Cervical Cancer: The Cancer You Can Prevent

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It is estimated that, in 2010 alone, over 12,000 women were diagnosed with cervical cancer, with more than 4,000 patients dying of the disease. What sets cervical cancer apart is that, unlike other cancers, cervical cancer is almost always caused by Human Papillomavirus (HPV). The bad news is that this cancer is caused by an incredibly common virus. The good news is that makes this one of the very few preventable cancers. Please join Dr. Diana Willadsen as she discusses this disease and the important—and life-saving—vaccines.

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Cervical Cancer: The Cancer You Can Prevent

  1. 1. Cervical Cancer Diana Willadsen, MD Hematology & Oncology
  2. 2. CERVICAL CANCER <ul><li>Accounts for 11,000 new cancers and 3870 cancer deaths yearly in the U.S.A. </li></ul><ul><li>Higher incidence in minorities (double in Hispanics, 30% higher in African Americans) </li></ul><ul><li>Average age is 47 </li></ul><ul><li>Earlier onset with : </li></ul><ul><ul><li>-Earlier onset of sexual activity -Smoking (4x) </li></ul></ul><ul><ul><li>-Multiple partners -Hi-risk partner </li></ul></ul><ul><ul><li>-Oral contraceptives -More births </li></ul></ul>
  3. 3. INCIDENCE <ul><li>75% decrease over the last 50 years in developed countries </li></ul><ul><li>Remains the #2 cause of cancer mortality in undeveloped countries, with a 55% mortality </li></ul>
  4. 5. HUMAN PAPILLOMA VIRUS <ul><li>40 types exist; 15 are oncogenic </li></ul><ul><li>These account for 99.7% of cervical cancer </li></ul><ul><li>Also responsible for genital warts, cancer of the vulva, anus, penis, and some head and neck cancers </li></ul><ul><li>Most infections are cleared by host in 8-24 months </li></ul><ul><li>It may take 15 years to go from an unresolved infection to preinvasive cancerous changes to invasive cancer </li></ul>
  5. 6. FROM INFECTION TO CANCER <ul><li>1. HPV infection </li></ul><ul><li>2. Persistence of virus </li></ul><ul><li>3. Development of a clone of precancerous </li></ul><ul><li> cells </li></ul><ul><li>4. Invasion into healthy tissues </li></ul>
  6. 7. SCREENING <ul><li>PAP smear: a sample of cells is scraped off with a wooden tool, smeared on a slide, and examined for abnormal cells </li></ul><ul><li>False positives can occur in infections and other circumstances </li></ul><ul><li>Dysplasia requires further investigation </li></ul><ul><li>Conization or hysterectomy </li></ul>
  7. 8. SCREENING <ul><li>Most patients with invasive cervical cancer have never been screened </li></ul><ul><li>Average age at diagnosis is 47---if those ladies had been screened at 32, 35, 38, 40, 45 they might have been prevented from invasion, or at least caught early </li></ul><ul><li>Screening can be stopped after many years of no abnormal PAPs and monogamy </li></ul>
  8. 9. VACCINATION <ul><li>FDA approved for girls 11-12, as young as 9 </li></ul><ul><li>Some recommend vaccination up to age 26 </li></ul><ul><li>Boys can also be vaccinated </li></ul><ul><li>Early is important! </li></ul><ul><ul><li>Pre-exposure: 97-100% effective </li></ul></ul><ul><ul><li>After sexual debut: 44% </li></ul></ul>
  9. 10. “ My daughter is a nice girl and doesn’t need it.” “ My daughter will be a virgin when she gets married.” “ If you vaccinate your child, you might as well tell them that you don’t trust them.” “ If I vaccinate my child, she will think it means I approve of her sleeping around.” “ My daughter would NEVER have sex!” +
  10. 14. PRESENTING SYMPTOMS <ul><li>VAGINAL BLEEDING </li></ul><ul><li>BACK PAIN </li></ul><ul><li>SWOLLEN LYMPH NODES </li></ul><ul><li>SWOLLEN LEGS </li></ul><ul><li>BLADDER IRRITABILITY </li></ul><ul><li>RECTAL PAIN </li></ul>
  11. 15. TREATMENT <ul><li>RADICAL SURGERY </li></ul><ul><li>RADIATION THERAPY </li></ul><ul><li>CHEMOTHERAPY </li></ul><ul><li>THESE SHOULD ALL BE PREVENTABLE!!! </li></ul>
  12. 16. Questions?

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