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Cancer / Oncology

What to know about melanoma

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Melanoma is more like a type of skin cancer. It is not the most common, but it is the most dangerous, because it spreads frequently. It can be difficult to handle when this happens and the outlook could be low. Risk factors for melanoma include, among others, over-exposure to the sun, fair skin and a family history of melanoma.

Receiving an early diagnosis and prompt care can improve the outlook for melanoma sufferers.

Receiving an early diagnosis and prompt care can improve the outlook for melanoma sufferers.

For this purpose, humans should keep track of any moles that alter or grow. Using adequate sun exposure protection can help a person prevent melanoma altogether.

This article covers melanoma signs, how it can be treated by a doctor and ways to treat it. We’ll also clarify how to better prevent melanoma.

What is melanoma?

Melanoma in the foot
A person may be more at risk of melanoma if they have a family history of the condition.

Melanoma is a form of skin cancer that develops when cell-producing pigments called melanocytes mutate and begin to uncontrollably divide.

Most cells in the skin produce pigment. Melanomas can grow anywhere on the skin but some areas are at greater risk than others. It is most likely to impact both the chest and back in men. The legs are the most popular site between women. Certain common melanoma sites include facials.

Melanoma, however, can also occur in the eyes and other areas of the body, including the intestines – on very rare occasions.

For people with darker skin melanoma is relatively rare.

The American Cancer Society (ACS) predicts about 96,480 new melanoma diagnoses will occur in 2019. We also predict about 7,230 people will die in 2019 as a result of melanoma.

Stages

Diagnosis stage of a cancer would show how far it has already spread and what form of treatment will be necessary.

One method of assigning melanoma to one stage identifies the cancer in five stages, from 0 to 4:

  • Stage 0: The cancer is only present in the outermost layer of skin. Doctors refer to this stage as “melanoma in situ.”
  • Stage 1: The cancer is up to 2 millimeters (mm) thick. It has not yet spread to lymph nodes or other sites, and it may or may not be ulcerated.
  • Stage 2: The cancer is at least 1 mm thick but may be thicker than 4 mm. It may or may not be ulcerated, and it has not yet spread to lymph nodes or other sites.
  • Stage 3: The cancer has spread to one or more lymph nodes or nearby lymphatic channels but not distant sites. The original cancer may no longer be visible. If it is visible, it may be thicker than 4 mm and also ulcerated.
  • Stage 4: The cancer has spread to distant lymph nodes or organs, such as the brain, lungs, or liver.

The more advanced a cancer is, the more difficult it is to treat and the worse the outlook is.

Types

There are four types of melanoma. Learn more about each type in the sections below.

Superficial spreading melanoma

This type of melanoma is the most common, and it mostly occurs on the trunk or limbs. At first, the cells begin to expand gradually, until they disperse across the skin surface.

Nodular melanoma

This is the second most common type of melanoma that occurs on the trunk, head, or neck. It appears to grow faster than other types, and can look like a reddish or blue-black colour.

Lentigo maligna melanoma

It is less common and tends to occur in older adults, particularly in areas of the body that have had over many years of prolonged sun exposure, such as the face.

It starts off as the freckle of a Hutchinson, or lentigo maligna, that looks like a skin stain. This typically grows slowly, and is less harmful than melanoma of other forms.

Acral lentiginous melanoma

That’s the rarest form of melanoma. It occurs on the hands’ palms, feet soles, or under the nails.

Since people with darker skin do not usually get certain forms of melanoma, those with darker skin forms tend to be the most common form of melanoma among those.

Risk factors

Research is under way on the exact causes of melanoma.

Scientists do note however that people with other types of skin are more likely to develop melanoma.

Factors that can also lead to an increased risk of skin cancer include:

  • a high density of freckles or a tendency to develop freckles following exposure to the sun
  • a high number of moles
  • five or more atypical moles
  • the presence of actinic lentigines, also known as liver spots or age spots
  • giant congenital melanocytic nevi, a type of brown birthmark
  • pale skin that does not tan easily and tends to burn
  • light eyes
  • red or light hair
  • high sun exposure, particularly if it produces blistering sunburn, and if sun exposure is intermittent rather than regular
  • older age
  • a family or personal history of melanoma
  • a previous organ transplant

Only sun exposure and sunburn could be avoided of those risk factors. Eviting overexposure to the sun and avoiding sunburn will dramatically reduce skin cancer risk. Tanning beds are also a source of damaging ultraviolet (UV) rays.

Pictures

  • Acral lentiginous melanoma. Image credit Will Blake, 2006.
  • Nodular melanoma. Image credit: Dermnet New Zealand.
  • Superficial spreading melanoma. Image credit: National Cancer Institute.
  • Lentigo maligna melanoma.

An early diagnosis can be helped by being able to tell the difference between normal moles or freckles and those that suggest skin cancer

  • Superficial spreading melanoma
  • Nodular melanoma
  • Lentigo maligna melanoma
  • Acral lentiginous melanoma
  • Skin changes due to cancer
  • Normal mole

Symptoms

Melanoma can be difficult to spot in its early stages. The skin should be tested for any signs of transition.

Changes in skin appearance are essential indicators of melanoma. Doctors use these in the course of diagnosis.

The Foundation for Melanoma Research provides pictures of melanomas and regular moles to help a person know how to tell the difference.

They also list other symptoms that may cause a doctor to visit, including:

  • any skin changes, such as a new spot or mole or a change in the color, shape, or size of an existing spot or mole
  • a skin sore that fails to heal
  • a spot or sore that becomes painful, itchy, or tender
  • a spot or sore that starts to bleed
  • a spot or lump that looks shiny, waxy, smooth, or pale
  • a firm, red lump that bleeds or looks ulcerated or crusty
  • a flat, red spot that is rough, dry, or scaly

ABCDE examination

ABCDE moles test is an effective tool for the discovery of potentially cancerous lesions. It identifies five basic features to look for in a mole that can either help a person confirm or rule out melanoma:

  • Asymmetric: Noncancerous moles tend to be round and symmetrical, whereas one side of a cancerous mole is likely to look different to the other side.
  • Border: This is likely to be irregular rather than smooth and may appear ragged, notched, or blurred.
  • Color: Melanomas tend to contain uneven shades and colors, including black, brown, and tan. They may even contain white or blue pigmentation.
  • Diameter: Melanoma can cause a change in the size of a mole. For example, if a mole becomes larger than one-quarter of an inch in diameter, it might be cancerous.
  • Evolving: A change in a mole’s appearance over weeks or months can be a sign of skin cancer.

Treatment

Skin cancer therapy is similar to that used by other cancers. Unlike other cancers within the body, however, it is easier to reach and extract the cancerous tissue altogether. Operation is the preferred treatment choice for melanoma, for that reason.

Surgery includes extracting the lesion and any of the underlying noncancerous tissue. When the surgeon removes the lesion, they send it to pathology to assess the severity of the cancer presence, and to ensure they have removed it all.

If melanoma covers a wide area of the skin, it can involve a skin graft.

If there is a risk of the cancer spreading to the lymph nodes a doctor may order a biopsy of the lymph node.

Also, they can recommend radiation therapy for melanoma treatment, particularly in later stages.

Melanoma may be metastasised in other tissues. If so, a doctor will ask for therapies depending on where the melanoma has spread, including:

  • chemotherapy, in which a doctor uses medications that target the cancer cells
  • immunotherapy, in which a doctor administers drugs that work with the immune system to help fight the cancer
  • targeted therapy, which uses medications that identify and target particular genes or proteins specific to melanoma

Prevention

Avoiding excessive UV radiation exposure can reduce skin cancer risk. Users will have this achieved by:

  • avoiding sunburn
  • wearing clothes that protect the body from the sun
  • using broad spectrum sunscreen with a minimum sun protection factor (SPF) of 30, preferably a physical blocker such as zinc oxide or titanium dioxide
  • liberally applying sunscreen about half an hour before going outside in the sun
  • reapplying sunscreen every 2 hours and after swimming or sweating to maintain adequate protection
  • avoiding the highest sun intensity by finding shade between the hours of 10 a.m. and 4 p.m.
  • keeping children in the shade as much as possible, having them wear protective clothing, and applying SPF 50+ sunscreen
  • ]keeping infants out of direct sunlight

Wearing sunscreen isn’t a excuse to remain in the sun for longer. People will also be taking action to restrict exposure to the sun where possible.

Those working outdoors, too, will take care to minimize exposure.

Doctors warn to stop tanning booths, lights, and sunbeds.

What about vitamin D?

Currently, the American Academy of Dermatology (AAD) does not recommend sun exposure (or tanning) for vitamin D intake.

Instead, they recommend “seeking vitamin D from a [healthy] diet that includes foods naturally rich in vitamin D, vitamin D-fortified foods and beverages, and/or vitamin D supplements”

Diagnosis

Most melanoma cases concern the skin. They produce normally changes in existing moles.

By periodically inspecting existing moles and other colored blemishes and freckles, a person can detect the early signs of melanoma themselves. People should get their backs inspected frequently, as moles in this area can be harder to see.

A spouse, family member, friend, or doctor may help examine the back and other places that are difficult to see without help.

Any changes in appearance of the skin need further examination by a physician.

Some apps claim to help identify a individual and monitor the changing moles. Many aren’t accurate though.

Clinical tests

Doctors may use microscopic or photographic tools to take a more detailed look at a lesion.

They will have a dermatologist biopsy of the lesion if they suspect skin cancer to determine whether it is cancerous or not. A biopsy is a procedure in which a health care provider takes a sample of a lesion and sends it to the laboratory for analysis.

Outlook

Melanoma is an aggressive form of cancer that can be dangerous if spreading. People who recognise an early lesion, however, will get a very positive outlook.

The 5 year relative survival rates for melanoma were estimated by the ACS. These compare the chance of a person with melanoma living for 5 years with that of a person without cancer.

If a doctor detects melanoma and treats it until it spreads, the average survival rate for 5 years is 98%. Nevertheless, if it extends to deeper tissues or neighboring lymph nodes, the rate would fall to 64%.

If it enters distant organs or tissues, it reduces the chance of survival to 23 percent for 5 years.

It is therefore important to monitor any changing moles and seek medical attention for anyone that is changing, becoming irregular or growing. It is also important to take protective steps when spending long periods of time in the sun.

Question :

Should I have regular checkups for skin cancer?

Answer:

The AAD recommend performing regular skin self-exams. If a person is concerned by anything on their skin, they should see a board certified dermatologist.

Some individuals, such as those with a family history of melanoma or a personal history of skin cancer, should have their skin checked regularly — even in the absence of any skin concerns.

A dermatologist can provide guidance regarding the recommended frequency of a person’s skin exams. Owen Kramer, MD

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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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