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Cancer / Oncology

What’s to know about carcinoma?

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The most common form of cancer in the United States is skin cancer. The two most common forms of skin cancer are basal cell carcinoma, and squamous cell carcinoma. Melanoma is the third most common skin cancer which is more severe and causes the most deaths.

About 3 million people in the U.S. are diagnosed with nonmelanoma skin cancer each year, and basal cell carcinoma (BCC) accounts for about 80 percent of these cases, according to estimates.

BCC and squamous cell carcinoma ( SCC) are normal and highly treatable, in comparison to melanoma.

We look at the diagnosis and treatment of those carcinomas in this article.

What is carcinoma?

Excessive exposure to the sun can lead to carcinomas, the most common type of skin cancer.

The two most common types of skin cancer include BCC and SCC.

Carcinomas are also classified as skin cancers but are not melanoma. A carcinoma is a cancerous tumor of the epithelial tissue, which is the tissue underneath the skin.

Also present in the digestive tract, blood vessels, and other organs is epithelial tissue which means that carcinomas can affect areas of the body other than the skin.

BCC is more common than squamous cell type, many times. There is also a rare type of skin cancer called Merkel cell carcinoma.

For the vast majority of cases, individuals who obtain a diagnosis of carcinoma are over 50 years of age. Statistics also indicate that in people with white skin 90 percent of carcinomas occur.

Types

Healthcare professionals define the different carcinomas by the type of cell in which they occur.

Basal cell carcinoma

BCC grows in the basal cells, which are round skin cells that lie far below the squamous cells in the skin’s epidermis. They form the epidermis base layer which meets the dermis.

BCC is unlikely to spread, but doctors who believe that this form of carcinoma is present in an individual will still refer them for further examination.

Squamous cell carcinoma

Squamous cells make up much of the skin’s top layer which people call the epidermis. These cells are flat and scale-like.

Doctors suspecting SCC will provide a more urgent referral, since it is more likely to spread than BCC.

But SCC is much rarer than BCC. It has less than 20 percent responsibility for nonmelanoma skin cancers.

Pictures

Causes

The primary cause of carcinoma and other skin cancers is exposure to ultraviolet ( UV ) radiation from sunlight.

Some people are more sensitive to UV light than others, and are more vulnerable to the cancer development effects of sunlight. For example , increased UV exposure from tanning beds and UV drying lamps in nail salons can add to a person’s risk as well.

UV radiation in skin cells can cause damage to the DNA, resulting in mutations during cell division, and likely leading to skin cancer.

Risk factors

Factors and features that increase the risk of carcinoma include a personal history of skin cancer and radiation treatment for any form of cancer, especially in childhood. A family cancer history can also contribute.

Further risk factors include:

  • having numerous, irregular, or large moles or freckles
  • a tendency to burn before getting a suntan
  • having fair skin, blue or green eyes, or blond, red, or light brown hair
  • autoimmune diseases, such as systemic lupus erythematosus (lupus)
  • inherited conditions, such as xeroderma pigmentosum and nevoid basal cell carcinoma syndrome, also known as Gorlin syndrome
  • a weakened immune system, possibly due to HIV, receiving an organ transplant, or taking immunosuppressant drugs
  • taking medicines that make the skin photosensitive, such as vandetanib (Caprelsa), vemurafenib (Zelboraf), and voriconazole (Vfend)
  • human papillomavirus (HPV) infection, particularly in people with a weakened immune system

Actinic keratosis, which consists of rough, raised growths causing precancerous changes in skin cells, is an SCC-specific risk factor. The most common form of precancerous skin lesion is those growths.

That condition may develop into skin cancer without treatment.

While UV radiation is the leading risk factor for SCC, the following skin damage may also increase the risk of carcinoma of this type:

  • burns to the skin
  • chemical damage
  • exposure to X-ray radiation

BCC may also occur in childhood after exposure to X-ray radiation, though this is a much less common cause of carcinoma than exposure to UV.

Symptoms

Both BCC and SCC are skin tumors, and have several characteristics in common. Nevertheless, the presence of these skin lesions can differ.

Some carcinomas retain a flat surface and may look like healthy skin as a result. Anyone with any unexpected lesions will contact and track a healthcare provider for a checkup.

Apart from its appearance, a lump or lesion in its early stages sometimes causes no obvious symptoms. It may not be visible as a result until it is fairly big where it may itch, bleed, or cause pain.

Basal cell carcinoma

Usually BCC is presented as a shiny papule, a small red or pink lump which grows slowly.

After some months or years, a shiny, pearly, or waxy-looking border can develop.

A raised edge often rings a central ulcer, and it can become apparent to abnormal-looking blood vessels. These may emerge as blue, brown , or black areas. Instead, they may be pink growths or patches of pale or yellow resembling scars.

Because of this wide range of appearances it is important to receive an accurate diagnosis from a doctor.

BCC can look scaly, sometimes causing frequent crusting or bleeding. This that look like a healing scab as it crusts over but sores may still appear. Individuals with BCC also seek medical help when they come across a sore that is not healing.

Squamous cell carcinoma

Usually SCC is viewed as persistent, thick, rough, scaly patches or as a firm pink lump with a flat, scaly, and crusty surface.

Such lesions can bleed when bumped, scratched, or scraped by a human. Although they often resemble warts, with a crusted surface or raised edge, they can also appear as open sores.

It is important to obtain a health care professional’s advice about the creation of any new growths or improvements in pre-existing skin growths or sores.

Diagnosis

Diagnosing skin cancer requires physical examination and biopsy.
Diagnosing skin cancer requires physical examination and biopsy.

A doctor may do a physical exam to diagnose some type of skin cancer. The skin lesion will be examined and its size, shape , texture and other physical attributes recorded.

You can also take a professional analysis photo of the lesion, or record its current size and appearance for potential comparisons. The doctor will often check up on additional skin symptoms for the rest of the body.

They will also take a medical history that focuses on the lesion and any associated conditions, like sunburn.

Due to their spreading propensity, a doctor must immediately refer suspected SCC cases for specialist examination and treatment. Suspected BCC tumors should not be referred as urgently because they are less likely to spread.

If they believe a lesion may be cancerous, then the doctor is likely to perform a biopsy as well. There are four different forms of skin biopsy all involving the removal of skin tissue for laboratory assessment.

The different types are:

  • Shave biopsy: Using a sharp surgical blade, the doctor shaves the top layers of skin cells, usually as far as the dermis but sometimes deeper. This type of biopsy often results in bleeding, but it is possible to stop this by cauterizing the wound.
  • Punch biopsy: The doctor uses a sharp, hollow surgical tool that resembles a tiny cookie cutter to remove a circle of skin from below the dermis. A person may need a single stitch to close the resulting wound.
  • Incisional biopsy: The doctor removes part of the growth with a scalpel, cutting away a full-thickness wedge or slice of skin. This type of biopsy often needs more than one stitch afterward.
  • Excisional biopsy: The doctor removes the whole growth and some surrounding tissue with a scalpel. The resulting wound usually requires stitches.

Once the tissue sample is taken, the doctor will send it under a microscope to a pathology laboratory for analysis. The pathology department must test the cells to detect cancerous traits. If cancer is present, they will determine its type.

For people with BCC, further inquiries are generally not required as this rarely spreads. People with SCC can need to undergo cancer tests in other tissues, however.

Many assessments typically include imagery, and may include:

Staging

When a doctor detects skin cancer, then they may label it as a stage. To do so, they must determine its size and depth and to what degree it has spread to local and remote locations in the body, such as nearby lymph nodes or other organs.

The doctor can also take tissue from lymph nodes close to the carcinoma site to help them stage cancer. A fine needle biopsy is also used by them for laboratory analysis.

Staging may not be performed until after a skin tumor has been surgically removed. The stages range from 0 to 4, with 0 representing in situ carcinoma which only affects the skin’s top layer.

Step 4 carcinoma refers to a carcinoma that has spread across the body to other parts. The stages between describe lesion size, tissue depth, and any nearby invasion.

Treatment

cryotherapy process
Many methods are available for removing potetially harmful moles, including cryotherapy.

The treatment strategies for both forms of carcinoma are similar, but the medical team puts more focus on monitoring people with SCC for signs of metastasis.

The particular treatment or treatments that the doctor recommends will depend on the size, form, stage, and location of the carcinoma. Additional factors such as potential side effects and individual preference, will also be taken into account by the doctor.

Nonetheless, diagnosis is likely to require a team of health care practitioners including dermatologists and experts in surgical , medical, and radiological cancer.

Possible care choices can include:

Curettage and electrodesiccation: This is a common treatment for a minor lesion removal operation. A small, sharp, spoon- or ring-shaped tool called a curette is used by the doctor to scrape the carcinoma away before burning the site with an electric needle.

A complete removal of the cancer cells may require more than one round of curettage and desiccation.

Surgical excision: The lesion is removed by a surgeon, often in a process called Mohs surgery, which works best with larger lesions. During this procedure, after removing each layer the surgeon tests for the presence of cancer cells.

Mohs surgery is particularly useful in cases that involve removal of as little skin as possible, such as on near-eye lesions. It is also used by doctors on lesions with a high risk of recurrence.

Cryosurgery: This procedure, which involves applying liquid nitrogen to freeze and kill cancer cells, may be used by doctors for small tumours. Then the lesion blisters over and falls off within weeks of treatment.

Topical chemotherapy: The doctor may apply chemicals or medicines directly to the skin which destroy cancer cells.

The option for chemotherapy is 5-fluorouracil which includes Carac, Efudex, Fluoroplex and other drugs. For several weeks a doctor can apply this cancer-killing drug to the skin once or twice a day.

Since this local treatment does not reach other systems in the body, it does not cause side effects for other types of cancer which often occur with chemotherapy.

Nonchemotherapeutic treatment options include the imiquimod cream, sold under the Aldara and Zyclara labels. For small BCCs, this cream is adequate and it works by stimulating the body to produce interferon, which allows the immune system to fight the tumour.

Also, a doctor may directly inject interferon into the lesion.

Radiation therapy: The treatment team is treating lesions with a concentrated radiation that are large or difficult to remove.

Photodynamic Therapy (PDT): often, physicians will use this two-step procedure to treat BCC. They will add a light-sensitive cream to the infected skin region, and then expose it to a powerful source of light. The light has the same wavelength of blue light, which results in the death of carcinoma cells.

Given that the skin remains sensitive to light for the next 48 hours, during this time people should avoid UV light to minimize the risk of severe sunburn.

Laser carcinoma therapy: It includes the use of different forms of laser to kill cancer cells. Many lasers vaporize, or ablate, the top layer of the skin, removing any lesions present in it.

Some lasers are non-ablative and penetrate the skin without the top layer being covered. Their success in treating low, superficial BCCs is some evidence.

BCC laser therapy has not yet been approved by the US Food and Drug Administration ( FDA). However, if other therapies have not been effective, doctors can often use this as a secondary therapy.

Prevention

There is actually no systematic carcinoma screening programme. Instead, people should check for irregular lesions themselves, or ask a doctor for a physical test.

UV light is the primary risk factor for all forms of carcinoma. The best strategy for prevention is to adopt sensible sun exposure practices, and avoid tanning beds.

Minimizing sun exposure: People can reduce their risk of sunburn, skin damage and all types of skin cancer, including carcinoma, by reducing their exposure to UV light.

Although some exposure to the sun is required to maintain adequate levels of vitamin D, which is essential to maintaining skin health, sunburn increases the risk of carcinoma.

People can limit sun exposure by finding shade, usually by 10 a.m., when the sun is at its peak. And, at 4 p.m.

Clothing: Skin-protecting clothes from the sun involve hats with a large brim or crown, sleeve tops and sunglasses.

Clothes in sun-protective fabrics would have UV 400 or UV protection factor (UPF) labels on them. Choose tight weave over loose-weave fabrics for better protection.

When buying sunglasses, check the labels for a 100 percent mention of UVA and UVB radiation protection.

Approved wide-spectrum sunscreens: Pick an effective sunscreen and apply it liberally and consistently to the skin to minimize UV light exposure.

Check the label to ensure the sunscreen protects against UVA radiation and UVB radiation.

Because some sunscreens are ineffective and contain suspected cancer-causing substances, check consumer reports to make sure a particular sunscreen brand is safe and effective prior to use.

Using a sunscreen with a minimum sun protection factor ( SPF) of 30 and reapply it every 2 hours on all exposed skin. Increasing the application after intense sweating or swimming to once an hour. There are also lotions which are waterproof.

Children and youngsters are especially vulnerable to sun exposure. People should also be aware that the levels of UV light are more dangerous at higher altitudes, in places closer to the equator, and at sunny locations throughout the year.

The U.S. Task Force on Preventive Services recommends that infants, teenagers and young adults between the ages of 10 and 24 with fair skin will limit their exposure to UV radiation.

Avoid tanning beds: tanning beds, tanning parlors and sunlamps raise the risk of carcinoma significantly.

Artificial tanning, since it exposes the body to a concentrated source of UV rays, is more harmful than normal sunbathing. Avoid using nail lamps when receiving manicure or pedicure as this may also increase skin cancer risk.

This advice is especially important for people undergoing routine nail therapy.

Self-examination

Skin cancers
Self-examination is vital for identifying moles and lesions that could become skin cancer.

The fundamental concept of carcinoma screening and other types of skin cancer is to look for unresolved skin changes.

To be successful the skin should be self-examined:

  • paying particular attention to areas of skin that get lots of sun exposure
  • asking a partner or family member to check difficult-to-see areas and using full-length and hand mirrors
  • knowing your skin and learning how moles and marks usually look to recognize any changes
  • taking photos, which can help track changes
  • checking for changes in size, shape, color, or texture
  • performing self-examination in good lighting
  • seeking medical attention for any sores that do not heal
  • working across the body systematically from head to toe to examine all areas
  • checking all areas of the body, including the more intimate ones
  • keeping a note of any observations and recording the dates of self-examinations

Those interventions can help individuals detect carcinomas early on and treat them before spreading.

Outlook

Treatment is likely to be more successful in situations where an patient early on detects skin changes and receives prompt medical attention.

Prompt treatment significantly increases the odds of survival in cases where cancer is responsible for changes in the skin and decreases the risk of severe tissue damage and disfigurement.

BCC has an excellent survival rate, since it spreads very rarely beyond the original site. Often, doctors may treat it in-office.

In its early stages, SCC is treatable, and most therapies are more than 90 percent successful. Mohs surgery is the most effective option for 97 per cent of people who receive this treatment to resolve SCC.

However, if SCC extends beyond the original site and enters other body systems, the survival rate would decrease to around 30 percent.

Effective recognition is important for a person’s outlook to be enhanced.

Question:

How do I tell the difference between melanoma and carcinoma?

Answer:

Melanoma commonly occurs in the skin that is regularly exposed to sunlight, like that on the face , neck, hands , and arms.

This is also noticeable, as it makes a skin area look darker than the rest. Melanoma has this effect as it starts in cells called melanocytes which are in the lowest epidermis layer and play a role in the color of the skin.

Nonmelanoma, or BCC and SCC, are respectively in the mid and upper layers of the epidermis. Possible signs and symptoms of these carcinomas include irregular changes in skin appearance, such as ruggedness, redness, scaliness, or thin, high, smooth or red areas.

If you notice anything unusual on your skin, please visit your dermatologist for a physical examination.

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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