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The female reproductive system consists of two ovaries, two fallopian tubes, the uterus (womb) and the vagina. The cervix is the neck of the womb and is that part of the womb that can be seen via the vagina.
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Cancer of the cervix is the commonest cancer of the woman's reproductive system. Yet it is the most accessible of the female reproductive system. The accessibility of the cervix allows the wide use of the Papanicolaou (Pap) smear as a reliable and economical screening test for cancer of the cervix. All sexually active females should have regular Pap smears done. |
CAN CANCER OF THE CERVIX BE PREVENTED?
Cancer of the cervix is one cancer where some risk factors can be reduced. The two risks factors are early sexual activity and having multiple sex partners.
Risk Factors
- Sexual intercourse at early age.
- Multiple sex partners.
- Genital infection eg. herpes simplex virus type 11, human papilloma virus.
- Early pregnancy with a first baby before 20 years of age.
- Age 40 - 60 years
- Symptoms of established or invasive cancer of the cervix
- Bleeding after sexual intercourse
(Postcoital staining)
- Irregular vaginal bleeding
- Vaginal bleeding one year or more after the menopause (Post-menopausal bleeding)
- Foul-smelling vaginal discharge
- Pre-Cancer of the Cervix is without symptoms.
DIAGNOSIS
It is important to detect the disease when it is in the pre cancerous stage because with proper treatment at this time the cure rate is almost 100%. The following are the means of detection.
Pap smear
Colposcopy
Cone biopsy
THE PAP SMEAR
This cytological screening test was first suggested by Papanicalaou in 1947 and adopted for use since the 1960's. The smear is used to reveal exfoliated cells collected from the cervix that may be
pre-cancerous or cancerous. If your pap smear is abnormal and you are advised to go for further tests and treatment by your doctor, please do so. If untreated, a
pre-cancerous lesion has the potential to become an invasive cancer. The use of the test has decreased the death rate of women from cancer of the cervix. It has also reduced the incidence of women having established cancer of the cervix.
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How is Pap smear done?
This simple procedure can be done as an outpatient and takes about 5 minutes only. The patient lies on her back with the knees drawn up and apart. The doctor passes the speculum up the vagina. The cervix is displayed using the vaginal speculum. The surface cells of the cervix are scrapped and smeared onto a slide for viewing under a microscope. If abnormal cervical cells are seen after staining, further tests should be performed. Sometimes, monilia (fungus), trichomonas (parasitic infection) or bacterial infections are seen. These can be treated by medication. |
PAP SMEAR RESULT
It will indicate whether the smear is normal or abnormal. If you have an abnormal test, your doctor might advise further investigations.
WHEN SHOULD A PAP SMEAR BE DONE ?
An initial smear should be performed once a women is sexually active and repeated after one year. After that, the Pap smear can be done annually or once in 2 - 3 years as advised by your doctor.
COLPOSCOPY
The colposcope is a binocular microscope which allows a magnified stereoscopic view of the cervix. The cells and the distribution of the vessels are seen. Abnormal distribution of the blood vessels and cells may be detected.
A biopsy is taken (a piece of tissue taken for microscopic examination) if any abnormalities are found.
Treatment of pre-cancer of the cervix may be by laser, surgery,
electrocautery, or cold coagulation.
A cone of tissue is cut out of the cervix to include the whole of the abnormal area and leave as much normal cervical tissue as possible. A cone biopsy is required when the upper limit of possible abnormalities cannot be seen by the
colposcope. In pre-cancer of the cervix, removal of all the abnormal tissue by cone biopsy can be a form of treatment.
TREATMENT OF ESTABLISHED INVASIVE CANCER OF THE CERVIX
This is by surgery of early stages of the cervix if the patient is fit.
Otherwise, radiotherapy is given in the following 2 stages.
External Radiation
High-energy rays are used to destroy cancer cells that may have spread outside the cervix - to the sides of the pelvic and the other parts of the abdomen. Treatment is carried out as an outpatient basis over period of 6 weeks.
Internal Radiation
Radioactive isotopes are placed inside the uterus and around the cervix. Cancer cells in the cervix are destroyed by closed-ranged radiation.
After treatment
The woman will be checked at regular intervals after surgery or radiotherapy.
Sexual intercourse should be avoided temporarily after treatment. Normal physical and social activities may be resumed in 2 - 3 months after the beginning of treatment.
Where to have your Pap smear done ?
- By your family doctor
- By a gynecologist
- At the Singapore Cancer Society
- At the Well Women Clinic
Cancer Facts
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