Cancer of the Uterus and Other Parts of the Female Reproductive ...

Ovarian cancer is rarer than uterine cancer; there are about 20,000 new cases diagnosed each year. It also has a higher mortality rate, resulting in more than 12,000 deaths per year. Cancers of the vagina and other female genital organs are very rare. In the last decade, there have been reports of a slight increase in precancerous changes in the vaginal tissue among young women whose mothers took DES, an artificial estrogen that was given until the late 1960s to prevent a miscarriage. These young women should have regular gynecological checkups, but early reports of increases in vaginal cancer have been exaggerated.

Regular Pap smears-the microscopic examination of cells shed from the surface of the cervix-have been instrumental in the dramatic decline in cervical and uterine cancer deaths. By detecting cervical cancer in its early localized or even precancerous stages, treatment with laser, freezing, burning (cauterization), or local excision is usually sufficient to cure the disease. Women who are at risk of developing either cervical or uterine cancer should undergo yearly gynecological examinations. The American Cancer Society recently relaxed this recommendation for women with a history of normal Pap smears and no risk factors, saying they are probably safe having a gynecological examination and Pap smear every 2 or 3 years until age 50 and annually thereafter. The American College of Obstetricians and Gynecologists recommends, however, that women over the age of 20 or 25 who are sexually active undergo an annual pelvic examination, noting that cancer is only one of many conditions that doctors look for.

In discussing uterine cancer, the question of hormone therapy inevitably arises. Studies have found that long-term estrogen replacement following menopause appears to increase the likelihood of endometrial cancer. This prompted a marked decline in the use of postmenopausal hormones in the 1970s. In recent years, the trend has reversed somewhat, largely because of an increase in osteoporosis (thinning of the bones) among older women. There is now a greater tendency to give women who are likely to benefit from estrogen therapy small doses of the hormone with periodic interruption of the estrogen with a second female hormone, progesterone, which causes the shedding of the endometrium similar to what occurs during menstruation. This prevents a buildup of the endometrial tissue, which, in theory, should also prevent endometrial cancer. In addition, women on long-term estrogen therapy are advised to have annual endometrial biopsies and periodic pelvic examinations. In younger women, hormone manipulation does not seem to increase the risk of uterine cancer. Women who use oral contraceptives seem to have a lower incidence of cancer than women who use other forms of birth control.

A precancerous condition (carcinoma in situ) affecting the cervix is relatively common among young women, especially those in their thirties who have borne children. It has no specific symptoms and is usually detected by an abnormal Pap smear or sometimes visually during a pelvic examination. Treatment depends upon the age of the woman, extent of the diseased tissue, and the probability that it may develop into invasive cancer or spread to other parts of the body. If there is no indication of spread, the diseased tissue may be removed by surgery, laser surgery, electrical cautery, or cryosurgery. These treatments are frequently followed by radiation therapy to ensure that any abnormal cells that may have spread to nearby tissues are destroyed. A hysterectomy may be recommended for a postmenopausal woman or a woman who has completed her family.

Treatment of established cervical cancer depends upon the extent of the disease. If it is localized, with no evidence of spread, removal of the cancer and surrounding tissue followed by radiation therapy and perhaps chemotberapy may be sufficient. A hysterectomy may be indicated if a large portion of the cervix is involved or if the disease has spread to the uterus.

Uterine cancer is usually treated surgically with removal of the uterus and, depending upon age and other circumstances, the ovaries and Fallopian tubes also may be removed. If the woman has not yet reached menopause, the ovaries may be left intact. In postmenopausal women, the tendency is to remove them, thus ending the risk of later ovarian cancer. In some cases, radiation may be used instead of or in addition to surgery. If the cancer has spread, chemotherapy may be given. If diagnosed early, the 5-year survival is 81 percent for cervical and 88 percent for endometrial cancer. If treatment is delayed until the cancer has spread to adjacent tissue, however, the 5-year survival drops to 57 percent for cervical cancer and 75 percent of endometrial cancer.

Ovarian cancer is much more difficult to detect in its early stages, largely because there are no obvious early symptoms and no simple screening test. Masses on the ovaries can be felt during a pelvic examination, but these usually are not cancer. Vague abdominal pain is the most common symptom of ovarian cancer, but this often does not occur until the disease is advanced. Treatment is usually with surgery followed by radiation and/or chemotherapy.

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Source: http://g-xp.com/cancer-of-the-uterus-and-other-parts-of-the-female-reproductive-organ/

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