cancer in women
Fossil Birds: Surfaces Of Cervical Vertebrae Show Conspicuous Tubercles That May Have Served As 'internal Bony Armor'
An international research team has examined unusual skeletal structures of various European bird fossils from the Eocene. The bone surfaces of the approximately 40- to 50-million-year-old cervical vertebrae show conspicuous tubercles, whose origin as yet remained elusive.
In their study, recently published in the Journal of Anatomy, the scientists conclude on the basis of micro-computed tomography analyses that the tubercles may have served as part of an internal "armor" to protect against deadly neck bites from mammalian predators.
Over the course of evolution, many animal species have developed different strategies to defend themselves against predators—from sophisticated camouflage and venom to protective armor. A research team led by ornithologist Dr. Gerald Mayr from the Senckenberg Research Institute and Natural History Museum Frankfurt has now identified an unusual variant in a group of Eocene birds.
"We have examined a number of fossil avian cervical vertebrae, all of which exhibit a pronounced tubercular surface structure—a striking feature that is unknown in modern birds. We hypothesize that these tubercles are part of a protective 'reinforcement' of the cervical spine," explains Mayr.
Such cervical vertebrae covered by conspicuous tubercles were first observed in roughly 48 million-years-old fossils of various bird species from the Messel Pit in Hesse, and they were subsequently also identified in similar finds from the London Clay Formation with an age of up to 53 million years.
The origin of these unusual structures remained obscure. One possible explanation discussed was that they might represent pathological features. "Understanding the phenomenon was impeded by the fact that these fossil vertebrae were initially only available in the form of flattened fossil remains. For the first time, we now had the opportunity to examine four additional, three-dimensionally preserved specimens from the Quercy site in France," reports Mayr.
High-resolution images of four previously unstudied cervical vertebrae from an approximately 37-million-year-old specimen have been generated using micro-computed tomography, which enabled a detailed examination of their structure.
"One of the arguments against a pathological origin of the tubercles is that they are absent from functionally critical structures of the vertebrae such as the articular surfaces," says Mayr. "The micro-CT scans also show that the bone substance of the cervical vertebrae is very dense.
"In contrast, the cervical vertebrae of recent birds—apart from a few specialized divers—have air-filled cavities and are much more lightweight and fragile. The tubercles, along with the dense interior of the bone, presumably evolved to further strengthen the protective sheath around the vital arteries, nerves, and spinal cord that run here."
The skull of the African maned rat (Lophiomys imhausi), which is covered with similar tubercles, indicates that comparable structures can develop under normal conditions. The maned rat evolved unusual defensive structures to protect itself against predators. The research team interprets the tubercles in this species and the fossil birds as functional adaptations that strengthened the bone structures in the back of the head and neck, respectively.
"The fossil birds, which belong to the extinct family Perplexicervicidae, presumably lived on the ground and some species were flightless. In the Eocene epoch, these birds occurred together with carnivorous mammals, whose modern relatives kill their prey with a neck bite. It seems plausible that conspicuous vertebrae evolved to protect their rather long necks of these birds from such predatory bites," concludes Mayr.
"If our hypothesis is correct, the Eocene Perplexicervicidae would be the first known example of such an 'internal bony armor' in birds."
More information: Gerald Mayr et al, Reinterpretation of tuberculate cervical vertebrae of Eocene birds as an exceptional anti‐predator adaptation against the mammalian craniocervical killing bite, Journal of Anatomy (2023). DOI: 10.1111/joa.13980
Citation: Fossil birds: Surfaces of cervical vertebrae show conspicuous tubercles that may have served as 'internal bony armor' (2024, January 4) retrieved 7 January 2024 from https://phys.Org/news/2024-01-fossil-birds-surfaces-cervical-vertebrae.Html
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