Causes, incidence and risk factors
Worldwide, cervical cancer is the third largest type of cancer in women. In developing countries, cancer is more rare because of routine pap smear exam (pap smear).
In general, cancer develops slowly, starting with pre-cancerous condition called with dysplasia. Conditions dysplasia can be detected with a pap smear and can be cured 100%. Therefore it is important for women to have regular pap examinations. Almost all women who had cervical cancer, not previously do ‘follow up’ there is an abnormal Pap result.
Of pre-cancerous condition until the onset of symptoms of cervical cancer in general take many years. Pre-cancerous changes are not detected will develop into cancer and spread.
Almost all cervical cancers are caused by HPV (Human Papilloma Virus), which is a common virus transmitted through sexual contact. There are many types of HPV virus, and certain types of cervical cancer is the leading cause (especially types 16 and 18). The other type of disease often causes genital warts that do not develop into cancer and almost no problem at all.
All women who have had sexual intercourse, has the risk of HPV infection, especially those who had sexual intercourse at an early age (under age 20 years), frequently changing sexual partners, sexual paired with someone who also frequently change partners or to have high-risk sexual activity , accompanied by low socioeconomic status and immune system (immune) a weak body.
on early-stage cancer slalu almost no symptoms. If found symptoms, usually in the form of: bleeding through abnormal vegina occurring outside the menstrual cycle, during intercourse or after menopause Menstruation usually more numerous and longer than usual. In addition, there are sometimes accompanied by whitish brown color, mixed with blood and smelled.
In a state that has been advanced, cervical cancer can give symptoms such as: low back pain, severe fatigue due to frequent bleeding, loss of appetite, leg swelling, weight loss, and more as a manifestation of a state cancer that has spread.
The existence of pre-cancerous cervical changes can not be seen with the naked eye. It required tests and specialized equipment will be undertaken by trained health personnel. Pap smear examination is a method for detecting (screening) of such changes but not a final many diagnostic tools. If the obtained results are abnormal pap, it would require examination using colposcopy (cervical state is looking for directly with magnification). then do a biopsy (taking a bit of cervical tissue) in the suspected areas are pre-cancerous changes are then sent to a laboratory for examination (histopathology).
Patients who have been diagnosed with cervical cancer, will undergo further investigation to determine how far the disease has spread, including chest x-fotosinar examination, CT scans, IVP maybe even an MRI.
treatment of cervical cancer depends on cancer stage, tumor size, age and general health status, and whether the patient still wants to have children later in life. In pre-cancerous condition or early-stage cancer treatment can be done by performing excision or destruction of pre-cancerous tissue. There are various methods without having to lift the uterus or damaging the cervix, so that patients can still have children later in life. Such methods include LEEP (using electricity to remove abnormal tissue), cryotherapy (freezing the cells are not normal), laser (to burn abnormal tissue), even konisasi (cutting a cone tissue).
Operation pengakatan uterus (hysterectomy) performed on radically more advanced cancer but not in getting deployment, accompanied by removal of tissue around the uterus, including the lymph nodes and upper vagina.
Radiation is needed to deal with cervical cancer that has spread beyond the uterus or cancer recurrence. Chemotherapy is sometimes used before or after surgery.
Some prevention efforts to prevent cervical cancer include sexual activity safe (using condoms, do not have multiple sexual partners and not having sex at an early age).
Conduct regular pap (regular) can detect pre-cancerous changes, so it can be treated before they turn into cancer. A woman who has sexual intercourse, at least within three years should have done further investigation and do it regularly every one or two years. For women smokers, should immediately stop, because cigarette smoke triggers an increased risk of cervical cancer.
Now available vaccinations to prevent cervical cancer. In June 2006, the U.S. FDA has approved the use of a vaccine that can prevent HPV infection, especially against the two HPV types that play a role in almost all cases of cervical cancer.
Various studies show that the vaccine could prevent cervical cancer and early-stage lesions of pre-cancerous. According Hogi (Association of Oncology Ginokologi Indonesia), vaccination will provide the best preventive effects when given to women aged 9-26 years and had never been infected with HPV (or have never had sexual intercourse). Although it had been vaccinated, then it is recommended to specify a routine pap examination, because not all types of HPV virus causes cervical cancer can be prevented by vaccine.