Women's Health BACK TO WRITERS BLOCK   Cervical Cancer by Nikki Coffee   You just received a call from your gynecologist regarding your annual pap test.  You were told there were some abnormal cells, or cell changes, found and they’d like to see you in three months to repeat it.  You’ve heard about this from other women, repeated Pap tests, the colposcopy, the LEEP procedure and now you are alarmed, worried, and keep thinking about the “C” word.  Cancer!   Abnormal cell patterns found during a Pap do not necessarily spell the “C” word.  Cancer of the cervix does not form rapidly.  Initially, cells begin to alter from normal to pre-cancerous and then can develop into cancer.  These cell changes are called dysplasia and are classified in three categories: mild, moderate and severe. Many health care professionals feel that dysplasia (the existence of abnormal cells within the cervix) itself, may not actually cause health problems, it is considered a “precancerous” condition, and if left untreated, can progress into an early stage of cervical cancer over time.   In many cases of mild dysplasia the cells can regress and return to normal on their own without treatment.  The remaining levels of dysplasia are less likely to resolve without treatment and have a higher likelihood of developing into cancer.   Some doctors use a colposcopy to confirm the presence of cervical cancer.  This procedure consists of a Pap smear and then washing the cervix with a diluted vinegar solution.  A Colposcope, a light and magnifying device are then inserted to detect abnormal areas of the cervix. This can help determine whether or not further evaluation is necessary. Many times a biopsy is performed to help gauge a definitive diagnosis.   The American Cancer Society estimates about 9,710 new cases of cervical cancer in the US in 2006.  They also predict that nearly 4,000 women will die from the disease.   Second to breast cancer, cervical cancer is one of the most common types of cancer in women. In the past, cervical cancer used to be one of the most fatal forms of cancer, but as a result of the Pap test and strong encouragement to have it done, this has changed in the United States.  Between 1955 and 1992, deaths from cervical cancer declined 74 percent, due to preventive measures like the Pap test.  However, world-wide, cervical cancer remains the leader in cancer deaths.   Who is at risk? And what are the risk factors? Researchers found that women of lower socioeconomic status, who may not have access to proper regular medical screenings, are at high risk.  Compared to Caucasians, African American, Hispanic, Native American as well as Vietnamese women are at greater risk.   •  Age: Women of all ages can be at risk, however, the majority of women diagnosed are between the ages of 30 and 55.   • Multiple partners: Having multiple partners or engaging in intercourse with a partner who has multiple partners •       Early age sexual intercourse •       Smoking: The nicotine and cotinine chemicals in cigarettes can increase the risk.  The chemicals have been found in the cervical cells of women who smoke.  These chemicals can  also be excreted in a man’s semen. •       Poor diet: Poor nutritional intake can weaken the immune system, decreasing the body’s ability to fight viruses. •       Other STD’s:  Being infected with other types of STD’s greatly increases your chance of abnormal cells developing into cancerous cells. •       Family History:  Current research has revealed that family history can play a part in the      development of cervical cancer.  Women who had family members with the disease may be   less able to fight off the HPV virus. •       Oral Contraceptions: Research is also showing the oral contraception use may play a factor in the development of cervical dysplasia. One reason could be that oral contraceptives interfere with folic acid metabolism in the cells surrounding the cervix.  Folic acid may help prevent or improve cervical dysplasia. •       HIV infection.  Being HIV positive weakens the immune system making someone less able to ward off the HPV virus and early cancers.   The medical community continues to scratch their heads when asked about the direct cause of cervical cancer.  They are sure, however, that the main factor contributing to cervical cancer is a virus called the Human papillomavirus (HPV).  HPV’s are a group of many viruses that cause warts and other cell changes in the body.  There are various strains of the HPV virus and about 30 of them are sexually transmissible and can infect the genital area of both men and women.   Often the HVP virus will dissipate on its own, especially in younger women. While it is an important factor for cervical cancer, many women carrying the infection do not develop cervical cancer. Most HPV infections resolve within six months and many women become immune.  When HPV is present and infects the skin of the genital organs, it usually causes raised bumpy warts.  The particular strains that cause genital warts rarely develop into cancer and are considered low-risk.  It is believed that other factors must come into play for this cancer to cultivate.   Signs and Symptoms: The first sign of any problem related to cervical cancer is usually detected by an abnormal Pap test.  Other symptoms that are common are: •       Abnormal vaginal bleeding (this includes spotting after sexual intercourse, between           menstrual periods and/or increased menstrual bleeding) •       Pain while urinating •       Pain during sexual intercourse •       Low back pain •       Abnormal, foul-smelling vaginal discharge   If you notice any abnormal changes with your body, do not ignore the symptoms.  Talk to your doctor as soon as possible.   Prevention and Treatment:   Use common sense in preventing conditions for cervical cancer.  This would include not smoking, abstinence from sexual intercourse unless you are in a committed, monogamous relationship, if not, limit the number of sexual partners and use barrier methods of contraception.  Make sure you have a balanced diet with plenty of fresh fruits and vegetables, especially leafy green vegetables.   Cervical cancer treatments may vary and depend on the stage of the cancer.  Numerous types of surgeries, including radical hysterectomy, and the LEEP procedure are common.  LEEP stands for Loop electrode excision.  Electrically heated wire loops are used to remove the abnormal tissue.  Radiation and chemotherapy are other treatments typically used in cervical cancer cases.   Regarding the HPV virus, doctors can now test for the types of HPV that are related to cervical cancer. The DNA is examined for genetic information on cell growth, division and function.  The findings for the DNA test can direct doctors in treating patients with slightly abnormal Pap test results.   For further information, talk to your healthcare professional or log onto the American Cancer Society at www.cancer.org .  The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) sponsored by the Center for Disease Control offers a program which provides testing to women without health insurance.  Use this link for further information.    http://www.cdc.gov/cancer/nbccedp/sps/index.htm.  The Women's Cancer Network has a cancer risk survey that is accessible online.  The survey covers breast, cervical, ovarian and endometrial cancers. www.wcn.org/.      GOOD HEALTH TO YOU