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Condylomata acuminata

Condylomata acuminata A type of wart that commonly occurs in the genital area. Found throughout the world, the condition is readily spread by sexual contact. The warts are also known as acuminate warts or veneral warts. Cause This type of wart is caused by infection with human papillomavirus (hpv). Giant condylomata acuminata can invade local tissue, which may rarely develop into a form of skin cancer. Treatment There is no known treatment that will eradicate human papillomavirus from the skin, and the virus has survived even laser treatment recurrence, therefore, is common. Treatment is aimed at removing

Nature Of This Cancer Type

The most important risk factors for laryngeal cancer are tobacco-smoking (all forms) (IARC 2004) and heavy consumption of alcohol, especially when drinking and smoking occur in combination (IARC 1988). Cancer of the larynx is rare in lifelong nonsmokers, even though nonsmoking drinkers have been reported to have increased risk (Burch et al. 1981, Elwood et al. 1984). Risk increases with the number of cigarettes smoked per day and duration of smoking. The independent effect of tobacco on laryngeal cancer is greater than that of alcohol consumption. The effects of occupation on the risk of laryngeal cancer have been difficult to study, because of the powerful relationship of this cancer with tobacco use and alcohol consumption, and the little information on alcohol consumption and tobacco use in many occupational studies. Exposure to strong sulfuric acid mist is an established cause of laryngeal cancer (IARC 1987). Other factors that may increase risk, but on which current data are...

Anticarcinogenic Effects Of Ginger

The most common model used to study the effectiveness of ginger as an antitumor agent in vivo seems to be the two-stage initiation-promotion mouse skin model. In this paradigm, tumors are initiated by one application of 7,12-dimethylbenz a anthracene (DMBA) followed by repeated topical applications of TPA beginning a few days later. Ginger and its constituents have been shown to inhibit tumor promotion in mouse skin (33). Another study indicated that topical application of (6)-gingerol onto the shaven backs of female ICR mice reduced the incidence of DMBA-initiated TPA-promoted skin papilloma formation and also suppressed TPA-induced epidermal ornithine decarboxylase activity and inflammation (34). In a similar more recent study, Chung et al. (35) reported that in the DMBA TPA skin tumor model, topical application of 6 -paradol and 6 -dehydroparadol prior to the application of TPA significantly reduced both the number of tumors per mouse and the fraction of mice with tumors (35). They...

Prentif Cervical Cap

Figure Cervical Cap

Like the diaphragm, a cap requires a physical examination, including a Pap smear, and a fitting session. The standard fitting procedure also includes a follow-up Pap smear after the cap has been used for 3 months. A cervical cap usually needs to be replaced every 12 to 18 months. In a study of cervical cap use sponsored by the National Institutes of Health, 4 percent of the women who entered the study with normal Pap tests developed cervical tissue abnormalities during their first 3 months of using the cap. Researchers theorize that the layer of cells that lines the cervix may become more vulnerable to the human papilloma virus when a cervical cap is used regularly. Several of the many strains of human papilloma virus are associated with, or cause, cancer of the cervix. For this reason, the FDA has recommended that a Pap test be performed before a cap is fitted and again after three months of use. If either test shows any abnormal cells, another form of contraception should be...

Drugs Used to Treat Infectious Diseases

Interferon-alpha is approved for use in some patients with hairy cell leukemia, Kaposi's sarcoma, or condylomata acuminata. Studies have shown that interferon-alpha2 nasal spray can prevent upper respiratory infections caused by rhinoviruses. Interferon is also effective against shingles in patients with impaired immune systems. podofilox (Trade name Condylox) An antimitotic drug synthesized from plants used to treat external genital warts (condyloma acuminatum). It is not used to treat perianal or mucous membrane warts. Correct diagnosis of the lesions is essential.

How to examine a womans vagina and womb

Midwives Examine

Test the cervix for signs of cancer by using either the vinegar or Pap test (see page 379). The Pap test The Pap test can give you much more information than the vinegar test. The Pap test can tell you whether a problem on the cervix is an infection or cancer. It may tell you what type of infection a woman has, or how severe a cancer is. But the Pap test is expensive, and you need a laboratory to know the results You can do these tests for a woman at almost any time, including when she has her monthly bleeding or during pregnancy. During a woman's monthly bleeding is not the best time to do the Pap test, because the blood can make the test less clear But it is better to do the test during a woman's monthly bleeding than not to do the test at all . If the woman is having her monthly bleeding, use a long swab to gently wipe the blood away from her cervix before you do the test Many people are infected with a sexually transmitted virus called human papilloma virus (HPV). Women get HPV...

Shaken baby syndrome 451

STDs include gonorrhea, syphilis, chancroid, scabies, herpes, genital warts, pubic lice, trichomoniasis, genital candidiasis, hepatitis B, nonspecific Health problems caused by STDs tend to be more severe and more common among girls and women, partly because girls may not have symptoms and thus do not seek care until serious problems occur. Some STDs can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease, which in turn is a major cause of infertility and tubal pregnancy. STDs in girls and woman also may be eventually associated with cervical cancer. For example, human papillomavirus infection causes genital warts and cervical cancer.

Skin lesions disorders and diseases

Papilloma (moles) these are small growths on the skin that vary in size and colour. They may be pale to dark brown and may lie flat to the surface or be raised above the surface attached by a short stalk. There is a danger of trapping these with the fingers when massaging. Massage around the area, avoiding the mole.

Evidence for the association between Mfvmfrvs and prostate cancer 41 The Interferon IFN pathway

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Tial report by Monini et al. 149 was followed by an interesting paper by Das et al., since they found BKV DNA positivity more frequently in malignant tissue 150 . However, also these studies were not confirmed 151 152 . v. Human Papilloma Viruses (HPVs) Extensive work has focused on these viruses throughout the years. Their relevance was also surmised from studies on women cervical uterine cancer -pioneered by Harald zur Hausen (Nobel Prize for Medicine in 2008)- where HPVs are clearly involved in 90 of cases 153 . However i) even Zur Hausen in reviewing this subject in his Nobel lecture dismisses the role of HPVs in PCa in this sense, men would be some kind of healthy carriers of the viral carcinogen 154 ii) Several studies have been published, some of which with positive results (for example, in an Argentinean study, 42 PCa were positive versus 0 BPH samples) 155 . However, in 24 studies from other Countries, there is no evidence of different HPV involvement between cancer specimens...

First Steps Ive Been Diagnosed with Cervical Cancer

Women often have one of two reactions to being told they have cervical cancer. If they have been having Pap smears, they may feel confused But I had a normal Pap smear last time How did this happen And if they haven't had a Pap smear in a while, they may feel guilty I should have seen the doctor sooner. Either way, the diagnosis can be devastating. Cervical cancer may be difficult for women to discuss because it involves the cervix (the opening of the womb), which is not a part of the body women usually talk about. Also cervical cancer is caused by a sexually transmitted virus, and women might feel embarrassed. Let's deal with these issues first. Cervical cancer and the precancerous entity dysplasia are caused by a virus called human papillomavirus (called HPV for short). There are many different types of HPV, some of which cause warts and some of which can cause cervical dysplasia and cancer. HPV is sexually transmitted, and may be likened to a sexually transmitted common cold. Of...

Managing Risk What if My Cancer Comes Back

A pelvic examination and a Pap smear are usually sufficient to check for recurrences. Imaging studies (such as CAT scans) may be performed, but their usefulness is unclear. The average age of women with cancer of the cervix is around 50 years. However, one in five women with cervical cancer is at least 75 years of age. Although the wide use of the Pap smear has dramatically decreased the frequency of cervical cancer in developed countries such as the United States, the older population remains at risk.

The risk factors paradigm

It is estimated that approximately 15 of all cancers can be attributed to viral infections. The oncogenic role of at least six viruses has strongly been established, including Epstein-Barr virus (EBV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), several Human Papillomavirus (HPV) types, Human T-cell Lymphotropic Virus type I (HTLV-I) and Human Immunodeficiency Virus type I (HIV-I) (Boccardo & Villa, 2011). Cells infected by these viruses may turn towards oncogenesis after many years of infection latency, The great opportunity for cancer prevention, at the global scale, lies in the development and distribution of antiviral vaccines (Schiller & Lowy, 2010). Commercially available HBV and HPV vaccines are already in use, and the major focus is now on their delivery, especially to low-income countries (Dempsey, 2010 El-Serag, 2011). The reasoning is based on the fact showing that HBV infection accounts for about 60 of the total liver cancer in developing countries, while for only...

How is a diagnosis of MS made

In between the start and end of the day, I drove to the university to pick up my students' exams for grading and then to the doctor for him to examine my ears and give me my annual pap test. My father took me to the neurologist, who said I had either a large brain tumor or MS and scheduled an MRI for that day as well as a spinal tap for the next day. The MRI center was having a holiday party, and while we waited for the results to take back to the neurologist, the office administrator offered us Santa party hats and snacks to keep us distracted. My husband who was in New Jersey, kept saying, I thought you were having a pap test and had a problem with your ears. What are you doing at the neurologist ' We were all a bit in shock as the surreal nature of the day continued. With MRI results and party favors in hand, we went back to the neurologist who had waited after hours for our return. He looked at the MRI and said, You have MS.'

Will I get cancer from having Barretts esophagus

Doctors routinely screen for cancer, prostate checks, breast exams and pap smears, and colon cancer screening. For a patient with Barrett's esophagus, cancer diagnoses in 2004, only 14,000 cases were esophageal cancer, and half of those were associated with Barrett's esophagus. Or consider it this way of all the cancers in the United States in 2004, half of 1 (1 in 200 cancers) were associated with Barrett's. When I give patients the diagnosis of Barrett's esophagus, I tell them to relax. Even with Barrett's, the risk of getting other cancers completely unrelated to the esophagus is much higher than is the risk of getting a cancer associated with Barrett's. Doctors routinely screen for cancer, including prostate checks for men, mammograms, breast exams and pap smears for women, and colon cancer screening for those age 50 and older. For a patient with Barrett's esophagus, periodic endoscopy and biopsies are added to the cancer screening routine, and the condition really is just another...

Physiological Functions of atRA

Incidence of spontaneous and carcinogen-induced cancer. Chemopreventive trials in humans show some promise for retinoids in actinic keratoses, oral premalignant lesions, laryngeal leukoplakia, and cervical dysplasia. The US Food and Drug Administration has approved retinoids for acute promyelocytic leukemia and for non-life-threatening diseases, such as cystic acne and psoriasis. Retinoids also provide the active ingredients in agents to treat sun age-damaged skin.

Learning more about your disease before the first visit

Less radical treatment of these diseases. One important development is that we can obtain the same cure rates with fewer side effects. In most cases, long-term cure can be achieved with little impact in long-term quality of life. In fact in most cases of cervical dysplasia and some cases of early stage cervical cancer, treatment can be obtained while still maintaining your ability to become pregnant and deliver a baby. These issues will be discussed in more detail in subsequent chapters. The term stage is a fancy way of saying how advanced your cancer is. If you have cervical dysplasia, this precan-cerous process is usually not staged, though in some cases as explained below, it may be called stage 0. If you have a cervical cancer, the recommended treatment depends a lot on what stage your cancer is, so let's jump-start your knowledge base before your doctor's visit.

Animal Studies On Pufas And Cancer Metastasis

In an animal model of the benz-a-pyrene (BP)-induced skin papilloma, it has been shown that mice fed on 10 corn oil had the longest latency period and among the lowest incidence of skin papillomas when compared to those receiving a lower percentages of this dietary oil (105,106). The study suggests that tumour promoting activity of dietary linoleic acid may have target tissue specificity . However, the animal studies are made complicated by the fact that in EFA deficient animals, there were less lung colonisation from melanoma than normal controls (107)

Deficiency Signs And Symptoms

Epidemiological studies have also found an association between low serum carotenoid levels, including lutein and zeaxanthin levels, with all-cause mortality (De Waart et al 2001), the risk of inflammatory polyarthritis (Pattison et al 2005), breast cancer (Tamimi et al 2005), prostate cancer (Jian et al 2005), colon cancer (Nkondjock & Ghadirian 2004), cervical cancer (Garcia-Closas et al 2005, Kim et al 2004), human papilloma virus persistence (Garcia-Closas et al 2005), type 2 diabetes and impaired glucose metabolism (Coyne et al 2005), chronic cholestatic liver diseases (Floreani et al 2000), Alzheimer's disease and vascular dementia (Polidori et al 2004), and low fruit and vegetable consumption (Al-Delaimy et al 2005).

Chemopreventative Role

Cervical cancer The potential role of folate in the prevention of cervical cancer has been equivocal and results from intervention studies on cervical cancer have been inconsistent (Henao et al 2005, Kwanbunjan et al 2005, Sedjo et al 2003). Many of these studies have methodological limitations, including a lack of information on high-risk human papillomavirus (HR-HPV) infection, a risk factor for cervical cancer. This is notable as folate deficiency may increase the risk of cervical cancer in individuals infected with HR-HPV (Piyathilake et al 2004). The most promising RCT involved 47 patients taking an OCP who demonstrated mild to moderate intraepithelial dysplasia. A dose of 10 mg folic acid daily over 3 months resulted in significantly lower biopsy scores in the treatment group and a significant reduction in cytology scores from baseline (Butterworth et al 1982). Other studies have shown that folic acid treatment does not alter the course of disease in patients with...

June Halper Mscn Anp Faan

General healthcare should include regular general checkups by your primary care physician, with assessments appropriate for your age and current symptoms and concerns. Assessment of current symptoms and problems, blood pressure assessment, Pap smears, prostate examination, and tests and examinations appropriate for the person's age are indicated. Table 12.1 summarizes the National Multiple Sclerosis Society's preventive care recommendations for adults with MS.

Ovarian and Urogenital Hormones

Female sex hormones have also been shown to exhibit effects on microbial cells, which may play a role during infection (reviewed by Sonnex 1998). Clinical anecdotes first led to the recognition that certain sexually transmitted diseases, such as Gonorrhea and Chlamydia, were more likely to occur in females at the time of menstruation (Sweet et al. 1986). While part of the reason may be related to hormonal influences on the host immune response, there is also evidence to support effects of female sex hormones on the bacteria themselves. Of note, Neisseria gon-orrhoeae shows adherence to vaginal epithelial cells, which varies depending upon the stage of the menstrual cycle (Sobel et al. 1981). In addition, a protein that contains estrogen-binding sites has been identified in Trichomonas vaginalis, along with evidence that estrogen may affect the organisms' motility and adherence to cells (Ford et al. 1987 Sugarman and Mummaw 1988 1990). Estrogen also has direct effects on the growth of...

Water contaminated 297

With a positive Pap test should seek medical help regularly to monitor the changes. Anyone who has genital warts or who has been diagnosed in the past should always use a condom during sexual intercourse. At present, there is no way to prevent the disease. Physicians at the University of Rochester Medical Center are beginning the world's first test in humans of a potential vaccine to protect against the virus.

Chemopreventive Potential of SM

More recently, Chen et al. (140) showed that a synthesized simplified phenolic analog of tanshinone, S-3-1, also exhibited potential activity in preventing the development of cancer. With the Ames test, S-3-1 was found to efficiently suppress the mutagenicity of benzo a pyrene. This result is consistent with the inhibitory effect of S-3-1 on the activation of benzo a pyrene by hepatic microsomal enzymes. Besides the anti-initiation effects, S-3-1 could significantly inhibit the croton-oil-induced increase of mouse skin epithermal ornithine decarboxylase activity. Moreover, S-3-1 quenched both superoxide and hydroxyl free radicals whereas it inhibited LPO in the in vitro model. These results suggest that S-3-1 might act as anti-initiation and antipromotion agents through reversing the biochemical alterations induced by carcinogen during carcinogenesis. It was also shown that S-3-1 ihibited the ben-zo a pyrene-induced transformation of V79 Chinese hamster lung fibroblasts. At 10-40 mg...

Classic Methods For Suicide Gene Transfer

Other viruses, including the human papilloma virus, vaccinia virus, avipox virus, and baclovirus, are under investigation for gene therapy application. The improvements and continued refinements of presently available viral vectors as well as the development of new vectors should greatly expand the efficacy and applicability of suicide gene therapy.

Screening of cervical cancer

Cervical cytology based on Pap smears remains the cornerstone of cervical cancer prevention programs, although this filed has rapidly been developing due to improved understanding of the natural history of the disease and technology innovations, such as liquid-based cytology, automated interpretation of Pap smears and testing for human papillomaviruses (HPVs) (American Cancer Society Guidelines, 2011 ESMO European guidelines for quality assurance, 2010). This, on the one hand, points up the neccessity for establishing the uniform indicators for monitoring program performance, to enable data comparison across the countries, and on the other hand - leads to fast exchanges of practice guidelines (Table 4) (ESMO European guidelines for quality assurance, 2010). It is now well known that a persistent infection with sexually transmittable human papillomaviruses is responsible for virtually all cases of cervical cancer (Haie-Meder, 2010). Early age at first sexual intercourse and early...

Sexually Transmitted Diseases

There are many types of STDs which can affect youth and over half of STDs occur to adolescents (1,3,29-31). The majority of STDs involve individuals aged 15 to 29 years. Each year, 1 in 20 adolescents in the world obtains a curable STD (3). STDs can be asymptomatic and youth often do not seek treatment even if symptomatic. Adolescents are less likely than adults to use protection (i.e., condoms). The most common STDs among youth are infections due to human papillomavirus (HPV), herpes simplex virus, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. HPV is main cause of cervical cancer in females under 30 years of age and the recently developed HPV vaccine can prevent 70 of these cervical cancers.

Making the transfer

Embryo transfer is a rather simple procedure that takes only a few minutes and is about as painful as a PAP smear. Some clinics have a TV screen mounted in the transfer room so that you and your partner can glimpse the embryo as it's about to be transferred. Seeing the very first stages of human pX- ST( f. development is pretty exciting you'll find the image stays with you.


In June 2006 the Advisory Committee on Immunization Practices (ACIP) voted to recommend Gardasil, the first vaccine developed to prevent cervical cancer (and other diseases) caused by some types of human papillomavirus. It is recommended for eleven- to twelve-year-old girls and can be given to girls as young as nine. The vaccine is recommended for young girls because ideally it should be administered before one becomes sexually active. The vaccine is given in a series of three shots over a six-month period. Studies have shown that the vaccine provides protection for at least five years, and further studies are being done to see if a booster vaccine is needed later on.


Although neoplasms are not a cause of acute or chronic pharyngitis, tumors arising in the oropharynx often present with signs and symptoms that most commonly indicate an infectious etiology. Patients treated for infectious pharyngitis, who do not improve, warrant further investigation to identify a possible neoplasm. Common presenting symptoms of oropharyngeal cancer include unilateral sore throat, dysphagia, odynophagia, weight loss, and otalgia. On physical exam, an asymmetric pharyngeal mass is the hallmark clinical finding and warrants further investigation (Fig. 4). The mass may be ulcerative, fungating, or mucosal covered and detectable only by palpation. Cervical adenopathy is present with advanced disease that has metastasized to the locoregional lymph nodes. Risk factors for oropharyngeal cancer include tobacco and alcohol abuse. The human papilloma virus has a role in a subset of oropharyngeal tumors.

The Male Condom

Use The Comdam

The male condom is a soft, flexible cover that fits over the penis. It may be made of latex, polyurethane, Tactylon, or treated animal tissue that is thin, strong, and flexible. (The female condom is described in Chapter 3.) Because a condom prevents semen from entering the vagina, it is a very effective barrier to pregnancy. Except for those made of animal skin, condoms also act as a barrier to viruses and bacteria, protecting both partners from sexually transmitted diseases such as syphilis, chlamydia, gonorrhea, genital warts, genital herpes, candidiasis, trichomoniasis, and AIDS. Some of these diseases may make you very sick and some can make you infertile.

Indications Saffron

Dermatosis (f CRC KAB) Diabetes (f CRC) Diarrhea (f NAD) Dysmenorrhea (f DAA HHB MAD PNC) Dyspepsia (f1 VAD) Edema (f1 APA) Enterosis (f JLh) Epistaxis (f MAD) Fear (f CRC DAA) Fever (f CRC NAD PH2) Fibroid (f JLH) Fibrosarcoma (1 HH3) Fractures (f KAB) Gas (f1 MAD VAD) Gastrosis (f JLH) Gingivosis (f1 VAD) Gout (f MAD) Hangover (f LIL) Headache (f KAB PH2) Hemicrania (f KAB) Hemoptysis (f DAA MAD) Hemorrhoid (f NAD) Hepatosis (f1 CRC DEP JLH SKJ X12776492) High Blood Pressure (1 APA X12648816) High Cholesterol (1 APA) Hysteria (f BOU CRC DAA MAD) Induration (f JLH) Infection (f1 HJP) Inflammation (f1 JLH X11914135) Lachrymosis (f JLH) Laryngosis (f JLH) Leukemia (f1 JLH X12776492) Lochiostasis (f PH2) Lymphoma (1 APA JLH HH3) Measles (f CRC DAA MAD) Melancholy (f12 CRC DEP HHB KAB X15852492) Menorrhagia (f HHB HOS PH2) Menox-enia (f CRC) Nausea (f KAB) Nephrosis (f JLH KAB) Neuralgia (f NAD) Neurosis (1 CRC FNF) Obesity (f1 VAD PR14 149) Ophthalmia (f JLH HOS) Orchosis (f JLH)...

Dna Vaccines

Schematic The Constructed Promoter

Following these initial reports, DNA vaccination and the generation of antibody and T lymphocyte responses, as well as protective responses in a variety of animal models, have been reported in the scientific literature for many human pathogens such as hepatitis B virus, rabies virus, herpes simplex virus, hepatitis C virus, human T cell leukemia virus, human papilloma virus, and tuberculosis (8-10).


Stage 0 disease or carcinoma in situ is a noninvasive disease. A cold knife cone or a LEEP is usually all that is necessary. These surgeries not only confirm the diagnosis but are also considered sufficient treatment. Occasionally, especially in a woman who has had multiple cold knife cones and or LEEPs, a hysterectomy is recommended because a cold knife cone can not be performed safely. As with cervical cancer, there is always a chance that even if all the disease is removed it can come back, and you will need to continue to get PAP smears after your surgery.


162. ter Harmsel B, ran Belkum A, Quint W, Pron KA, Kuijpers J, Ramaekers F, Tandon A, Smedts F (1995) p53 and human papilloma virus type 16 in cervical intraepithelial newplasia. IntJ Gynec Path, 14,125-133 186. Bosch, FX, Mano, MM, Munox N, Sherman M (1995). Prevalence of human papilloma virus in cervical cancer a worldwide perspective. Journal of the National Cancer Institute 87 796-802. 189. Feltkamp MCW, Smits HL, Vierboom MPM, Minnaar, RP, de Jongh BM, Drijfhout JW, ter-Schegget J, Melief CJM & Kast WM (1993) Vaccination with cytotoxic T lymphocyte epitope containing peptide against a tumor induced by human Papillomavirus type 16-transformed cells. Eur .J. Immunol. 22, 22422249. 193. Nimako MA, Fiander AN, Wilkinson GW, Borysiewicz LK (1997) Human papillomavirus-specific cytotoxic T lymphocytes in patients with cervical i ntraepthelial neoplasia grade 3. Cancer Research 57(21) 4855-61. 194. Evans E M, Man S, Evans AS, Borysiewicz LK. (1997) Infiltration of cervical cancer tissue...


Every teen and young adult who has survived cancer should be counseled about safe sexual practices. Despite the prevalence of sexual messages in our culture, most teens are woefully underinformed about the facts. Many survivors think, erroneously, that if they are infertile, they do not have to be concerned about the use of condoms or other birth control. However, all sorts of diseases, some potentially fatal (hepatitis C, HIV ARC AIDS) and some not (genital herpes, genital warts, gonorrhea), can be transmitted through sexual intercourse.

Parasomnia 383

Applying spermicides with nonoxynol-9 to affected or treated areas may be helpful in reducing transmission of the virus. Everyone with genital lesions, and all partners of persons with genital lesions, should alert new sexual partners about HPV infection risk and take precautions to limit spread of HPV.

Urogenital problems

In men, urethral infection is common, usually with a discharge and possibly affecting the prostate gland. In women, there may be vaginal infection, often with profuse discharge. Inflammation may spread through the pelvic area. Genital warts and herpes may develop, as may ulcers and uterine polyps. Thuja may also be given to treat suppressed gonorrhea. Symptoms better For warm air for drawing up the limbs.


Cervical dysplasia is usually a precancerous lesion that if not treated can become cancerous. It is a condition of abnormal cells on the cervix surface. Pap smears, a sampling of cells, are taken to detect cancer of the cervix. Women susceptible to cervical cancer often have low nutrient levels such as vitamin C, the carotenoids, vitamin B6, and selenium. A folic acid deficiency can cause an abnormal papsmear 10 mg daily for three months then 2.5 mg daily until Pap smears are normal is recommended.

Cancer Treatment

In a RCT, 90 patients with cervical lesions infected with human papilloma virus were given either a capsule containing 200 mg of (-)-epigallocatechin-3-gallate (EGCG) and or an ointment containing 200 mg of polyphenon E to be applied daily (Ahn et al 2003). There was a 69 responder rate when compared with placebo, with the ointment showing the best effects.


A vaccine called Gardasil is now available which protects against the most dangerous types of HPV, as well as the HPV viruses that cause most genital warts. The vaccine is a series of 3 injections that can be given to young women between the ages of 9 and 26. It should not be given during pregnancy, and cannot be used to treat a woman who already has HPV.

Other Vaccines

The newly introduced HPV vaccine (Gardasil) is being recommended for girls to reduce the risk of cervical cancer. There is some concern that it may stimulate the immune system enough to cause increased complaints in children with rheumatic disease, but preventing cervical cancer is an important goal that rheumatologists feel justifies any increased arthritis-related problems.


CERViCAL DYSPLASiA Cervical dysplasias (precancers) are confined to the cervix. They have not yet learned to spread to other parts of the body. Early cases are observed. More severe cases are surgically removed. As mentioned in Chapter i, we recommend the involvement of a gynecologic oncologist for the treatment of cervical cancer. A gynecologic oncologist often manages women with cervical dysplasia. However, because these lesions are precancers and not cancers, patients with cervical dysplasia are usually treated by a primary gynecologist. These physicians receive appropriate training in the treatment of cervical dysplasia and provide excellent care for these lesions. Pathologist You will likely never meet this doctor, but he or she will examine the tissue from any surgeries or biopsies you have. The pathologist is the person who decides if your biopsy shows cervical dysplasia or cancer. Your pathologist's input will help determine what treatments you will need.

Genetic alterations

In cervical cancer p53 is involved in the carcinogenic process through a series of interactions with human papilloma virus. Accumulation of p53 plays no part in the progression from intraepthelial to invasive neoplasia and the commonly found p53 mutations have not prognostic significance (83).


The common wart-causing human papillomavirus has been linked to many cases of cervical cancer. Other papillomaviruses are linked to skin cancer. Hepatitis B and C viruses are associated with deadly liver cancer, sometimes many years after the patient has been infected with either one. The human T-cell leu-

Immune System

There is a strong association between human papilloma virus (HPV) and cervical cancer, particularly HPV types 16 and 18 have been demonstrated in approximately 93 of cervical cancers of all cell types (186). Continued expression of HPV oncogenic proteins E6 and E7 has been demonstrated to be required for the maintenance of the transformed phenotype (187) and this, together with its high frequency of occurrence, may make it an attractive and powerful foreign


The Pap test helped somehow in the past through incidental detection of some early cases with endometrial cancer, however, the test was proven to be of too low sensitivity and positive predictive value in terms of detecting both cervical and endometrial cancers. (8)It must be remembered that screening refers to the evaluation of the asymptomatic patient. When bleeding occurs, evaluation becomes diagnostic rather than screening. A history of bleeding or demonstrated radiographic evidence of endometrial pathology removes a patient from the realm of screening and demands investigation, i.e., an endometrial biopsy.(9)

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