Vaccin col uterus
This article deals only with invasive forms of cancer of the cervix. For the form known as in situ cervical dysplasia see article
Cervical cancer is cancer that develops from the epithelium of the cervix. Cancer of the cervix is the second most common form of cancer among women worldwide after breast cancer. This cancer is directly related to sexual activity.
The detection of precancerous lesions is possible through the practice of Pap screening. The discovery of precancerous lesions including severe dysplasia or carcinoma in situ allows treatment to ensure healing of the patient with a very low recidivism rates.
Monitoring
At the end of treatment, the effectiveness of the latter is assessed by clinical examination accompanied by intravenous urography. Surveillance is conducted every six months to a gynecological clinic and complete with every year, carrying a kidney ultrasound and a pap smear.
Between the outer cervix (ectocervix) and the inner part (endocervix) is a junction area that is fragile area where the malignancy begins in general.
The epithelium consists of a surface layer and a deep layer. These two layers are separated by a training histological called basal lamina. When the basal lamina is not affected, only epithelial cells are surface modified and it is a squamous intraepithelial carcinoma or pre-invasive cancer or Stage 0 or carcinoma in situ.
Recently, two vaccines prevent infection by HPV, cause cancer of the cervix: Gardasil ® and Cervarix ®. On March 9, 2007, the Higher Council of Public Hygiene of France (CSHPF) and the Committee on Immunization Practices (CTV) recommend the vaccination of young girls of 14 years against human papillomavirus. The same opinion recommends also offer vaccination to girls and young women 15 to 23 years who have not had sex or at the latest, within one year after the start of their sex life.The system covers 65% each dose of Gardasil ® in which the price is € 135.59 including VAT. The vaccination requires three doses. Demand for repayment of Cervarix ® is currently being investigated.
The non-invasive carcinoma in situ is completely silent: there are no symptoms. It is a discovery of systematic cervical made under the annual gynecological checkup or during the medical surveillance of inflammation or cervical dysplasia (polyp, ulcer etc. …)
When cancer is talked about, the patient usually consults for blood loss (bleeding) often caused (sex, personal hygiene etc.).. Of leucorrhoea (white discharge) are sometimes associated painless.
The Pap smear is a simple. It involves removing cells from the cervix by scraping a simple painless, and spread the levy on a slide. After fixation, the slides are examined under a microscope by a doctor who specializes in this reading, the pathologist.
He describes in his report that he saw the cells and can classify the smear in classes I to V, but it is not absolutely necessary, the description of the cells enough to decide what is normal what is suspicious or frankly pathological.
It is recommended to perform two smears a year apart all women who have sex, and that from the age of 25. It seems appropriate then to control a normal smear every three years until about age 65. This frequency can be increased if the doctor deems necessary.
In cases of dysplasia, it is classified (Bethesda) according to its importance in CIN (cervical intraepithelial neoplasia) I, II or III. The presence of koilocytes sign papillomavirus infection and is the equivalent of CIN I. If closely monitored, every two or three months may be sufficient to CIN I, cervical biopsy under colposcopic control needed before a CIN II or III.
The minutes of the Pap smear will describe the observed epithelial cells, hormonal status, the presence of inflammation, dystrophic or metaplastic lesions, signs of viral infection with human papillomavirus (HPV) or neoplasia.
The Pap smear is an important consideration, because it is simple, painless and can detect lesions at their early stages, at a stage where treatment is extremely effective.
The extension is mainly loco-regional lymphatic system. The extension of the tumor is locally to the vagina, bladder, rectum, ureters. The lymph node is to the pelvic wall. Metastases are always late (liver, lungs)
This balance is very important since treatment and prognosis depend on it. Touching the pelvic (vaginal and rectal) are supplemented by additional tests:
It uses radiation therapy (brachytherapy uterovaginal and cobalt) and surgery. Chemotherapy is used in some cases.
Uterovaginal brachytherapy consists of placing a radioactive source in the uterus and vagina in direct contact with the tumor. The principle of a homogeneous high dose in a small volume, is the basis of effectiveness and good tolerance of brachytherapy. The applicator is placed under general anesthesia. Once in place, it is loaded into a second time with a projector sources. Dosimetry is performed by computer.
At the stage of carcinoma in situ, the response may be limited in young women desiring more children to a simple cone biopsy or cervical amputation under cover of a carefully monitored. Among older women, the uterus removed (total hysterectomy way) is performed.
Forum Health Forum Psychology Forum Nutrition
VACCINATION AGAINST CANCER CERVICAL EXPLANATIONS AND DIRECTIONS EMPLOIL’apparition of cancer following a viral or bacterial infection is not new.And cancer of the stomach is largely related to a microorganism called helicobacter pylori that has been in recent years become accustomed happy to find and destroy. Similarly many liver cancers are linked to viruses, mainly that of hepatitis B, that’s why a vaccine has been developed to eradicate this virus. For cancer of the cervix, a family of viruses has been demonstrated, the family of HPV. We used to look for abnormalities (dysplasia) associated with its presence during the reading of ‘Pap’ and watch even sometimes surgical treat persistent or severe forms (conization of the cervix). The main risk of dysplasia is the progression to cervical cancer, the idea of vaccinating against this virus family has its way. The vaccine exists, the results seem promising. Tune-ups are needed to understand the limitations of information and reservations .. The indications vacciner.Le vaccine can be done from the age of 9 years.Preferably, it will be done between 14 and 23 in young women without a priori by yet had sex. There will be a first intramuscular injection followed by two reminders, the first after two months, the second after six months. This vaccination does not exempt a gynecological and frottis.En case of occurrence of pregnancy in post vaccination, no adverse effects were found on the indications and fœtus.Explications réserves.La immunization will preferably be between 16 and 23 years for many reasons: The evaluation of the effectiveness of vaccination was done on people in this age group. We do not know the effectiveness beyond. This age was chosen because the diseases HPV are sexually transmitted diseases. These viruses also provide cervical cancer, genital warts or ‘warts’. And papillomas.Vaccination is not beneficial in people already infected, hence the importance of vaccination before the risk of contamination and thus before the first sexual studies are underway to assess the contribution of this vaccine at ages ‘later.’ Vaccination will not prevent all cervical cancers. He does not vaccinate all HPV (there are over 100), but the major papillomavirus responsible for cervical dysplasia. For them the efficiency is maximized with 98% of HPV are avoided. The occurrence of warts and papillomas are seen as small. Virus selected for vaccine development are responsible for approximately 70% of cancers col.Cette notion of imperfect coverage requires thus a search for gynecological dysplasia allegedly could generate other papillomavirus.Les réserves.Le decline that was on people vaccinated is insufficient to evoke a long-term protection. Currently there is some good protection for at least 5 years.The vaccine significantly reduces cervical dysplasia.We do not have enough experience to say that reducing the number of dysplasias will result in a reduction of cervical cancer, although this seems to fall under the senses. Cervical cancers affecting primarily women ages later, not yet included in the group of persons already vaccinated, it will have to wait another few years to get statistical evidence. In total, then: Vaccination certainly useful does not in any way or a gynecological or use a condom when having risky sex infectieuxUn site that talks about: www.passezlinfo.fr
Treatments
The treatment of cancer is the most frequently experienced and specialized institutions. There is no single treatment but multiple treatment options. Finally, the rapid evolution of medical knowledge requires the use of doctors receiving appropriate medical training.
Chemotherapy
Depending on the stage of cancer, chemotherapy may be used in combination with radiotherapy.She is also the only means of therapy on the occurrence of metastases.
Laser
In cases of high grade lesion but even if it does not touch the endocervix and is totally visible on colposcopy, laser treatment can be proposed that will destroy the lesion.
Directions
Overall only small cancers can be treated only surgically. For larger cancers, some countries use a treatment with radiotherapy alone, others a combination of surgery and radiotherapy
Extension
Before any treatment, it is necessary to determine the volume of cancer. Indeed, the prognosis is directly related to the volume. In terms of volume, some treatments are unnecessary because they do not survive more prolongée.L ‘magnetic resonance imaging during the study of the urinary tract, can clearly see the lymph nodes, but if they are small size, it does not discriminate between good and normal lymph nodes.Positron emission tomography, computed tomography (CT) seems to be a promising technique in these cases.
Classification of the International Federation of Gynaecologists and Obstetricians
Clinic
Functional signs
The main sign is bleeding from the genital tract, caused most often during intercourse, and this, apart from menstruation. But any abnormal bleeding, whatever its characteristics, can be cancer.
Clinical examination
In advanced stages, examination speculum, one sees a budding or ulcerative lesion or the neck of the uterus or sometimes even ulcerative budding. The vaginal examination will assess the spread of cancer beyond the cervix: vagina, lateral wall of the cervix, cul-de-sac, lateral vagina is palpated through which the parameters that can be invaded, bladder and rectum (the rectal examination).
The biopsy of the lesion is the key examination confirms the diagnosis and invasiveness of cancer, its histological type and grade of differentiation.
VACCINE AGAINST CERVICAL CANCER DE L ‘UTERUS
Invasive cancer of the cervix and neoplasia
(Malignant) cervical intraepithelial are associated with certain types of HPV (16 and 18 in particular).
But be aware that very few women infected with these viruses develop the disease.
The fact remains that infection increases the risk of a non-negligible compared to women who do not have HPV infection
So the discovery of these viruses must exercise a strict surveillance to detect any precancerous lesion.
By mid-February 2004 the HPV test will be reimbursed by Social Security, if the smear is equivocal and undetermined significance.
A positive HPV test does not mean the inevitable development of cervical cancer, but it can better monitor patients at risk.
Remembering that many risk factors associated with the presence of HPV can allow the outbreak of the disease.
As co-factors include: herpes, chlamydia, AIDS, smoking, hormones, nutritional factors, and immunological.
The detection of DNA (qv) of a papillomavirus is an additional tool that is useful in cases where laCYTOLOGIE and colposcopy (see these terms) are very explicit, as in some glandular atypia. atypia or low grade. (See CANCER CERVICAL).
In these cases the discovery of a papillomavirus allow the implementation of more aggressive treatment.
In October 2005 the results of an experiment are published.
They are presented by Professor Laura Koutsky of San Francisco.
THIS IS THE FIRST TIME A PREVENTIVE VACCINE AGAINST CANCER IS ACTIVE /
A tetravalent vaccine (GARDASIL, SANOFI-PASTEUR LABORATORIES-MSD) against HPV 6,11,16 and 18 reduced persistent HPV infection by 90%.
But the important thing is not to judge the effectiveness in terms of virological protection but to evaluate the incidence of cancerous lesions cervical intraepithelial neoplasia (CIN) grade 2 and 3.
The study involved 12,167 women aged 16 to 26 years.
Half of them received three doses of vaccine on day 0 followed by two months and finally at six month intervals.
The other a placebo.
Vaccine protection appears complete.
None of the vaccinated women showed any precancerous or cancerous cervical lesions associated with HPV 16 and 18, after a mean follow up of 17 months, whereas such lesions were diagnosed in 21 placebo patients.
Another vaccination trial in a population infected or not by a human papillomavirus type 16 or 18 seems very conclusive because the risk of CIN 2 or 3 was decreased by 97%.
Only one case was recorded in the vaccinated group against 36 in the placebo group.
The effectiveness of the vaccine seems demonstrated.
You should know that HPV 16 and 18 are responsible for 70% of cases of cervical cancers.
It would be possible to vaccinate young girls before their first sexual intercourse, ie prior to potential exposure to HPV.
We do not yet know the duration of vaccine protection.
It will identify strategies reminders especially for women a little older.
The placing on the market GADASIL (WMA) is granted in France since the end of November 2006
This vaccine can be now found in pharmacy
It is recommended for girls before their sexual debut.
Its cost is high and it is not reimbursed by Social Security.
Show: PAPILLOMAVIRUS
PAPILLOMAVIRUS AND POTENTIAL CANCER
PAPILLOMAVIRUS TYPES
CERVICAL CANCER marital fidelity