Cancer Screening, Cancer surgeries, pap smear, COLPOSCOPY, Ovarian Cancer
CANCER SCREENING
Cancers of the female organs are the diseases that cause the most death among all female cancers.
When the United States is taken into account due to its regular statistical data, it is reported that 15.800 cervical cancer, 4800 death due to this cancer, 600.000 unusual pap tests, 50,000 new pre-cancer diseases were detected in 1995. Again, according to the information of the country, it is calculated that 4 billion dollars are spent annually due to cervical cancer. As can be seen from these numbers, it is more humane, more economical and more successful to detect cancer before it occurs.
As a result of various studies, it is emphasized that it is possible to detect female cancers before they occur. Positive developments have been seen after the identification of precancerous lesions and the development of diagnostic procedures.
HPV, Cervical Cancer and Vaccine, For Warts See…
WHAT ARE THE SYMPTOMS THAT NEED A CANCER SCREENING OR INVESTIGATION?
Symptoms to be suspected in gynecological cancers;
1. Bleeding or discharge in menopausal women
2. Menstrual irregularity
3. Non-menstrual bleeding
4. Post-coital pain, abdominal pain and discomfort in the abdomen
5 .Swelling in the abdomen
6. Eating and drinking disorders
7. Itching, wound or swelling in the vaginal area
8. Bleeding after sexual interest
While many problems are treated quickly before cancer occurs with the timely diagnosis…
GYNECOLOGICAL CANCER SURGERY
The last formula that can be applied is surgery if regular follow-up and inspections cannot be done, if it is delayed or in cases where it is difficult to notice on time, or when some develop for different reasons.
Endometrial Cancer
Ovarian Cancer
Cervical Cancer
Vagina Cancer
Vulva Cancer
Trophoblastic Diseases…
When we select and apply today’s contemporary medical practices, especially as a TEAM, in the most appropriate hospitals with advanced technology and devices, in this type of surgery, if chemotherapy and radiotherapy are required, extraordinary treatment and results can be obtained. PAP SMEAR
George Papanicolaou showed that by taking a cervical swab, it is now possible to recognize precursor diseases that have the potential to transform into cancer before cancer develops (average 10 years). Thus, the cytological screening method introduced by Papanicolaou, as the Pap Test, was widely accepted and spread all over the world. The formula has been the basic screening test in every country, depending on the state policies. In the United States, the 90% decrease in the death rate from cervical cancer in 20 years since 1970 is attributed to Pap test screenings. Before cancer, precursor diseases or lesions are most often seen between the ages of 25-35. However, the screening test is a method applied to all women to detect these lesions early in time. Detection of unusual cells on the scan does not definitively indicate the presence of disease. In this case, pathological examination of the tissue should be performed by taking a biopsy to make a definitive diagnosis of the disease.
To obtain a biopsy (taking a tissue section), it is necessary to determine exactly where the abnormal cells are shed. Visual examination of the external genital (female sexual) organs by magnifying them with a special microscope for biopsy from the most accurate place (tissue removal) is the generally accepted system: Apart from that, it is a painless, easy, quick result, solid application. When there is a problem in gynecological examination, pap smear or HPV tests, colposcopic examination and biopsy with the help of colposcope are accepted as the gold standard all over the world today. It is possible to make a true diagnosis with a Pap test and, if necessary, colposcopic biopsy.
The main thing in cancer screening is to catch cancer without cancer, in the period of pre-cancer diseases and to carry out the necessary follow-up or treatment. The recipe for early detection here is not entirely without flaws. Because the goal is to detect the precursors of cancer, not the cancer. However, catching cancer at an early stage can be a second benefit and it is possible with this program.
Today, cytological screening is no longer discussed in the world. The discussion is to whom, when, how often, up to what age and with which cytological system (Pap test, thin prep, co-test, HPV test, etc.) system will be screened. Although our country has important educational and socio-economic problems in these discussions, not being able to move the issue from scientific platforms to social prevalence, there have been developments in recent years. Many women do not know about standard screening, screening in risk cluster, screening forms. Thus, the responsibility of the obstetrician and the obligations of the patient and the insurance system could not be determined in the confusion that emerged. In developed countries, having a pap test is seen as a necessity for physicians, and insurance companies encourage this. Based on the practices in the world, it may be rational to apply the following protocol, and our practices are in this direction. While screening protocols are being prepared and guidelines are being prepared, it is necessary to determine age and risk clusters in terms of cervical cancer.
WHAT IS PAP SMEAR TEST?
It is an easy test that detects a random cellular change in the cervix that may be the onset of cancer.
The most reliable and easily screened female cancer today is cervical cancer.
This test sometimes also detects some mild signs of infection.
It is an early detection method.
HOW TO MAKE PAP SMEAR? IS THE PAP SMEAR TEST PAINFUL?
During the gynecological examination, a sample of discharge in the form of a swab from the cells poured into the discharge in the cervix with a sterile special plastic brush-like swab is taken on a sample glass or liquid without causing any discomfort or pain. This sample is sent to the PATHOLOGY LABORATORY, where it is examined by pathologists and a pap smear report is issued.
Frequency of screening with Pap Test, presence of HPV virus
In recent years, the guidelines have changed frequently and risk-based and individualized screening protocols have been created. Previously, screening was usually started after the first sexual intercourse or in the 20s. Although there is no consensus on how to screen until the age of 65, it is a generally accepted rule to have a regular pap test until the age of 65. However, there are also publications emphasizing that the survival rate of the patient increases by 63% when screening is continued after the age of 65, and that it is wrong to set an age limit for screening. As a result, if the pap smear test is performed in accordance with the standards:
In the High Risk Cluster;
If the First Pap Test is normal, once a year
In the Low Risk Cluster;
3 years in a row if Pap Test is normal 1 in 3 years
1 in 3 years after uterus removal for non-cancerous reasons ?
Following treatment for cancer or precancerous causes
First 2 years 3 -6 months 1
Next 3 years 1 6 months
Longevity 1 per year pap smear test should be done, but;
However, since it is done together with HPV typing, which we call co-test, makes the follow-up and treatment more effective by calculating the power of the test, diagnosing and risk calculation, these two tests have been used together frequently in recent years according to the risk and age status of the patient, and new protocols/guidelines have been developed.
HOW TO VALUE THE RESULT OF PAP SMEAR? WHAT DOES AN EXTRAORDINARY SMEAR AND BIOPSY MEAN?
A mild infection that can be treated easily or some cellular changes in the area where the sample is taken can be detected with this test. Not every cellular change means cancer. However, some changes may need to be monitored more closely by the doctor. Sometimes these cellular changes mean cancer. When changes that mean cervical cancer are found, the chances of being treated quickly arise.
Although it varies depending on the age and general condition of the person, pap smear and colposcopic biopsy results that may be unusual are results such as ASCUS, ASC-H, LSIL, LGSIL, HSIL, HGSIL, CINI, CIN II, CIN III. CIN III and beyond indicate anomalies such as cancer…
Cervical cancer, which may result in the death of the woman if delayed, will not be a trace of the disease if timely intervention is made with these tests, sometimes without the need for major surgery in the early stage. With these tests, the diagnosis is made in the earliest period. One of the treatments performed in the early period without the need for major surgeries is LEEP Conization, often there is no need for hospitalization.
Pap Smear WHO SHOULD HAVE, When?
Since Pap smear is a test for early diagnosis, the woman does not have to have a complaint to have it done. Women who have sores in the cervix, feel pain and stinging during sexual intercourse, have dripping bleeding or have a discharge all the time should have a pap smear test done without delay. WHICH PERIOD SHOULD IT BE DONE? The best time for a Pap smear is in the middle of two menstrual periods. The absence of sexual intercourse for 48 hours before the test and the absence of medication in the chamber will provide more adequate results.
HOW FREQUENTLY SHOULD I HAVE?
Since practice guidelines have changed all over the world in this regard, you should act in line with the offers to be made by your physician who knows your risk situation most adequately. If you have been diagnosed with genital herpes or have warts on your genitals or if there is HPV – papilloma virus in the tests, which is known to be the main cause of cervical cancer in some types today, or if you have had an unusual pap smear in the past, the frequencies will change, as often as your doctor recommends. Repetition would be helpful.
WHERE TO APPLY ?
Smear test, colposcopy and biopsies should be performed by obstetrician doctors in line with the results of the examination and in accordance with the guidelines.
Ovarian (ovarian) cancers
With the prestige of being the most insidious cancers that can be diagnosed late, because there are no screening tests that can be applied frequently and quickly in the community (or because they are not safe) and they are the most deadly cancers, researches on this subject have been carried out rapidly. in progress. Studies done by measuring some cancer markers (such as CA-125) and a group of index calculations in the blood of vaginal ultrasound, Doppler and ovarian cancer patients have not been very satisfactory. However, these methods can be used in the patient group with a high risk of ovarian cancer and in menopause.
In this respect, risk clusters for ovarian and intrauterine (endometrium) cancers or cases where the disease is seen frequently have been defined. These;
Ovarian cancer;
Women who have not given birth and breastfed
Those who have ovarian cancer in their first degree relatives
Those who use ovulation drugs for a long time for the treatment of infertility
More common with some other cancers are reported to be visible.
Endometrial (intrauterine) cancer
Many researches are carried out to diagnose other women’s cancers before they occur. Among these, thickness measurements with vaginal ultrasound for endometrial (intrauterine) cancer, diagnostic and operative hysteroscopy and biopsies in doubtful cases are promising. Especially in women who have gone through menopause, if the thickness of the intrauterine tissue is found to be increased, it is possible to detect precancerous diseases or cancer in the early period by taking tissue sample (biopsy) with probe curettage or the safer endoscopy (hysteroscopic).
Very overweight and high blood pressure (more than 30% of ideal weight)
Diabetic
Childless and not breastfed
Polycystic Ovary (More of the ovary) It is reported that it is more common in women with a disease (characterized by a large number of cysts).
The precursor symptoms of this cancer begin in the form of unsystematic bleeding and uterine thickening on ultrasound or endometrial hyperplasia.
