Routine screening & guidelines

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Dr Nupur Gupta,
Senior Consultant & Unit Head,
Department of Obstetrics & Gynecology
Paras Hospital Gurgaon
CERVICAL CANCER: lets Get
Screened & Beat Cervical Cancer

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What You Need To
Know about
Cervical cancer?

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Anything that changes your chance
of getting a disease
What is a Risk Factor?

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HPV Infection
Smoking
Poor Immune System (HIV), Chlamydia
Diet low in fruits & vegetables
Being overweight
Longterm use of OCPs
IUD use (protective)
Having multiple fullterm pregnancies
Being younger than 17 at your first pregnancy
Low socioeconomic status
DES exposure in utero
Having a family history of cervial cancer
Risk Factors for Cervical Cancer

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Where does it arise?

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 Lower part of uterus
 Cells of cervix grow
abnormally & invade other
organs
 Invasive Cancer – lungs,
liver, bladder & vagina
 Slow growing cancer
What is Cervical Cancer?

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Main Cause of Cervical Cancer: HPV

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AN EARLY STAGE CERVICAL CANCER
IS ASYMPTOMATIC
Why should we screen?

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YES!!! IT IS PREVENTABLE

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 To look for abnormal cells in the cervix
Screening Test: Pap Test
 It is treatable
 It is one of the most preventable

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 Looks for the virus that can cause these cell changes
Screening Test: HPV DNA

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How do we take the Smear?

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How can it be more accurate?
 Not to do during menses
 Don’t use tampons or vaginal cream or
medicines
 Don’t douche 2 to 3 days before
 Don’t have vaginal sex 2 days before

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HOW OFTEN TO SCREEN?

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How do you know
you have Cervical
Cancer?

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 ABNORMAL VAGINAL DISCHARGE
 ABNORMAL VAGINAL BLEEDING (Bleeding after sex or
Bleeding after menopause, heavier bleeding)
 UNCOMFORTABLE URINATION
 SEX IS LESS ENJOYABLE
 PELVIC PAIN
 UNEXPLAINED WEIGHT LOSS & FATIGUE
 LEG PAIN WITH SWELLING
SIGNS YOU SHOULDN’T IGNORE

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Late Signs & Symptoms
 Dull backache
 Continuous dribbling of urine
 Diarrhoea, or pain or bleeding from the
rectum
 A swollen abdomen, nausea, vomiting, &
constipation

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Commonest Report: INFLAMMATION
Atypical cells, CIN, LSIL, HGSIL, Carcinoma

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 If your pap test is abnormal
 Cervix looks abnormal during a
pelvic exam
 Tests show you have HPV
 You have unexplained bleeding
Diagnosis: Colposcopy

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 Only if your doctor finds
something that doesn’t look
normal during your
colposcopy
Do you need a Cervical Biopsy?

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 Cone biopsy - cone-shaped piece of tissue from your
cervix to remove any precancerous cells. This surgery
can treat very small cervical cancers that haven't
spread.
 Cryotherapy - liquid gas to freeze abnormal cells from
your cervix
 Loop Electrosurgical Excision Procedure (LEEP)
Treatment Options

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HPV & Other Cancers

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 Targets types 16 and 18 HPV virus
 The ideal time: before you’re sexually active
 Upto 26 yrs (US & UK), Upto 45 years (India)
HPV Vaccine

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HPV VACCINES

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 Have fewer sex partners
 Work to keep your weight healthy
 Eat lots of fruits & vegetables
 Not use birth control pills for an
extended time
 Not smoke (Smokers are twice as
likely to get cervical cancer)
What else can u do?

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Don’t worry

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 STAGING & TYPE OF CANCER
 Age & Parity
Diagnosis: Cervical Cancer?
Just know that it’s usually
very treatable. It will relieve
your symptoms, and help
you live longer

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 Surgery
 Radiotherapy
 Chemotherapy
 Targeted therapy
 Take time to review all your options. Make sure you
understand how each treatment works. If you're not sure
about something, ask questions.
What are the treatments for
Cervical Cancer?

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 Main treatment for small cancers that
haven't spread outside your cervix
 Abdominal hysterectomy
 Laparoscopic hysterectomy
 Hospital stay - 1 to 5 days
Surgery: Total Hysterectomy
Hysterectomy: Simple or Radical +/- LN Sampling

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TYPES OF HYSTERECTOMY

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 For early-stage cervical cancer or post surgery
 High-energy X-rays kill cancer cells & stop their growth
 A small device is placed near your cervix
Radiation: Brachytherapy

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 5 days a week, for 5 to 6 weeks
Side effects
 Fatigue, loose stools, diarrhoea
 Nausea, Vomiting
 Pain during sex
 Skin changes
 Discomfort and urge to urinate often
 Menstrual changes
 Swollen legs (if lymph nodes are irradiated)
Radiation: External Beam

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 Drugs kill or slow the growth of cervical cancer cells
 Chemoradiation. Adding chemo makes the radiation work
better. Chemotherapy is good if cancer has spread
Side effects
 Changes in your periods
 Fatigue, hair loss
 Increased risk for infection
 Loss of appetite, mouth sores
 Nausea & vomiting
Chemotherapy

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 It kills cancer cells but spares healthy cells
 It can slow down tumor growth in advanced cervical
cancer, because tumors need new blood vessels for
nourishment
 Side effects - high blood pressure, fatigue, loss of
appetite, & blood clots or bleeding
Targeted Therapy

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 To stimulate a person’s own immune system to
recognize & destroy cancer cells more effectively
 To treat cervical cancer that has spread or come
back (recurred)
 It can shrink some tumors or slow their growth
Immunotherapy

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I take care of myself, so I can take
care of my family

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TOGETHER……………..
We can
prevent more
than 30,000
cancers each
year!

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How can you prevent cancer
or find it early?
 Pay attention to your body & know what is
normal for you
 Make healthy lifestyle choices
 Know your family health history
 Get the HPV Vaccine
 Get regular pap tests

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IF YOU CAN PREVENT IT
YOU DON’T NEED TO CURE
CERVICAL
CANCER

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 What is your risk of getting a Gyne Cancer?
 When should you have next pap test?
 What do your pap test results mean?
 Is the HPV test right for you?
 When should you stop getting pap test?
 Any other tests you need based on personal health
& family cancer history
 When should you visit based on new symptoms &
what should you do next?
Questions you can ask your Doctor

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Share Your Story & Inspire Others

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