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Cancer / Oncology

Colorectal cancer: What you need to know

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Colorectal cancer is any cancer that affects the colon and the rectum, also known as bowel cancer, colon cancer, or rectal cancer.

The American Cancer Society reports that in the United States about 1 in 21 men and 1 in 23 women will develop colorectal cancer during their lifetime.

It’s the second leading cause of death from cancer in women, and the third leading cause for men. However, the death rate from colorectal cancer has been declining due to advancements in screening methods and changes in therapies.

Colorectal cancer may be either benign, non-cancer, or malignant. A malignant cancer can spread and cause damage to other parts of the body.

Symptoms

Symptoms of colorectal cancer

Symptoms of colorectal cancer include:

  • changes in bowel habits
  • diarrhea or constipation
  • a feeling that the bowel does not empty properly after a bowel movement
  • blood in feces that makes stools look black
  • bright red blood coming from the rectum
  • pain and bloating in the abdomen
  • a feeling of fullness in the abdomen, even after not eating for a while.
  • fatigue or tiredness
  • unexplained weight loss
  • a lump in the abdomen or the back passage felt by your doctor
  • unexplained iron deficiency in men, or in women after menopause

Most of these signs can indicate other potential conditions as well. If the symptoms continue for 4 weeks or more it is necessary to see a doctor.

Treatment

Treatment may rely on many factors, including cancer size , location and level, whether it is recurring or not, and the patient’s current overall state of health.

Treatment options include chemotherapyradiotherapy, and surgery.

Surgery for colorectal cancer

It is the treatment which is most common. To minimize the risk of cancer spreading, the affected malignant tumors and any associated lymph nodes should be removed.

The intestine is normally stitched back together but often the rectum is entirely removed and a colostomy bag is inserted for drainage. The stools are stored in the colostomy bag. This is generally a temporary measure, but it may be permanent unless the ends of the bowel can be joined.

If the cancer is diagnosed early enough, this can be successfully removed by surgery. When surgery doesn’t stop the cancer, the symptoms will ease.

Chemotherapy

Chemotherapy includes the use of a drug or a chemical for the killing of cancer cells. It’s widely used for the diagnosis of colon cancer. This can help to shrink the tumor before surgery.

Targeted therapy is a kind of chemotherapy that targets precisely the proteins that facilitate the growth of some cancers. They may have fewer side-effects than other chemotherapy types. Bevacizumab (Avastin) and ramucirumab (Cyramza) are medicines which can be used for colorectal cancer.

A research found that patients with advanced colon cancer who undergo chemotherapy and who have a colorectal cancer family history have a substantially lower risk of recurrence and death from cancer.

Radiation therapy

Radiation therapy uses rays of high energy radiation to kill and prevent the cancer cells from spreading. This is most widely used in treating rectal cancer. This can be used in an effort to shrink the tumor before surgery.

Following surgery, both radiation therapy and chemotherapy can be given to help reduce recurrence chances.

Ablation

Ablation may make a tumor removed without destroying it. It can be achieved with radiofrequency, ethanol, or cryosurgery. These are delivered using an ultrasonic or CT scanning technology guided probe or needle.

Recovery

Malignant tumors will spread if left untreated, to other parts of the body. The chances of a complete cure significantly rely on how early the cancer is diagnosed and treated.

The recovery of a patient depends on the following factors:

  • the stage when diagnosis was made
  • whether the cancer created a hole or blockage in the colon
  • the patient’s general state of health

In some cases, the cancer may return.

Risk factors

Possible risk factors include:

Colon cancer and polyp
  • older age
  • a diet that is high in animal protein, saturated fats, and calories
  • a diet that is low in fiber
  • high alcohol consumption
  • having had breast, ovary, or uterine cancer
  • a family history of colorectal cancer
  • having ulcerative colitis, Crohn’s disease, or irritable bowel disease (IBD)
  • overweight and obesity
  • smoking
  • a lack of physical activity
  • the presence of polyps in the colon or rectum, as these may eventually become cancerous.

Many colon cancers (adenoma) arise within polyps. They are also located within the lining of the bowel.

Eating red or processed meats will add to the risk.

Individuals with a tumor suppressor gene known as Sprouty2 may be at higher risk for some colorectal cancers.

Colorectal cancer is the second most common tumor in both men and women, after lung tumors, according to WHO (World Health Organization).

Throughout Western Europe, around 2 per cent of people over 50 years of age will potentially develop colorectal cancer.

Causes

It is not clear exactly why colorectal cancer develops in some people and not in others.

Stages

A cancer stage determines only how far it has spread. Determining the stage assists in selecting the most appropriate therapy.

The stages of colon cancer

A widely used method gives a number from 0 to 4 for the phases. Colon cancer stage is:

  • Stage 0: This is the earliest stage, when the cancer is still in the colon or rectum’s mucosa, or inner layer. This is also known as in situ carcinoma.
  • Stage 1: The cancer has progressed through the inner colon or rectum layer but has not yet spread beyond the rectum or colon wall.
  • Stage 2: The cancer has spread through or through the colon or rectum wall, but has still not entered nearby lymph nodes.
  • Stage 3: The cancer has reached surrounding lymph nodes, but other areas of the body have not been affected yet.
  • Step 4: The cancer has spread to other areas of the body, including other organs such as the liver, the abdominal cavity lining membrane, the lung, or the ovaries.
  • Recurrent: After surgery the cancer has returned. This may come back, impacting the rectum, colon, or other body part.

In 40 percent of cases, diagnosis occurs at an advanced stage, when surgery is likely the best option.

Diagnosis

Screening can detect polyps until they become cancerous, as well as detect colon cancer when the chances of a cure are much higher during the early stages.

The following are the most common Colorectal Cancer screening and diagnostic procedures.

Fecal occult blood test (blood stool test)

It tests for the presence of blood to a sample of the patient’s stool (feces). It can be done in the doctor’s office, or at home with a kit. The sample is returned to the Physician’s office and sent to a laboratory.

A blood stool check is not 100 % effective, because not all tumors cause blood loss, or they do not bleed all the time. The test may therefore yield a false negative result. Blood can also be present due to certain diseases or disorders, such as hemorrhoids. Some foods may indicate blood in the colon, when there was in fact none.

Stool DNA test

The examination analyzes multiple markers of DNA which are shed into the stool by colon cancers or precancerous polyps. A kit with instructions on how to extract a stool sample at home can be given to patients. That has to be taken back to the office of the doctor. This is then sent to a laboratory.

This test is more effective than polyps for detecting colon cancer, but it can not identify all of the DNA mutations that suggest a tumor is present.

Flexible sigmoidoscopy

To view the patient’s rectum and sigmoid, the doctor uses a sigmoidoscope, a flexible, narrow, and lighted tube. The sigmoid column is the colon’s last part, before the rectum.

The examination takes a couple of minutes and is not painful but can be uncomfortable. There is a tiny chance of colon wall perforation.

When polyps or colon cancer are identified by the doctor, then a colonoscopy can be used to inspect the entire colon and remove any polyps present. All are to be examined under a microscope.

A sigmoidoscopy can find only polyps or cancer in the colon and the rectum in the end section. In no other part of the digestive tract does it detect an problem.

Barium enema X-ray

Barium is an enema-shaped contrast dye that is stored in the patient’s bowel, and it appears on an X-ray. As well, air is inserted in a double-contrast barium enema.

The barium covers and coats the bowel lining, providing a simple picture of the rectum, colon, and even a small section of the small intestine of the patient.

A flexible sigmoidoscopy can be performed to detect any tiny polyps that the X-ray barium enema can miss. If anything abnormal is detected by the barium enema X-ray, the doctor can prescribe a colonoscopy.

Colonoscopy

Colonoscopy

A colonoscope is more than just a sigmoidoscope. It is a slim, thin , flexible tube, attached to a video camera and monitor. The physician can see the whole colon and the rectum. Some polyps found during this test can be removed during the process and tissue samples, or biopsies, are often taken instead.

A colonoscopy is painless but to calm them down some patients are given a mild sedative. They can be given laxative fluid before the test to clean out the colon. In rare cases an enema is used. Colon wall bleeding and perforation are potential complications, but extremely rare.

CT colonography

Upon clearing the colon, a CT-machine takes pictures of the colon. When something suspicious is found, it can require traditional colonoscopy. This procedure can give patients with increased risk of colorectal cancer a less-invasive, better-tolerated, and good diagnostic accuracy alternative to colonoscopy.

Imaging scans

Ultrasound or MRI scans can help to show whether the cancer has spread to another body part.

Daily screening for people aged 50 to 75 is recommended by the Centers for Disease Control and Prevention ( CDC). Duration depends on test form.

Prevention

A number of lifestyle measures may reduce the risk of developing colorectal cancer:

  • Regular screenings: People who have had colorectal cancer before, who are over 50 years of age, who have a family history of this type of cancer, or who have Crohn’s disease, Lynch syndrome, or adenomatous polyposis should have regular screenings.
  • Nutrition: Follow a diet with plenty of fiber, fruit, vegetables, and good quality carbohydrates and a minimum of red and processed meats. Switch from saturated fats to good quality fats, such as avocado, olive oil, fish oils, and nuts.
  • Exercise: Moderate, regular exercise has been shown to have a significant impact on lowering a person’s risk of developing colorectal cancer.
  • Bodyweight: Being overweight or obese raises the risk of many cancers, including colorectal cancer.

A research published in the Cell journal indicated that aspirin could be effective in improving the immune system in breast, skin and bowel cancer patients.

A gene linked to the recurrence of bowel cancer and reduced survival may help predict outcomes for patients with the mutation – and take scientists a step closer to creating tailored therapies, research in the Gut journal reveals.

A research published in Science found that 300 vitamin C oranges inhibit cancer cells, indicating that one day the strength of vitamin C could be harnessed to fight colorectal cancer

Researchers also found that every day drinking coffee – including decaffeinated coffeewill reduce the risk of colorectal cancer.

Cancer / Oncology

What is cervical cancer screening: Who should get it?

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Cervical screening allows for the detection and treatment of cervical cancer in its early stages. To detect changes in the cells of the cervix and identify associated viruses, doctors utilise two major tests.

Cervical cancer occurs in the tiny area where the uterus meets the top of the vaginal canal at the lower end of the uterus. Human papillomavirus (HPV) is found in roughly 99 percent of cervical cancers, while most HPV instances do not progress to cancer. The most important risk factor for cervical cancer is having HPV.

Cervical cancer screening consists mostly on the Pap test and the HPV test.

Regular screening, according to the National Cancer Institute, lowers the risk of getting or dying from cervical cancer by 80% Trusted Source.

Because of advancements in testing and treatment, the incidence of deaths from cervical cancer in the United States is decreasing by about 2% per year.

We’ll look at how a pap test works, who should get one, and how to interpret the findings in this post.

Screening tests

cervical cancer screening

Cervical cancer screening may include HPV testing or the Pap test. At the same time, the doctor may perform a physical examination of the pelvis.

Pap smear

A healthcare expert expands the vagina using a tool they call a speculum to gain access to the cervix. They next extract a sample of cells from the cervix. They will send the cell sample to a laboratory for evaluation under a microscope.

The laboratory technicians check at the appearance of the cells. If they appear abnormal, it may be a sign that cervical cancer is in the early stages of development, known as precancer.

Early treatment can rectify these cellular alterations and prevent the emergence of cervical cancer.

HPV test

A doctor will perform the HPV test to discover the virus underlying many aberrant cellular changes that could lead to cervical cancer.

However, the HPV DNA test may identifiy numerous infections that specialists do not relate to cancer. A positive HPV test often does not guarantee that a person will go on to get cancer.

Screening criteria and recommendations

The American Cancer Society provide advice for regular cervical cancer tests in females of all ages.

21–29 years

Between these ages, a woman should receive Pap tests at 3-year intervals. HPV testing is not necessary at this point. However, a doctor may follow up a Pap test with HPV testing if results are abnormal.

In one study, 86.7 percent of people who tested positive for HPV did not acquire cancer in at least the following 10 years.

30–65 years

Doctors prescribe the following for people of these ages:

  • co-testing, or a combination of both tests, every 5 years
  • a Pap test every 3 years

The American Cancer Society warn that a combined HPV and Pap test can lead to more false positives, additional testing, and more intrusive treatments.

Over 65 years

Women who have had regular screening in the last 10 years with clean findings throughout can stop screening at this age.

However, if a test within the last 20 years has showed indicators of a dangerous precancer, screening should continue until 20 years following this precancer finding.

Women with a high risk of cervical cancer

Those who have a greater risk of cervical cancer should have more frequent testing.

This includes females with a compromised immune system, such as those with HIV or a recent organ transplant. People might also have a high risk if they received exposure to diethylstilbestrol (DES), a synthetic type of oestrogen, before birth.

After a total hysterectomy, which involves removal of the uterus and cervix, screening is no longer necessary. However, if a doctor did the hysterectomy to treat cancer, screening should continue.

Females who have gotten an HPV vaccination should continue get tests.

A person who has current or past cervical cancer or precancer will have their own screening and treatment regimen, as well as individuals with HIV infection.

A false positive result may not only cause stress but might lead to unneeded procedures that may have long-term risks. For this reason, doctors do not advocate yearly screenings.

Interpreting results

Cervical screening test results can be normal, ambiguous, or abnormal.

Normal: There were no alterations in the cells of the cervix.

Unclear: The cells appear like they could be abnormal, and the pathologist could not discover alterations that could suggest precancer. These aberrant cells could relate to HPV, an infection, pregnancy, or life changes.

Abnormal: The lab technicians identified alterations in the cervical cells. Abnormal cells do not usually signify cancer. The doctor will typically request more tests and treatment to evaluate if the alterations are turning malignant.

In an uncertain outcome, cell alterations have occurred, but the cells are very near normal and are likely to resolve without treatment. The doctor will likely order a repeat test within 6 months.

Younger people are more susceptible to low-grade squamous intraepithelial lesions (LSIL) that commonly heal without therapy.

Cervical erosion, which doctors sometimes refer to as an ectropion, may potentially lead to an uncertain result. Cervical erosion means that the cells of underlying glands can be visible on the surface of the cervix.

Erosions are widespread, especially among those individuals who are using the contraceptive pill, teenagers, or someone who is pregnant. Slight bleeding could also occur after sex.

Most occurrences of erosions resolve without therapy.

What to do following abnormal results

An abnormal result signifies that the pathologist discovered alterations in the person’s cervix. This result does not necessarily suggest that the individual has cervical cancer. In most cases, there is no cancer.

The aberrant alterations in the cervical cells are commonly attributable to HPV. Low-grade changes are mild whereas high-grade changes are more significant. Most low-grade alterations resolve without treatment.

It generally takes 3–7 years for “high-grade,” or severe, abnormalities to become cervical cancer.

Cells showing more serious alterations may potentially turn malignant unless a specialist eliminates them. Early intervention is crucial for treating cervical cancer.

Doctors will need to undertake more testing to confirm abnormal Pap or HPV test results.

Rarely, test results could reveal the presence of cervical intraepithelial neoplasia (CIN) (CIN). This word signifies that the screening discovered precancerous cells, but not that the individual has cervical cancer.

The findings may show the following:

  • CIN 1 (mild cell changes): One-third of the thickness of the skin that covers the cervix has abnormal cells.
  • CIN 2 (moderate cell changes): Two-thirds of the thickness of the skin that covers the cervix has abnormal cells.
  • CIN 3 (severe cell changes): All the thickness of the skin that covers the cervix has abnormal cells.

A doctor will need to confirm these results by requesting a biopsy.

Test difficulties

While both routine cervical screening tests are typically reliable and useful, confusing or abnormal results may represent a problem with the examination rather than the existence of altering cells.

A person may have to repeat the test due to a “inadequate” sample, implying that their results were inconclusive.

An insufficient sample could be due to:

  • too few cells being available from the test
  • the presence of an infection that obscures the cells
  • menstruation, which can make viewing the cells hard
  • inflammation of the cervix, which may obstruct the visibility of the cells

If you want to get a cervical cancer screening, you should first take care of any infections or irritation in your cervix.

Conclusion

The Pap test and the HPV test are medically recommended tests for cervical cancer. These tests reveal either cell alterations or the presence of the HPV virus, both of which indicate a higher risk of cervical cancer.

Screening is frequently quite effective, allowing for early treatment. However, the results may be ambiguous, necessitating further testing.

Every three years, females over the age of 21 should have a Pap test.

It is possible that screening will be pricey. Many insurance, on the other hand, cover testing. This site can be used by people who don’t have access to cervical cancer screening to see if they qualify for free testing under the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

References

  • http://www.nccc-online.org/hpvcervical-cancer/cervical-cancer-overview/
  • http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening
  • https://www.cancer.gov/types/cervical/hp/cervical-screening-pdq#_1
  • https://www.cdc.gov/cancer/cervical/statistics/
  • https://www.medicalnewstoday.com/articles/254577
  • https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/des-fact-sheet
  • https://www.cdc.gov/cancer/nbccedp/
  • https://www.cdc.gov/nchs/fastats/pap-tests.htm
  • https://jamanetwork.com/journals/jama/fullarticle/2697704
  • https://www.cdc.gov/cancer/cervical/basic_info/test-results.htm
  • https://www.cdc.gov/cancer/cervical/basic_info/test-results.htm

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Cancer / Oncology

Symptoms, causes, stages, and treatment of cervical cancer

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Cervical cancer damages the womb’s entrance. The cervix is the thin section of the lower uterus, often known as the womb’s neck.

According to the American Cancer Society, clinicians in the United States will make 13,170 new cervical cancer diagnosis by the end of 2019. Cervical cancer will claim the lives of more than 4,200 women in the United States this year.

The human papillomavirus (HPV) is the most common cause of cervical cancer. HPV is successfully prevented by the HPV vaccine.

The vaccination was previously recommended for all people aged 9 to 26 years by the Centers for Disease Control and Prevention (CDC). The vaccination is now accessible for all women and men aged 26–45 who had the vaccine as a preteen, according to the CDC.

We’ll look at cervical cancer, its symptoms, and how to avoid and treat it in this post.

Early warning signs and symptoms

bleeding after sexual intercourse

A person may have no symptoms at all in the early stages of cervical cancer.

As a result, women should undertake cervical smear examinations, often known as Pap tests, on a regular basis.

A Pap test is a preventative measure. Its goal is not to identify cancer, but to reveal any cell alterations that may signify the onset of cancer so that treatment can begin sooner.

The following are the most prevalent signs of cervical cancer:

  • vaginal discharge with a strong odor
  • bleeding after sexual intercourse
  • vaginal discharge tinged with blood
  • pelvic pain
  • bleeding between periods
  • bleeding in post-menopausal women
  • discomfort during sexual intercourse

Other causes, such as infection, can cause these symptoms. Anyone who exhibits any of these symptoms should consult a physician.

Stages

Identifying a cancer’s stage is important because it allows a person to choose the most effective treatment option.

The goal of staging is to determine how far the cancer has gone and whether it has migrated to surrounding structures or further away organs.

The most frequent technique to stage cervical cancer is using a four-step system.

Stage one: There are precancerous cells present.
Stage 1: Cancer cells have spread from the surface into the cervix’s deeper tissues, as well as into the uterus and adjacent lymph nodes.
Stage 2: The cancer has spread beyond the cervix and uterus, but not to the pelvic walls or the lower section of the vaginal canal. It may or may not affect the lymph nodes in the area.

Stage 3: Cancer cells can be found in the lower section of the vaginal canal or the pelvic walls, and they can obstruct the ureters, which convey urine from the bladder. It may or may not affect the lymph nodes in the area.

Stage 4: The cancer is growing out of the pelvis and damages the bladder or rectum. The lymph nodes may or may not be affected. It will extend to distant organs, including as the liver, bones, lungs, and lymph nodes, later in stage 4.

Screening and obtaining medical attention if any symptoms arise can assist a person in receiving early treatment and increasing their chances of survival.

Causes

The uncontrolled division and development of aberrant cells causes cancer. The majority of our body’s cells have a defined lifespan, and when they die, the body regenerates new cells to replace them.

There are two issues that abnormal cells can cause:

  • they do not die
  • they continue dividing

This causes an overabundance of cells to pile up, eventually forming a lump or tumour. Why cells turn malignant is a mystery to scientists.

Some risk factors, on the other hand, may raise the risk of cervical cancer. These are some of them:

  • HPV: This is a virus that is spread by sexual contact. There are about 100 different varieties of HPV, with at least 13 of them having the potential to cause cervical cancer.
    Having a lot of sexual partners or beginning sexually active young: Cancer-causing HPV kinds are almost always transmitted through sexual contact with someone who has HPV. HPV infection is more likely in women who have had a risk of sexual partners. This raises their chances of getting cervical cancer.
  • Smoking: Cervical cancer, as well as other types of cancer, is increased as a result of this.
  • A weakened immune system: Cervical cancer is more common among people who have HIV or AIDS, as well as those who have had a transplant and are using immunosuppressive medicines.
  • Birth control pills: Long-term usage of various common contraceptive pills boosts a woman’s risk by a small amount.
  • Other sexually transmitted diseases (STD): Cervical cancer is more likely in people who have chlamydia, gonorrhoea, or syphilis.
  • Socio-economic status: In locations where income is low, rates appear to be higher.

Treatment

Surgery, radiotherapy, chemotherapy, or a combination of these treatments may be used to treat cervical cancer.

The type of treatment chosen is determined by a number of criteria, including the cancer’s stage, age, and overall health.

Early-stage cervical cancer treatment, while the cancer is still contained within the cervix, has a high success rate. The lower the success percentage, the further a cancer spreads from its original location.

Early-stage options

When the cancer has not gone beyond the cervix, surgery is a typical therapeutic option. If a doctor suspects cancer cells are present inside the body after surgery, radiation therapy may be beneficial.

Radiation therapy may potentially lower the chances of a recurrence (cancer coming back). Chemotherapy may be used if the surgeon wants to shrink the tumour to make it easier to operate on, albeit this is not a frequent technique.

Advanced cervical cancer treatment

Surgery is usually not an option when the cancer has progressed beyond the cervix.

Advanced cancer is also known as invasive cancer since it has spread to other parts of the body. This form of cancer necessitates a more intensive treatment regimen, which often includes radiation therapy or a combination of radiation therapy and chemotherapy.

Palliative therapy is used by healthcare providers in the final stages of cancer to reduce symptoms and improve quality of life.

Radiation therapy

Radiation therapy is also known as radiation oncology or XRT by some clinicians.

It entails the use of high-energy X-rays or radiation beams to kill cancer cells.

When a treating doctor uses radiation to treat the pelvic area, the following adverse effects may cause, some of which may not appear until after the therapy is completed:

Chemotherapy

Chemotherapy
FatCamera/Getty Images

Chemotherapy is the treatment of any disease with chemicals (medicine). It refers to the killing of cancer cells in this context.

Chemotherapy is used by doctors to target cancer cells that surgery can’t or won’t eradicate, as well as to alleviate the symptoms of people with advanced cancer.

Chemotherapy has a wide range of adverse effects, which vary depending on the medicine. The following are some of the most common negative effects:

Cervical cancer clinical trials

For some people, taking part in a research study may be the greatest therapy option.

Clinical trials are an essential component of cancer research. Researchers use them to see if novel treatments are safe and effective, as well as whether they are superior than existing ones.

People who take part in clinical trials help to advance cancer research and development.

Prevention

Cervical cancer can be prevented by taking a variety of precautions.

Human papillomavirus (HPV) vaccine

The association between cervical cancer and some forms of HPV is undeniable. Cervical cancer could be reduced if every female adhered to the current HPV immunisation programmes.

Cervical cancer and safe sex

Only two HPV strains are protected by the HPV vaccine. Cervical cancer can be caused by other strains. Using a condom while having sex can help prevent HPV infection.

Cervical screening

Cervical screening may help a person detect and treat signs of cancer before the condition progresses or spreads too far. Screening does not identify cancer, but it does reveal alterations in the cervix’s cells.

Having fewer sexual partners

The greater a woman’s sexual partners, the greater her risk of transmitting the HPV virus. Cervical cancer is a risk as a result of this.

Delaying first sexual intercourse

The higher the risk of HPV infection, the younger a woman is when she has her first sexual encounter. The longer she waits, the lesser her risk becomes.

Stopping smoking

Cervical cancer is more likely to develop in women who smoke and have HPV than in those who do not.

Diagnosis

Early detection of cervical cancer boosts treatment success rates.

The American College of Surgeons recommends the following screenings as part of a routine examination:

Under the age of 25: The American College of Surgeons does not suggest screening.

Between the ages of 25 and 65: For cervical cancer prevention, people should get an HPV test every five years.

Over the age of 65: Unless individuals have a high risk of cervical cancer, the ACS does not suggest screening for those who have received adequate screening in the past.

People who have had a hysterectomy with the cervix removed do not need to be screened unless they had previously had precancerous lesions or cervical cancer.

These are the general screening recommendations, although each person’s screening needs should be discussed with a doctor.

Cervical smear test

According to the American Cancer Society (ACS), approximately 13,000 new cases of invasive cervical cancer will be diagnosed in 2019. Around 4,000 women will die as a result of the disease. Regular screening, on the other hand, could avert the majority of these deaths.

Screening does not identify cancer; instead, it searches for abnormal changes in cervix cells. Some aberrant cells can develop into cancer if they are not treated.

HPV DNA testing

This test determines if the person has any of the HPV varieties that are most likely to cause cervical cancer. It entails taking cells from the cervix for laboratory examination.

Before any abnormalities in the cervical cells become visible, the test can detect high-risk HPV strains in cell DNA.

A doctor may offer additional tests if there are signs and symptoms of cervical cancer or if the Pap test indicates abnormal cells.

These include:

  • Colposcopy: A speculum and a colposcope, a lighted magnifying device, are used to examine the vagina.
  • Examination under anaesthesia (EUA): The doctor will be able to inspect the vaginal and cervix in greater detail.
  • Biopsy: Under general anaesthesia, the doctor removes a little piece of tissue.
  • Cone biopsy: For evaluation, the doctor removes a tiny cone-shaped portion of aberrant tissue from the cervix.
  • LLETZ: Diathermy, which involves heating a wire loop with an electric current, aids in the removal of aberrant tissue. After that, the healthcare provider sends the tissue to a lab for analysis.
  • Blood tests: A blood cell count can aid in the detection of liver or kidney issues.
  • CT scan: A barium liquid may be used by a medical expert to reveal any cellular abnormalities.
  • MRI: Cervical cancer can be detected in its early stages using some types of MRI.
  • Ultrasound of the pelvis: On a monitor, high-frequency sound waves generate an image of the target region.

Outlook

The stage at which a person is diagnosed with cervical cancer can assist determine their odds of surviving for at least another 5 years:

  • Stage 1: The chances of surviving at least 5 years are 93 percent in early stage 1 and 80 percent in late stage 1.
  • Stage 2: Early in stage 2, the rate is 63 percent, but by the conclusion of stage 2, it has dropped to 58 percent.
  • Stage 3: The possibilities drop from 35 percent to 32 percent at this point.
  • Stage 4: Cervical cancer people at stage 4 have a 15 to 16 percent probability of living another 5 years.

These are average survival rates, which do not apply to all people. Treatment can be effective up to stage 4 in some situations.

Sources:

  • http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening
  • https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/staged.html
  • http://www.who.int/immunization/hpv/deliver/en/
  • http://www.who.int/mediacentre/factsheets/fs380/en/
  • https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html
  • https://jamanetwork.com/journals/jama/fullarticle/2697704
  • https://www.medicalnewstoday.com/articles/159821
  • https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html
  • http://www.cancer.org/cancer/cervicalcancer/moreinformation/cervicalcancerpreventionandearlydetection/cervical-cancer-prevention-and-early-detection-h-p-v-test
  • http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-key-statistics
  • http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-risk-factors

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Cancer / Oncology

Chronic eosinophilic leukemia (CEL): What to know

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Chronic eosinophilic leukemia (CEL) is a type of blood cancer that causes in an overabundance of eosinophils in the body. Eosinophils are a type of white blood cell that helps the body fight infection, but having too many of them can be hazardous.

CEL is uncommon, but researchers do not know how common it is in the United States.

This page examines the symptoms and causes of CEL, as well as treatment options and outlook.

What is it?

blood test

CEL is an uncommon form of myeloproliferative neoplasm, which is a type of blood cancer caused by myeloid stem cells in bone marrow producing an abnormally large number of red and white blood cells and platelets.

CEL causes the body to overproduce eosinophils, a type of white blood cell. Eosinophils secrete substances to protect the body from infections or allergic reactions.

Eosinophils are high in the bone marrow, blood, and other tissues of people with CEL. This can cause to issues including organ damage.

Symptoms

People may not have symptoms in the early stages of the disease. A regular blood test can also detect CEL in people who have no symptoms.

Other people may get severe symptoms as a result of high eosinophil levels.

Among the signs of CEL are:

  • unexplained weight loss
  • shortness of breath
  • swollen lymph nodes
  • anemia
  • fatigue
  • fever
  • cough
  • swelling under the skin around the eyes, lips, throat, hands, or feet
  • muscle aches or pains
  • itchiness
  • diarrhea
  • night sweats

CEL is most commonly diagnosed in people between the ages of 20 and 50, but it can also affect youngsters and the elderly. CEL is more frequent in men than in women.

Causes

The cause of CEL is unknown. There is no link, for example, between CEL and a mutation in genes or chromosomes, according to researchers. CEL may be caused by environmental factors such as smoking or exposure to radiation or certain chemicals in rare situations.

Diagnosis

In most circumstances, doctors try to rule out all other potential causes of the patient’s symptoms. If they then rule out CEL, this is referred as as a diagnosis of exclusion.

A doctor evaluates any symptoms, performs a physical examination, and may subsequently run a variety of tests, including:

  • a bone marrow biopsy and aspiration, which involves removing a small sample of bone marrow for testing
  • blood chemistry tests, which show how well organs are functioning
  • a complete blood count, which gives the amount and quality of white and red blood cells and platelets

Outlook

CEL is typically slow to progress and can persist for many years.

However, a person’s condition can quickly deteriorate if CEL progresses to acute myelogenous leukemia.

A 2020 study of CEL patients in the United States discovered a median survival period of 2 years following diagnosis. CEL progressed to acute myelogenous leukemia in many of these patients.

Researchers behind a different 2020 study discovered that the outlook for CEL varies, and they called for greater research on the subject.

Other studies indicated that people who got stem cell transplantation as a treatment had survival rates ranging from 8 months to 5 years. Despite the fact that this strategy can be effective, clinicians do not typically accept it as a credible treatment for CEL.

Treatment

The appropriate approach for each person with CEL may differ.

Corticosteroids and interferon alfa (Intron A, Wellferon), for example, may be used to treat the disease. Doctors may also administer chemotherapeutic drugs such as:

  • hydroxyurea (Hydrea), possibly in combination with steroids
  • cyclophosphamide (Cytoxan, Procytox)
  • vincristine (Oncovin)

A doctor may advise you to use targeted chemotherapy medications, which target certain genes or parts of leukemia cells.

In addition, treatment with the medication imatinib (Glivec) may result in long-term remission in some people with CEL. This medication prevents the formation of excessive eosinophils.

People with aggressive CEL may benefit from stem cell transplants if stem cells from a donor with similar genes are available.

Follow-up treatment

A doctor may offer further approaches to relieve CEL symptoms, such as:

  • Leukapheresis: An electrophoresis machine is used to separate out extra white blood cells from the blood, lowering the number of eosinophils.
  • Blood-thinning medication: CEL can cause blood clots, and these medications can help avoid them.
  • Splenectomy: High eosinophil levels can cause the spleen to expand, resulting in significant abdominal pain. In this instance, a doctor may advise removing the spleen by surgery.
  • Cardiac surgery: If a person has heart disease, surgery to remove scarring of the heart muscle or replace heart valves may assist improve heart function and extend life.

Hypereosinophilic syndrome vs. CEL

Hypereosinophilic syndrome (HES) is a group of blood diseases characterized by elevated amounts of eosinophils. CEL is a type of HES.

An overabundance of eosinophils can cause problems in a variety of places of the body, most notably the:

In many situations, the cause of HES is unknown. It may be caused by an increase in the synthesis of a specific protein in some white blood cells. A person has lymphocytic HES in this case.

An hereditary genetic mutation can also cause the illness. A person in this situation has familial HES.

The high quantity of eosinophils in someone with CEL is caused by alterations in the bone marrow. CEL is a form of HES that is myeloproliferative.

HES symptoms may include:

  • problems with the nervous system, such as vertigo or tingling sensations
  • heart problems
  • anemia
  • deep vein thrombosis
  • skin rashes or swelling
  • breathing difficulties
  • stomach pain or upset
  • muscle and joint pain

Certain medications, such as imatinib mesylate (Glivec) and mepolizumab, may aid in the treatment of HES (Nucala).

Conclusion

CEL is a form of blood cancer that is extremely rare. It causes the body to overproduce eosinophils, a type of white blood cell.

Medication, such as chemotherapy, and other approaches, such as stem cell transplants or surgery, may be used in treatment.

Many people’s CEL develops slowly, and treatment may result in long-term remission.

Sources:

  • https://seer.cancer.gov/seertools/hemelymph/51f6cf58e3e27c3994bd53fc/
  • https://www.cancer.gov/types/myeloproliferative/hp/chronic-treatment-pdq
  • https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.23664
  • https://www.medicalnewstoday.com/articles/what-is-chronic-eosinophilic-leukemia
  • https://rarediseases.info.nih.gov/diseases/2804/hypereosinophilic-syndrome
  • https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/drugs/imatinib
  • https://www.sciencedirect.com/science/article/pii/B9780323085939000760
  • https://onlinelibrary.wiley.com/doi/10.1002/ajh.25906

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