When you get a diagnosis of cancer, it’s natural to wonder what may have caused the disease. Doctors cannot always explain why one woman develops cervical cancer and another does not. However, we do know that a woman with certain risk factors may be more likely than others to develop cervical cancer. A risk factor is something that may increase the chance of developing a disease.

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Studies have found a number of factors that may increase the risk of cervical cancer. For example, infection with HPV (human papillomavirus) is the main cause of cervical cancer. HPV infection and other risk factors may act together to increase the risk even more:

HPV infections are very common. These viruses are passed from person to person through sexual contact. Most adults have been infected with HPV at some time in their lives, but most infections clear up on their own.

Some types of HPV can cause changes to cells in the cervix. If these changes are found early, cervical cancer can be prevented by removing or killing the changed cells before they can become cancer cells. The NCI fact sheet Human Papillomaviruses and Cancer: Questions and Answers has more information.

A vaccine for females ages 9 to 26 protects against two types of HPV infection that cause cervical cancer. The NCI fact sheet Human Papillomavirus (HPV) Vaccines: Questions and Answers has more information.

Lack of regular Pap tests: Cervical cancer is more common among women who don’t have regular Pap tests. The Pap test helps doctors find abnormal cells. Removing or killing the abnormal cells usually prevents cervical cancer.

Smoking: Among women who are infected with HPV, smoking cigarettes slightly increases the risk of cervical cancer.

Weakened immune system (the body’s natural defense system): Infection with HIV (the virus that causes AIDS) or taking drugs that suppress the immune system increases the risk of cervical cancer.

Sexual history: Women who have had many sexual partners have a higher risk of developing cervical cancer. Also, a woman who has had sex with a man who has had many sexual partners may be at higher risk of developing cervical cancer. In both cases, the risk of developing cervical cancer is higher because these women have a higher risk of HPV infection.

Using birth control pills for a long time: Using birth control pills for a long time (5 or more years) may slightly increase the risk of cervical cancer among women with HPV infection. However, the risk decreases quickly when women stop using birth control pills.

Having many children: Studies suggest that giving birth to many children (5 or more) may slightly increase the risk of cervical cancer among women with HPV infection.

DES (diethylstilbestrol): DES may increase the risk of a rare form of cervical cancer in daughters exposed to this drug before birth. DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.)

Having an HPV infection or other risk factors does not mean that a woman will develop cervical cancer. Most women who have risk factors for cervical cancer never develop it.

Treatment

Women with cervical cancer have many treatment options. The options are surgery, radiation therapy, chemotherapy, or a combination of methods. The choice of treatment depends mainly on the size of the tumor and whether the cancer has spread. The treatment choice may also depend on whether you would like to become pregnant someday. Your doctor can describe your treatment choices, the expected results of each, and the possible side effects. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.;

Your doctor may refer you to a specialist, or you may ask for a referral. You may want to see a gynecologic oncologist, a surgeon who specializes in treating female cancers. Other specialists who treat cervical cancer include gynecologists, medical oncologists, and radiation oncologists. Your health care team may also include an oncology nurse and a registered dietitian.

Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.

At any stage of the disease, supportive care is available to relieve the side effects of treatment, to control pain and other symptoms, and to help you cope with the feelings that a diagnosis of cancer can bring. You can get information about coping on NCI’s Web site at http://www.cancer.gov/cancertopics/coping and from NCI’s Cancer Information Service at 1-800-4-CANCER or LiveHelp (http://www.cancer.gov/help). You may want to talk to your doctor about taking part in a clinical trial, a research study of new treatment methods. See the section on Taking Part in Cancer Research.

Surgery

Surgery is an option for women with Stage I or II cervical cancer. The surgeon removes tissue that may contain cancer cells:

Radical trachelectomy: The surgeon removes the cervix, part of the vagina, and the lymph nodes in the pelvis. This option is for a small number of women with small tumors who want to try to get pregnant later on.

Total hysterectomy: The surgeon removes the cervix and uterus.

Radical hysterectomy: The surgeon removes the cervix, some tissue around the cervix, the uterus, and part of the vagina.

With either total or radical hysterectomy, the surgeon may remove other tissues: Fallopian tubes and ovaries: The surgeon may remove both fallopian tubes and ovaries. This surgery is called a salpingo-oophorectomy.

Lymph nodes: The surgeon may remove the lymph nodes near the tumor to see if they contain cancer. If cancer cells have reached the lymph nodes, it means the disease may have spread to other parts of the body. The time it takes to heal after surgery is different for each woman. You may have pain or discomfort for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain control. After a radical trachelectomy, some women have bladder problems for a few days. The hospital stay usually is about 2 to 5 days.

After a hysterectomy, the length of the hospital stay may vary from several days to a week. It is common to feel tired or weak for a while. You may have problems with nausea and vomiting, and you may have bladder and bowel problems. The doctor may restrict your diet to liquids at first, with a gradual return to solid food. Most women return to their normal activities within 4 to 8 weeks after surgery.

After a hysterectomy, women no longer have menstrual periods. They cannot become pregnant. When the ovaries are removed, menopause occurs at once. Hot flashes and other symptoms of menopause caused by surgery may be more severe than those caused by natural menopause. You may wish to discuss this with your doctor before surgery. Some drugs have been shown to help with these symptoms, and they may be more effective if started before surgery.

For some women, a hysterectomy can affect sexual intimacy. You may have feelings of loss that make intimacy difficult. Sharing these feelings with your partner may be helpful. Sometimes couples talk with a counselor to help them express their concerns. http://www.medicinenet.com/cervical_cancer/article.htm

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