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Hysterectomy: cancer of the cervix

        HYSTERECTOMY: CANCER OF THE CERVIX
There are several sites for cancer that prompt women to consider a hysterectomy. Cancer of the cervix, also called cervical cancer, develops in cells that line the cervix. The abnormal changes usually occur over a period of years, although in some women the changes seem to happen much faster. Abnormalities of the cells of the cervix, thought to be precursors of cervical cancer, used to be called dysplasia; but nowadays the term cervical intraepithelial neoplasia (ON) is used.
Cervical cancer is diagnosed in about 1100 Australian women each year. Although most diagnoses are made in women aged over fifty-five, it seems that increasing numbers of women in their twenties and thirties are now being affected. Tell-tale signs include bleeding between periods in pre-menopausal women, bleeding after sexual intercourse or at any time after menopause, and a smelly vaginal discharge.
Screening for cervical cell abnormalities that could develop into cancer is available using the Pap smear technique. A small sample or biopsy of cells from the cervix is obtained using a special brush and a fine wooden spatula. The cells are smeared onto a piece of glass and then sent to a laboratory for examination. From the appearance of the cells, it is possible to identify cancer at a stage early enough to permit its complete removal and cure. Australian health authorities recommend a Pap smear every second year from the time women start to be sexually active.
Over 400000 women in the State of Victoria, Australia, had a Pap smear during 1990, but seven out of ten women considered to be most at risk of cervical cancer did not come forward for testing. Of every ten smears done, eight were completely normal or showed insignificant changes. Less than four in every 100 smears showed CIN changes and only one in every 2000 was suggestive of possible cancer. If the results of a Pap smear raise concerns or if a woman experiences any unusual bleeding or cervical discharge, the cervix is examined for suspicious-looking tissue using a magnifying instrument called a colposcopy. A biopsy is usually taken and the tissue sample removed from the cervix is sent to a laboratory for microscopic examination. If the examination indicates severe CIN or pre-invasive cancer, any areas of the cervix which look abnormal are treated by cryosurgery (which destroys tissue by freezing), diathermy (which achieves the same end using an electric current), or else by heat or by laser. Diathermy or electrocoagulation entails using an electric current to produce points, loops or small balls of heat that burn the tissue while also closing blood vessels. Lasers are high-density beams of light energy that can cut tissue precisely and, at the same time, close off blood vessels. All these techniques have a high cure rate, and they do not interfere with a woman's sex life or prevent her from having children in the future. Occasionally, a procedure called conisation is performed in which a cone-shaped sample of tissue about a centimetre thick is removed from the cervix using a scalpel, diathermy or laser. Once again, it is rare for the technique to damage a woman's sex life or impair her ability to have children. If, however, there is any evidence that the disease has spread inside or beyond the cervix, a hysterectomy should be discussed. Radiation therapy or chemotherapy may also be suggested in a bid to ensure the complete destruction of cancer cells.
Although scientists do not know the exact cause of cervical cancer, there appears to be an association with sexual activity. Research suggests that certain strains of the human papilloma virus (HPV), which may be transferred during sexual contact, are involved in the disease process.

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Keywords for this page: Hysterectomy: cancer of the cervix


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