The remarkable drop in cervical cancer incidence in American women because of regular testing has not always been true for the Native American peoples in the US. To let this happen in the heart of USA is shameful to say the least but measures have been taken to change this.
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Since the beginning of the century The Navajo Nation Breast and Cervical Cancer Prevention Program(NNBCPP), has been implemented and has made a mission out of providing screening to Navajo women for who the life expectancy survival rate is well below the national average. Their mission doesn't end here but goes on to also introduce campaigns for raising awareness about cervical and breast cancer and quickly raise the rate of participation on Pap screenings. The testing was to be provided through Indian Health Service (IHS) facilities. The NNBCCPP also does not neglect the importance of follow-up treatment and further testing in the case of any abnormalities discovered. Case management service was also made available to treat each case individually and ensure the patient's understanding and appropriate treatment.



Pap smears must be made annually by all women over 18 for at least 3 years so this program had to be well thought out for a long term basis and it was. It first was conceived as a breast cancer prevention program but either because of its success or because of the fact the two diseases represent the biggest preventable risks in the lives of the Navajo Women. The goals of the program for the period between 2007 and 2012 include ensuring that older, low-income women have access to regular breast and cervical cancer screenings, to reduce the incidence of invasive cancer by ensuring precancerous conditions are detected and treated, providing prompt follow-up testing or treatment in the case of abnormalities found.

The NNBCCPP program, as a breast prevention method, began in 1996 and it was funded through an agreement with The Centers for Disease Control and Prevention Atlanta, Georgia. It functions under the Navajo Division of Health and deals with the Arizona portion of the Navajo Nation. The program is being implemented by placing a case manager and an office assistant in all major hospitals in the area. Program services include screening procedures and diagnosis specialized tests such as ultrasound, biopsy, fine needle aspiration and colposcopy.



The program also takes the responsibility to guarantee one-on-one patient education, case management, community outreach education, community health fairs, contract health safe ride services, referrals for mammogram screening and overall involvement in the community.

This program has reported a considerable success in the last years. More information is available about the program, eligibility conditions and further descriptions about the services implied through online PowerPoint presentations and periodical reports. You can also help the cause through donations or even by volunteering to contribute to the public campaigns and support services.

Cervical cancer has known one of the highest rates of incidence from all cancer forms in USA but that is not anymore the case. The main reason for this is the Pap test, a screening procedure that can detect precancerous cells in the cervix. This procedure, taken every year for at least 3-5 years by women who are sexually active or over 18, has immensely reduced the incidence of cervical cancer since the 20th century. Statistics show that at the middle of the 20th century 26000 people died every year from cervical cancer, and the rate had been constant for 25 years. In 1941 the Papanicolau smear was finally introduced and since then, at the end of the century only 4900 people were still dying from cervical cancer. If you think about it this means a 90% drop as the number should have doubled until then because the population had doubled too. This accomplishment is remarkable and it is hard to believe that the Pap screening does not actually give 100% certain results.
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The truth is that Pap screening is passable of missing 50% of cervical cancers and up to 15% of precancerous conditions. This sounds worse than it really is. This is the reason why women should take regular Pap tests for 3-5 years at least. The mechanism behind is that normally a cancer needs 10 to 20 years to develop from precancerous cells, and if you make the calculations, the yearly tests for three year will ensure that only 3 out of 5000 women will be missed over the course of three years. So the results don't look so bleak and the Test is far from being debated on over it being worth the effort. It most certainly is.



But what does missing the precancer mean? The Pap smear is a testing procedure devised to detect infection with HPV. About 80% of the people in USA are infected with it and about 80% from the patients suffering from cervical cancer have it as well. This does not mean you'll necessarily develop the cancer but it can lead to genital warts and untreated warts can lead to lesions and cancer. The Pap smear also detects these abnormalities. With the Pap smear you can have a series of diagnoses and depending on those you will search or not further testing or treatment. A normal smear is detected in about 20% of women and it means that there is no pathological change in the cervix.

The diagnose of a normal smear can also be made because of certain factors of interference which allows the precancerous cells to remain undetected. This can happen if inflammation obscures the cancer or if the brush used to scrape missed the area of the cancer or the cells may have been washed off the slide for whatever reason.



This is how cervical cancer can still develop with a normal smear. There is little chance for it though and the best thing you can do is to take the test regularly and not miss any of them in 3 years and maybe even more.

Cervical cancer is a very widespread but easy to prevent form of cancer found in women. As with all cancers and early diagnosis can be vital. In recent year the death rate associated with this cancer has plummeted. This is mainly due to the increased awareness on the significance of regular screening through Pap tests. These tests can immediately detect precancerous lesions diagnosed as dysplasia which are 100% curable. Even if diagnosed as cancer, if it is in its early stages it can be easily managed with surgery. Radiation therapy and chemotherapy can be resorted to in later stages of development.
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The first step in ensuring an effective treatment is evaluating the extent of the disease and there are specialized pretherapeutic procedures for doing that. Early cervical cancer is asymptomatic and almost 20% of patients diagnosed with cancer have never had any warning signs.



Ultrasound scans are a method used to stage cervical cancer, as devices part of the biopsy procedure essential in accurately diagnosing the cancer. Staging the cancer is vital. The pretreatment evaluation of patients with cervical cancer includes chest x-rays, intravenous urography and physical examination but also cross sectional imaging (CT or MRI). Magnetic resonance imaging (MRI) has a much better soft-tissue contrast resolution than computed tomography(CT) or ultrasound procedures(US-ultrasonography). Though ultrasound is also useful, an MRI is more effective and accurate in assessing the size and extent of the tumor, but also the degree of invasiveness and the exact determination of the area affected by the cancerous formations.  Actually both MRI and CT scanning are superior to ultrasound in what concerns the detection of swollen lymph nodes. US is not the first choice for staging the full extent of the invasiveness of the cancer. This particular procedure does not accurately detect all the potential sites of metastasis and also does not depict the areas of the body which contain lymph nodes. So there are significantly more limitations to  ultrasound screening.

Another disadvantage is also the fact that US depends a whole deal on the operator. The quality of the image is worsened by a large body habitus and visualization of parts of the pelvis and abdomen can be interfered with by bowel gas and bony structures and other irrelevant factors. The transabdominal ultrasound is also a procedure to be considered but it can also be affected by the degree of bladder filling and surgical lesions present on the body. This procedure implies a high degree of inaccuracy risk and it is best used as a complimentary testing procedure.



There's also the option for a transvaginal ultrasound which is more frequently done but also implies certain limitations among which a small field of view. This also applies to the transrectal ultrasound. Not to mention that many patients present certain intolerance to the transvaginal or transrectal approach.

Studies conducted not to long time ago have concluded that for early stage cervical cancer treated by surgery, namely radical hysterectomy, the adenosquamous cell type does not imply a worse prognosis than any of the pure cell types. This being said we can look further into what separates adenosquamous carcinoma of the cervix from other forms of cancers of the uterus.
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Types of cancers bear different names depending on the cells the affect. Cancer affecting the glandular cells is called adenocarcinoma and can also develop squamous cells.  Non-cancerous squamous cells can also be called adenocanthomas cancer and the cancerous ones are called adenosquamous carcinoma. This last one, on which we will go into more detail, is significantly more invasive and aggressive. This has lead to a lower cure rate in the case of such cancers but progress has been reported in what concerns the treatment.



The difference between these types of cancer is important though they are treated the same. Symptoms are also almost the same. Only a biopsy or a histology report can accurately establish the cancer type.

Symptoms that can lead you into getting tested include vaginal bleeding and vaginal discharge occurring outside your period, watery discharge during a cycle or after menopause, discomfort and bloating and others, depending on each individual’s reaction. Consult your doctor for a full list and for confirmation that you should indeed seek further investigation. A simple physical examination will determine the risk of having developed the cancer. This can be done simply by checking for swelling in the abdomen. A transvaginal ultrasound can also be useful in indicating the possibility of cervical cancer. It this have worrying results, to accurately diagnose the cancer and to pave the way for a treatment plan you should get blood tests, a chest x-ray and a dilation and curettage procedure.

Exact causes are not really known but risk factors you should be aware of include menopause, infertility, obesity, high blood pressure, family history of breast or bowel cancer, diabetes, exposure to radiation and excessive amounts of estrogen in the body.



Treatment options derive from the exact diagnosis and from the individual condition of the patients. Surgery is the standard procedure. The removal of the uterus and even of the fallopian tubes and ovaries might be necessary. If the cancer has become more invasive removal of the lymph nodes in the abdomen, of the cervix and of a small portion of the upper vagina also represent a vital intervention. Complimentary therapy is also standard in this case. Adjuvant therapies like radiation and chemotherapy can be of great efficiency in completely killing the cancerous cells. Blocking estrogen production can also inhibit during treatment of adenosquamous cells.

Consult your oncologist to eliminate any confusion on the subject and though it is not essential for you to understand the differences between these cancers and the particularities of adenosquamous carcinoma, you should be aware of the significance such particularities as those derived from the cells affected have for a successful treatment.

Cervical cancer is the developments of cancerous cells in the cervix, namely the passage that connects the uterus to the vagina. In recent years survival rates have grown incredibly because of more and more women taking the Pap test regularly. This is vital because, though the progression of cervical cancer is slower than other forms of cancer, it has almost no symptoms in its early stages, while it is 100% curable.  Later stages are much more difficult to treat and offer a small chance for eliminating the cancer for good.
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However, the fact that it spreads relatively slow gives you the chance to discover it on time and it gives the doctor the chance to develop a suitable treatment plan to also prevent relapse. It usually takes more years for the cancer to develop but that is not 100% sure as there have been cases of cervical cancers metastasizing in 12 months.



The cancer begins in its stage 0 with precancerous lesions on the cervix which is left untreated can develop into cervical cancer. But even before that, what represents the biggest risk for developing the disease is infection with HPV, the Human Papiloma Virus as this virus can generate abnormal growth that can become malignant. But the virus does not mean you'll automatically get cervical cancer. Doctors think that the cancer is not likely to develop in the case of women who live a healthy life and don't smoke.

If you do develop the cancer, the precancerous condition also known as dysplasia can turn malignant and then the cancer begins its development to complete invasiveness. During the early stage you will most likely experience symptoms like vaginal bleeding, vaginal discharge, weakness and discomfort. Treat such signs with great seriousness.

The cancer then progresses slowly but every day has a big impact on your chances for survival. 90% of women survive for 5 years or more after diagnosis at an early stage of development while a later stage offers very few chances for survival. Only 20% of the patients diagnosed at a later stage live for the next 5 years.



From the point it becomes malignant the cancer goes through stages graded from I to IV B. In stages I to II, the cancer grows from being only visible through the microscope to growing larger than 4 cm and spreading outside the cervix.

In the next stages the cancer continues to spread to the upper region of the vagina, then to lower vagina, to the pelvic wall and the bladder, until it finally spreads to other organs, such as the lungs.

In conclusion, even if inside the body the progress of cervical cancer is relatively slow, on the surface it can seem much faster as from the first day you notice a symptom and go in for a consultation, you may not have so much time to fight the disease.

5-FU is also known as 5-fluorouacil and it is and a chemotherapy agent used in concurrent chemo treatments greatly improving survival rates for three years in cervical cancer. This has been proven and officially announced by The National Cancer Institute quite a while ago as a conclusion of a series of studies conducted over almost ten years. This clinical announcement concluded that even if by that time the best chemo regimen had not been established, significant improvement in results was obvious with the use of using cisplatin alone or cisplatin in combination with 5-FU or other agents.
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In these studies the women were separated into groups and were administered radiation therapy alone or radiotherapy combined with chemotherapy. All in all, the three year survival rate was considerably higher in women who received a combination of chemo and radiotherapy.

Measures have been taken to spread this news and ensure that patients now consider adding concurrent chemo to their treatment of invasive cervical cancer.



Up to the moment of studying the effects of 5-FU and other chemo drugs, the standard treatment for cervical cancer had been surgery and radiation therapy. Results of more studies changed this standard treatment and has proven to really increase the survival rate for cervical cancer.

No wonder the NCI conducted studies made the staggering discovery that chemo alongside radiotherapy reduces the death rate from 50% to 30%.

There's still room for more discoveries as the contribution of 5-FU to the results is not clear enough and its is not certain what chemo regimen is actually the most effective. It also depends on the individual case as people can respond differently to chemo. Even so cisplatin combined with 5-FU reached positive results and have definitely increased the chances of finding the best chemo regimen.

However, it's no surprise that there are some side-effects to undergoing chemotherapy. Effects like low number of blood cells, nausea and vomiting are to be expected and studies also concluded of the increased intensity of such effects in patients using chemo. These side-effects are however temporary and last just while the treatment lasts. There’s always the option to interrupt the chemo, take a break, regenerate some white blood cells and then resume the treatments and get the same results.



The severe side effects were mainly leukopenia (low number of white blood cells) and nausea and vomiting. These were more frequent and more severe in the women who had the combined therapy than in those who had radiation alone. In general, these adverse effects were temporary and manageable. For instance, women with leukopenia stopped chemotherapy until their blood counts rose and then were able to resume the treatments.

Ask your doctor about more recent studies and new uses of 5-FU to increase your chances for survival. Enroll in clinical trials and make sure you're always up to date with developments in the field of cervical cancer treatments. Survival rates increase with every day.

The Leep procedure is the first step patients take after their annual Pap smear indicates some abnormalities in the cervix's tissue. This precancerous condition is usually known as dysplasia and it is 100% curable.
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The loop electrosurgical procedure (LEEP) is in fact just one of the options there are to definitively diagnose cancer and pave the way for appropriate treatment or excise the lesions completely by itself. Other procedures available to replace it or to accompany it are the colposcopy and the cone biopsy.



The way in which LEEP works is by using a thin wire loop electrode and an electrosurgical generator. Electrical current is then used to take a sample of tissue as the abnormal cells heat rapidly and burst, separating the tissue as the wire makes its way through the cervix. The tissue sample is then taken to the laboratory for testing and this ensures that the lesion was completely removed and can make more observations about the affected area. Don't worry about going through with the procedure. The doctor can lead you all the way and make sure you consult him before taking any drugs or methods for relieving pain before the intervention.

A LEEP procedure is actually quite simple and uneventful really with little to no chances of complications occurring. It lasts only half an hour at most and it is usually performed in the oncologist's office and contrary to popular opinion it has nothing to do with the surgery room. The way you will experience it is like a routine pelvic exam as you'll be lying on the table with your feet high.

The procedure can seem a little complicated but if your doctor would explain it you would realize it's actually quite simple. After the lesion is removed your doctor will use a ball electrode to stop any bleeding that might occur and you can usually leave your physician's office soon after the procedure. Bleeding and mild discomfort are actually the only complications you risk experiencing. If bleeding persists it would be best to seek your doctor's attention. Though highly improbable, you might also experience certain vaginal discharges or vaginal odor which should also be immediately reported.



Indications for post-intervention periods include not having any sexual intercourse for as long as the doctor says, not lifting any heavy objects, not using tampons and not taking showers.

This would be all you really need to know if you are scheduled for such an intervention. You can easily see there's no reason to panic and whatever you feel like you should be well aware that diagnosing dysplasia does not mean you have cervical cancer but that you won't have it so you should actually be relieved, grateful and recommend the Pap smear to all your friends.

Cervical cancer is one of the types of cancer most easily prevented and through many effective governmental programs and public campaigns the Pap screening has turned into the hero that has scared away cervical cancer for women in US.
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Cervical cancer is also one of the types of cancer with which early diagnosis is vital. Regular Pap tests usually detect precancerous condition, precancerous cells, lesions also known as dysplasia which is 100% curable. Early diagnosis of cancer refers to more than these precancerous conditions and it does not offer the same chance of treatment. Early cervical cancer is cancer in stage 1A, 1B or 2A. These are stages established by the degree of invasiveness of the cancer and are precious indicators and tools for choosing the optimal treatment plan for a patient. At these first stages the cancer is limited and non-invasive.



Though it doesn't guarantee a 100% survival rate treatment in an early stage is very encouraging and it may be even possible to treat the cancer through cone biopsy(conization) which is mostly used for accurate diagnosis but can also remove the lesion completely by itself.

Surgery is the standard treatment for cancer in its early stages. This can range from simple and local to complex and affecting a larger area. Easier ones are laser surgery and LEEP procedure. Laser surgery consists in sending a beam of intense light to kill all cancerous and precancerous cells. The Loop electrosurgical excision procedure (LEEP) is an intervention through which a wire loop is introduced in the cervix and an electrical current passes through it and removes cells by cutting them from the mouth of the cervix. Cryosurgery is still a simple intervention which freezes the cells. Surgery for a more advanced form of cancer is called hysterectomy and it is done to remove the cancerous areas completely including the cervix and uterus.

An operation just for removing the cervix can be successful in completely eliminating the tumor. Treatment at this stage also offers a greater chance to keep your fertility. If the operation is done to remove the entire cervix and not just the infected part then it is called radical hysterectomy. The uterus being completely removed, the patient is not able to ever remain pregnant afterwards.



Alongside surgery another treatment recommended for early cervical cancer is radiation therapy. This can also be combined with surgery if the oncologists sees it necessary. Sometimes radiation therapy is very effective in shrinking the tumor before operation or in killing remaining cancerous cells after operation. For stages 1B and 2A the oncologist might also recommend chemotherapy combined with radiation therapy for a more aggressive treatment that ensures the cells don't form again and that the cancer relapses.

There's no scientific proof to verify that breast and cervical cancer are directly related, that is to say more related that other forms of cancer. It is of course possible that the cancerous cells spread or reoccur after treatment in another organ. For example there are reasons to suspect that if a patient had cervical cancer early on in her life and now has developed breast cancer they are related somehow, and that the tumor has maybe developed due to cancerous cells that might have spread and reached the breast. Your medical history is very important when you are tested and diagnosed with cancer. It's a well known fact that if you have a medical history that includes some type of cancer you are under a greater risk of experiencing a relapse or having the tumor develop in an entirely different area of your body.
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The two also share some common causes or risks factors typical to a woman's life such as the time you decide to have your first baby or such as having no babies, which increases risks of developing both forms of cancer. There are also common dietary reasons that make you more exposed to these forms of cancer. Consult your doctor to become more aware about to what risks your lifestyle exposes you, how to improve your lifestyle and life a safer life and also learn to take prevention methods more seriously and don't ever put off going to the doctor.



But the thing that brings them together the most is that they both represent a terrible risk in a woman's life and that they are almost exclusively reserved for women. They are both one of the main cancer killers in women but they are also easy to prevent through regular screenings. Which brings us to the second connection between the two types of cancer. They have been united to become a common enemy for many administrations in the US.

More and more public and legal campaigns are initiated to encourage and implement regular screening tests for all women, locally and nationally.

It's of no surprise that these two cancers have caught the attention of authorities and that there has been more and more investment done to raise awareness. Breast cancer is actually the most common form of cancer diagnosed among women in some states of the United States of America and cervical cancer is usually not too far behind. Implementing screening programs can change this and results have also not failed to appear.



The success of well planned health education programs and communication campaigns combined with low-cost screening methods is proven by the decrease of incidence of and mortality because of breast and cervical cancer. Such programs are even being implemented internationally with the help of many foundations.

Cervical cancer is becoming rarer as methods and organizations for preventing it gain popularity and raise public awareness more successfully with every day.
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Even so, cervical cancer still finds it way and kills almost 300.000 women worldwide. The most susceptible to developing it are women from poor countries with at least 80% of cancers related deaths occur in developing countries, and regions like South Asia, sub-Saharan Africa and parts of Latin America.

Though we are all comforted by the fact that there are so many ways to prevent the cancer or eliminate it early in its development, women from poorer countries even if they are fortunate enough to have such methods within reach, they're most likely not able to afford it.

This is one of the reasons organizations have been formed to facilitate the reach to the Pap test or the vaccine and to fund countries to supply this medicine and tests to the people. One such organization is the ACCP.




With the help of a grant from the Bill & Melinda Gates Foundation, between 1999 and 2004, five international organizations formed the Alliance for Cervical Cancer Prevention (ACCP). They all shared the goal of working to fight and prevent cervical cancer in developing countries.

The ACCP's activities and measures include assessing innovative approaches to screening and treatment improves lateral services such as the delivery systems, ensures that a realistic approach is taken in relation with the specific needs of the community helped and works hard to raise awareness of cervical cancer among the people in the community but also to those at home.

The Bill & Melinda Gates Foundation has also done more than just jump start the whole thing. All throughout the implementations of its programs the foundation has continues funding and encouraged research and demonstration projects in Ghana, India, Peru, South Africa and Thailand. Their activity goes on as you read this and they are always welcoming new volunteers.

Unfortunately progress is slow and many times volunteers can diagnose the disease but are helpless when it comes to treating it and most of the time, they diagnose it too late in its development to prescribe any treatment at all except one for alleviating pain and other symptoms. But even painkillers are sometimes missing. The best chance for these women is a regular screening. This is vital for the women and it can actually be done using relatively simple technology. If the slightest abnormality is discovered in the tissue it can easily be treated and the women will not develop cancer and will not even experience the smallest discomfort from the condition.



The organization's activity has been highly effective in raising funds and allowing more and more women access to Pap screenings and the cervical cancer vaccine. You can look for a way to contribute yourself and you can be sure you made a difference.