Know Complete Cervical Cancer and Its Treatment ââ?¬â?? Cervical cancer is a malignancy that occurs in the cervix. Cervical cancer is also called cervical cancer or cervical cancer begins in the lining of the cervix. Cervical cancer is formed very slowly. First, some changes from normal cells into cells pre-cancerous and then into cancer cells. This can happen for many years, but sometimes it happens faster. These changes are often called dysplasia. They can be found with Pap smear tests and can be treated to prevent cancer. To understand cervical cancer, it helps us understand the anatomy of a woman's uterus in advance.

There are 2 main types of cervical cancer. Approximately 8-9 out of 10 species present is squamous cell carcinoma. Under the microscope, this type of cancer formed by cells such as squamous cells that cover the surface of the cervix. Most of the remainder are adenocarcinoma. Cancer begins in cells that make mucus glands. Rarely, cervical cancer have both kinds of features above and is called mixed carcinoma. Other species (such as melanomas, sarcomas, and lymphomas), which most often occurs in other parts of the body. If you have cervical cancer, ask your doctor to explain what type of cancer you have.

How many women get cervical cancer?

The number of women with cervical cancer prevalence in Indonesia is quite large. Every day, found 40-45 new cases with the number of deaths reaches 20-25 people. While the number of women at risk of the virus reaching 48 million people. Doctor Laila Nuranna SpOG (K), Head of Oncology Division of Obstetrics Gynecology, Faculty of Medicine, University of Indonesia, said that most cases of cervical cancer were detected in hospitals has been so difficult to treat advanced stage. "If the cancer is found early, the handling will be easier and greater life expectancy," he said during a discussion Effort Campaign and Cervical Cancer Treatment at the Hotel Lumire Jakarta, Monday, April 12, 2010.

Some researchers think that non-invasive cervical cancer (which only occurs in the cervix when found) is about 4 times more common than invasive cervical cancers. When found and treated early, cervical cancer often can be cured.

Cervical cancer tends to occur in middle-aged women. Most cases are found in women who are under 50 years. It rarely occurs in young women (aged 20 years). Many women do not know that when you get old, they are still at risk for cervical cancer. That is why it is important for older women to continue to undergo regular Pap smear tests

Cervical Cancer Treatment

Three main types of treatment for cervical cancer are surgery, radiotherapy, and chemotherapy.

Precancerous stage up to 1A typically treated with hysterectomy. If the patient still wants to have children, methods of LEEP or cone biopsy may be an option.

For stage IB and IIA cervical cancer:

* When the tumor size <4cm: radical hysterectomy or radiotherapy with or without chemo
* When the tumor size> 4cm: radiotherapy and cisplatin-based chemotherapy, hysterectomy, or cisplatin-based chemotherapy followed by hysterectomy

Advanced-stage cervical cancer (IIB-IVA) can be treated with radiotherapy and cisplatin-based chemotherapy. In the very late-stage (IVB), the doctor may consider a combination of chemo drugs, such hycamtin and cisplatin.

If recovery is not possible, the goal of treatment is to remove or destroy as many cancer cells. Sometimes treatment is aimed at reducing symptoms. This is called palliative care.

Other factors that may affect your treatment decisions include your age, your overall health, and your own preferences. Often wise enough to get a second opinion (second opinion) that gives you another perspective of your disease.

Surgery for Cervical Cancer

There are several types of surgery for cervical cancer. Some involve the removal of the uterus (hysterectomy), others do not. This list includes the most common type of surgery for cervical cancer.

Cryosurgery

A metal probe cooled with liquid nitrogen is inserted into the vagina and the cervix. This kills the abnormal cells by freezing them. Cryosurgery is used to treat cervical cancer, which only ad adi in the cervix (stage 0), but not an invasive cancer that has spread beyond the cervix.

Laser Surgery

A laser beam is used to burn the cells or remove a small portion of uterine tissue to be studied. Laser surgery is used only as a treatment for pre-invasive cervical cancer (stage 0).

Konisasi

Cone-shaped piece of tissue will be removed from the cervix. This is done by using a scalpel or laser tau using a thin wire heated by electricity (this procedure called LEEP or LEETZ). This approach can be used to find or treat early stage cervical cancer (0 or I). It is rarely used as the sole treatment except for women with early stage cervical cancer who might want to have kids. After the biopsy, tissue (cone shaped) was appointed to be examined under a microscope. If the boundary edge of the cone that contains pre-cancerous or cancerous cells, further treatment will be needed to ensure that all cancer cells have been removed.

Hysterectomy

Simple hysterectomy: The uterus is removed, but does not include the network that are nearby. Both the vagina and pelvic lymph nodes are not removed. The uterus can be surgically removed at the front of the abdomen (stomach) or through the vagina. After this operation, a woman can not become pregnant. Hysterectomy is used to treat several early-stage cervical cancer (I). It is also used to pre-stage cervical cancer (o), if cancer cells are found at the boundary edge konisasi.

Radical hysterectomy and pelvic lymph node dissection: in this operation, the surgeon will remove the entire uterus, nearby tissue, upper vagina bordering the cervix, and some lymph nodes in the pelvic area. This operation is most often done by cutting through the front of the abdomen and less frequently through the vagina. After this operation, a woman can not become pregnant. A radical hysterectomy and pelvic lymph node dissection is a common treatment used for stage I cervical cancer, and less frequently also used in some cases of stage II, especially in young women.

Sexual impact of hysterectomy: After a hysterectomy, a woman can still feel sexual pleasure. A woman does not need a uterus to reach orgasm. If cancer has caused pain or bleeding, however, surgery can actually improve a woman's sexual life in a way to stop these symptoms.

Trachelektomi

A procedure called radical trachelectomy allows certain young women with early stage cancer to be treated and still be able to have a child. This method involves the removal of the cervix and upper vagina and put it on the seam is shaped like a pouch that acts as the opening of the cervix in the uterus. Nearby lymph nodes are also removed. This operation is done either through the vagina or abdomen.

After this operation, some women may have long-term pregnancy and gave birth to a healthy baby by caesarean section. In one study, pregnancy rates after 5 years more than 50%, but the risk of miscarriage is higher than normal women in general. The risk of cancer recurrence after this approach is quite low.

Hip Ekstenterasi

Besides taking all the organs and tissues mentioned above, in this type of operation: bladder, vagina, rectum, and most of the large intestine was also removed. This operation is used when cervical cancer recurrence after previous treatment.

If the bladder has been removed, a new way to store and dispose of small water needed. A piece of short bowel can be used to create a new bladder. Urine can be emptied by placing a small tube (called a catheter) into a small hole in the stomach (called: urostomi). Or urine can flow into a small plastic bag placed in front of the abdomen.

If the rectum and part of colon removed, a new way to pass faeces / stool is needed. This is done with a colostomy, which made a hole opening in the abdomen where the dirt can be removed. Or the surgeon may be able to reconnect the colon so that no outside body bags required. If the vagina is removed, a new vagina made of skin or other tissue can be created / reconstructed.

It takes a long time, 6 months or more, to recover from this operation. Some say it took about 1-2 years to really adjust to this radical change. But women who have undergone this surgery can still lead happy and productive life. With practice and patience, they also can have sexual desire, pleasure, and orgasm.

Radiotherapy for Cervical Cancer

Radiotherapy is treatment with high-energy rays (such as X-rays) to kill cancer cells or shrink the tumor. Before radiotherapy done, you are likely to undergo blood tests to find out if you suffer from anemia. Cervical cancer patients who experience bleeding in general suffer from anemia. For that, blood transfusions may be necessary before radiotherapy is started.

In early stage cervical cancer, the doctor will usually give radiotherapy (external and internal). Sometimes radiotherapy is given after surgery. Lately, doctors often perform a combination therapy (radiotherapy and chemotherapy) to treat cervical cancer who were between stages IB to IVA. Namely, among others, when the tumor size larger than 4 cm or if the cancer is found to have spread to other tissues (excluding cervix), for example to the bladder or colon.

Radiotherapy there are 2 types, namely external radiotherapy and internal radiotherapy. External radiotherapy means of X-rays are directed into your body (pelvic area) through a large machine. While the internal radiotherapy means any radioactive material implanted into the uterus / cervix you for some time to kill cancer cells. One method of internal radiotherapy is frequently used brachytherapy.

Brachytherapy for Cervical Cancer

Brachytherapy has been used to treat cervical cancer since the beginning of this century. This treatment is successful enough to overcome the malignancy in the female organs. Both radium and cesium have been used as a radioactive source to deliver radiation internally. Since the 1960�s in Europe and Japan, introduced the HDR system (high dose rate) brachytherapy.

HDR brachytherapy is given in just minutes. To prevent potential complications of HDR brachytherapy, HDR brachytherapy is usually given in a few insertions. For patients with cervical cancer, standard treatment is 5 insertions. Time where the applicator is in line female (vagina, cervix and / or uterus) for each insertion was approximately 2.5 hours. For endometrial cancer patients who received brachytherapy alone or in combination with external radiotherapy, it would require a total of 2 inserts with each time about 1 hour.

The advantage of HDR brachytherapy are among others: patient enough outpatients, economical, radiation dose can be adjusted, there is no possibility of shifting the applicator. Enough plays an important role for the success of brachytherapy is the experience of the treating doctor.

Radiotherapy Side Effects Some side effects of radiotherapy, namely:

* Fatigue
* Heartburn
* Often backward (diarrhea)
* Nausea
* Vomiting
* Changes in skin color (like burning)
* Drought or scarring of the vagina causing painful intercourse
* Early menopause
* Problems with urination
* Brittle bones that fracture easily
* The low number of red blood cells (anemia)
* The low number of white blood cells
* Swelling in the legs (called lymphedema)

Discuss with your doctor or nurse about side effects you might experience. Often no treatment or other methods that will help. Because smoking increases the side effects of radiotherapy, if you smoke then you must immediately stop.

Chemotherapy for Cervical Cancer

Chemotherapy is the use of drugs to kill cancer cells. Usually the drugs are given via infusion into a vein or by mouth. Once drugs enter the bloodstream, they spread throughout the body. Sometimes several drugs are given at one time.

Chemotherapy can cause side effects. These side effects will depend on the type of drugs given, the amount / dose given, and how long treatment lasts. Side effects can be inaccessible:

* Heartburn and vomiting (doctors can give medicine nausea / vomiting)
* Loss of appetite
* Short-term hair loss
* Sprue
* Increase the likelihood of infection (white blood cell deficiency)
* Bleeding or bruising in the event of injury (due to lack of blood)
* Shortness of breath (from low red blood cell count)
* Fatigue
* Early menopause
* Losing the ability to become pregnant (infertility)

Most adverse events (except for menopause and infertility) stops when treatment is completed. If you have any problems with side effects, talk with your doctor or nurse, because often there are ways to help. Giving chemotherapy at the same time as radiotherapy can improve the patient's recovery prospects, but can give side effects worse. You will supervise a team of doctors these side effects and can provide medicines to help you feel better.