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Invasive cervical cancer is a very common malignancy in women of reproductive age. Most cases are suspected to stem from complications of human papillomavirus (HPV) infections. HPV gradually damages the lining of the cervix, and can result in cancer within a few years of infection. Modern advances in clinical testing and a growing number of women seeking regular gynecological exams have significantly decreased the rate of invasive cervical cancer in developed countries. The condition continues to be a leading cause of chronic illness and death in impoverished regions.
There are dozens of different strands of HPV, but only a few of them increase the likelihood of developing invasive cervical cancer. Since HPV is transmitted through sexual activity, women who have multiple partners and unprotected sex are at the highest risk of infection. Poor nutrition, smoking, family history, and immune system-compromising disorders can also raise the risk of HPV infection and eventual cancer complications.
In most cases, cervical tissue gradually undergoes changes that lead to cancer. Small patches of cells within the lining of the cervix may start to grow abnormally large and become discolored, resulting in masses called squamous intraepithelial lesions. Over time, the lesions begin to engulf underlying tissue and form deep tumors. The transition between squamous intraepithelial lesions and invasive cervical cancer generally takes about a decade, though some cases progress much quicker.
Invasive cervical cancer may not cause any physical symptoms, especially when it is in the earliest stages of development. If symptoms do arise, they may include excessive and irregular vaginal bleeding, odorous milky discharge, and pain during intercourse. It is essential to visit a gynecologist whenever abnormal bleeding or discharge symptoms are present so a diagnosis can be made and treatment administered immediately.
A gynecologist can check for signs of HPV infection by performing a pap smear, which involves scraping off cervical cells and testing them in a laboratory. The doctor can also peer into the vagina using a specialized type of microscope to look for abnormal lesions. A tissue biopsy is necessary as well to confirm the presence of a tumor and determine its stage of progression.
If cancerous lesions are detected before they spread through the outer lining of the cervix, a clinical procedure can be performed to freeze or burn them away. Cancer that has already become invasive typically requires surgery to remove part or all the cervix and uterus. If tumors persist or cancer spreads to other body parts, chemotherapy and radiation may be necessary.
We're totally confused. Can someone please help explain this?
May 2012: Abnormal Pap results Diagnosis: HPV, referred to Gyno.
Aug 2012: Colposcopy, Diagnosis: HGSIL, cone biopsy booked for Oct, patient told to repeat three times, "I don't have cancer."
One week after the colposcopy, we were called back to the gyno's office and the pathology results were: Abnormal endocervical cells consistent with adenocarcinoma in Situ AIL.
The patient was told, "this is serious... this is very serious...is as serious as it gets." They said it was "Grade3; suspect genetic rather than HPV strain", and said they would have to remove 50 percent of the cervix.
The patient has had annual Pap smears for the past 12 years, because her maternal
grandmother died of cervical cancer. No abnormalities were found until the most recent one.
The gyno is still saying to repeat three times, "I don't have cancer." We are so confused. We've heard abnormalities, precancer, cancer, grade 3, stage 0. It's all cancer, no matter how we look at it, isn't it? O.K., it may not be terminal at this moment, but isn't it still cancer?
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