Condition Cervical Dysplasia and Cancer
It is important to find a trusted specialist when diagnosed with cervical cancer. The three types of standard treatment are surgery, radiation therapy & chemotherapy. Choose a CIGC specialist to perform a minimally invasive laparoscopic procedure.
The cervix forms the lower, narrow portion of the uterus and leads from the uterus to the vagina. The surface layer of the cervix is mostly composed of squamous cells. These cells are where cancer typically begins to develop slowly. In cervical cancer, the cervix undergoes a transformation known as dysplasia, in which abnormal cells appear in cervical tissue. This is known as a precancerous condition. In time, if left undetected and untreated, these cancer cells start to grow and spread more deeply into the cervix and surrounding tissue.
WHAT ARE THE SYMPTOMS OF CERVICAL DYSPLASIA?
Cervical dysplasia is usually asymptomatic since the abnormal cells are only confined to the very top layer of the cervix. This is why the Pap smear is a very important screening test.
WHAT ARE THE SYMPTOMS OF CERVICAL CANCER?
In many cases, early cervical cancer does not have any symptoms which makes the Pap smear a very important test for detection.
Symptoms of cervical cancer may include:
- Abnormal bleeding
- Bleeding after intercourse
- Bleeding after menopause
- Pelvic or abdominal pain (advanced stage)
- Blood in urine (advanced stage)
- Blood in stool (advanced stage)
HOW IS CERVICAL CANCER DIAGNOSED?
Doctors who provide care for women routinely perform pelvic examinations and Pap smears to screen for cancer in the cells on the surface of the cervix. During a Pap smear, a sample of cells from the cervix is taken and examined under a microscope. Abnormal results from a routine Pap smear should not be cause for alarm. Approximately six percent of all annual Pap smears will produce an abnormal result, and this result rarely indicates the presence of cervical cancer. Cells taken from the surface of the cervix can appear abnormal, but may not be cancer. These abnormal cells, however, may be the first step in a series of changes that lead to cancer and are the reason additional testing may be advised. Abnormal cells, sometimes called precancerous cells, typically involve only the surface of the cervix.
I HAD AN ABNORMAL PAP SMEAR, NOW WHAT HAPPENS?
If physicians feel more information is needed following an abnormal Pap smear, they may use a colposcope (lighted microscope) to better visualize the cervix or perform a biopsy, which is the removal of a sample of tissue from the cervix in order to evaluate cervical cells. If the biopsy is normal or shows only mildly abnormal cell (low grade dysplasia), no surgical treatment is necessary. Most of the mildly abnormal cells go away on their own and should be followed with Pap smears to confirm resolution. If biopsy shows moderate or severe dysplasia, surgical treatment is usually required. A conization or cone biopsy removes a cone-shaped sample of tissue from the cervix. This procedure, known as “LEEP” (Loop Electrosurgical Excision Procedure), can be performed in the office without sedation or in the operating room under sedation. Infrequently, it may still remain unclear whether the abnormal cells are confined to the cervix or arise from inside the uterus. In this situation, a dilatation and curettage (D&C) may be recommended. During a D&C, a small sample of the uterine lining or endometrium is taken from the inside of the uterus.
Treatment of cervical cancer during pregnancy depends on the stage of the cancer and the stage of the pregnancy. For early stage cervical cancer found early or for cancer found during the last trimester of pregnancy, treatment may be delayed until after the baby is born.
HOW DO I KNOW IF MY CERVICAL CANCER HAS SPREAD?
As with other cancers, cervical cancer is described in terms of its presence in and beyond the cervix. The stage of the cancer describes the extent to which it has spread beyond the cervix, if at all:
- Stage 0: Precancerous lesion involves only the cells on the surface of the cervix.
- Stage I: Cancer is confined to the cervix, and may be evident only under microscopic evaluation (stage IA) or apparent by visible or physical examination (stage IB).
- Stage II: Cancer has spread beyond the cervix to involve the tissues surrounding the cervix or the upper portion of the vagina.
- Stage III: Cancer spreads beyond the cervix to the lower vagina or to the sides of the pelvis, or causes a blockage of drainage from the kidney, a condition called hydronephrosis.
- Stage IV: Cancer invades structures adjacent to the cervix such as the bladder or rectum or has spread to other parts of the body such as the liver or lungs.
- Recurrent: Cervical cancer is still detected or has returned (recurred/relapsed) following an initial treatment with surgery, radiation therapy, and/or chemotherapy.
WHAT ROLE DOES HUMAN PAPILLOMA VIRUS OR HPV PLAY IN CERVICAL CANCER?
Certain strands of HPV have been found to cause cervical cancer. These strands are called high-risk HPV. HPV-16 and HPV-18 are the most common high-risk strands that cause cervical cancer. When these high risk strands are detected in Pap smear, colposcopy is necessary to evaluate the cervix for abnormal cells. If no abnormal cells are found, no treatment is necessary because, in most cases, the infection is cleared spontaneously. Most sexually active women will have HPV at some point during their lifetimes; however, only a fraction will develop cervical cancer. Regular follow ups with Pap smear screenings allow for early diagnosis of precancerous cells and avoids progression to cervical cancer. In the United States, the rate of cervical cancer is dramatically lower than in countries where the Pap smear is not routinely performed.
Different types of treatment are available for patients with cervical cancer. The three types of standard treatment are surgery, radiation therapy, and chemotherapy.
Surgery is commonly used to treat cervical cancer. The type of surgical procedure that is needed depends upon the stage and grade of cervical cancer. Small, highly localized areas of precancerous cells or early stages of cervical cancer may be treated with cryosurgery, loop electro-surgical excision procedure (LEEP) or cold knife conization (CKC). Some of these minor surgical procedures can be performed in the office.
- Cryosurgery uses an instrument to freeze and destroy a small area of precancerous cells.
- LEEP can be used for slightly more invasive cells, because it uses a thin wire loop to cut away a small area of tissue.
- CKC can also be used to remove a small area of precancerous or cancerous cells. CKC is effective for lesions within the opening of the cervix or cervical canal.
For cervical cancer that is not localized to the cervix or for patients who do not wish to preserve future fertility, hysterectomy, removal of the uterus and cervix, is typically the best treatment option as it prevents a recurrence of cervical cancer.
- Laparoscopic hysterectomy offers women all of the benefits of minimally invasive surgery, including short to no hospital stays, minimal pain and fast recoveries. Fast and easy recoveries from surgery benefit cancer patients in particular. After laparoscopic surgery, women feel less sick, which enables them to have a brighter, more optimistic outlook. This positive outlook helps women through the rest of the cancer treatment and recovery process.
- Laparoscopic Modified Radical Hysterectomy (LMRH) is a revolutionary procedure for the surgical management of early stage cervical cancer. This is a technically difficult procedure that–in experienced hands–yields excellent results with much improved recovery and function. During an LMRH, the uterus and cervix are removed, and the tissue on the sides of the cervix are removed as well. To do this, the ureter, or the tube that transports urine from the kidney to the bladder, needs to be carefully separated from the tissue surrounding the cervix, in order to remove the potentially cancerous tissue without harming the ureter. This is the most difficult part of the operation. Ureter complications, including nicks and cuts, are the most common type of surgical complication with this and any other gynecologic surgery. Staging is performed at the time of the laparoscopic procedure to determine if the cancer has spread, and involves node dissection, or removal of the lymph nodes during the procedure. The removal of lymph nodes does not add time or additional complications to the surgical procedure. The advanced laparoscopic techniques allow our surgeons to completely isolate the ureter from the surrounding tissues and safely remove potentially cancerous tissues without harming the ureter and other essential structures. All patients with early stage cervical cancer are candidates for the procedure.
WHY CIGC FOR MY DYSPLASIA & CANCER TREATMENT?
As a patient who has been diagnosed with dysplasia or cancer of the cervix, uterus, or ovaries, it is important to find a GYN surgeon you trust. CIGC surgeons are laparoscopic surgical specialists who have dedicated their careers to the performance of minimally invasive GYN surgery.
Our commitment to surgery means that we have worked on a higher volume of cases, more difficult cases, and use advanced techniques and procedures learned in extensive training sessions. We strive to complete even the most complex surgeries with low complication rates.
Surgery is the only medicine practiced by our surgical specialists. We partner with OB/GYNs to ensure patients have the best possible care. Increased surgical volume is important to develop and maintain surgical expertise, and with dysplasia and cancer, a minimally invasive specialist who focuses solely on surgery is essential.
CIGC surgeons do not perform open hysterectomies on patients with dysplasia and cancer. Open surgeries are known to be painful, have a relatively high risk of complications, and have an extended recovery period. CIGC surgeons also do not perform robotic surgeries. Surgeries in which robotic technology performs the procedure is extremely expensive and has a high risk of complications. At CIGC, we perform minimally invasive, advanced laparoscopic hysterectomies using our advanced technique DualPortGYN. This type of hysterectomy is far superior to the aforementioned: it leaves you with minimal cosmetic scarring, has a recovery period of only a few days, and has a low risk of complications. Hear why our patients prefer our laparoscopic procedures.
The benefits of minimally invasive GYN procedures.
Patients of laparoscopic surgery have a short hospital stay or none at all, minimal pain, and a fast recovery. Since recovery is so easy and fast, patients feel less sick afterward, which contributes greatly to an optimistic outlook. Feeling better physically and mentally makes the rest of the cancer treatment and recovery process more tolerable. At the end of treatment, patients get to walk away with minimal scarring.
Know your options. Our surgeons do their best to assess our dysplasia and cancer patients on a case-by-case basis to choose the best treatment options. There are many different types of treatment options, and the type of surgical procedure needed depends on the stage and grade of cancer. We will offer you peace of mind by understanding your condition and options.
We know that our customers are picky when choosing their surgeons, and we think doing extensive research is important. When you are exploring your dysplasia or cancer treatment options, get to know our surgical specialists and see why they are the best in the industry.
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