Cervical cancer Awareness 3.3.19 Cann Win

Routine screening & guidelines

1. Dr Nupur Gupta, Senior Consultant & Unit Head, Department of Obstetrics & Gynecology Paras Hospital Gurgaon CERVICAL CANCER: lets Get Screened & Beat Cervical Cancer

2. What You Need To Know about Cervical cancer?

3. Anything that changes your chance of getting a disease What is a Risk Factor?

4. HPV Infection Smoking Poor Immune System (HIV), Chlamydia Diet low in fruits & vegetables Being overweight Longterm use of OCPs IUD use (protective) Having multiple fullterm pregnancies Being younger than 17 at your first pregnancy Low socioeconomic status DES exposure in utero H av ing a family history of cervial cancer Risk Factors for Cervical Cancer

5. Where does it arise?

6. Lower part of uterus Cells of cervix grow abnormally & invade other organs Invasive Cancer – lungs, liver, bladder & vagina Slow growing cancer What is Cervical Cancer?

7. Main Cause of Cervical Cancer: HPV

8. AN EARLY STAGE CERVICAL CANCER IS ASYMPTOMATIC Why should we screen?

9. YES!!! IT IS PREVENTABLE

10. To look for abnormal cells in the cervix Screening Test: P ap Test It is treatable It is one of the most preventable

11. Looks for the virus that can cause these cell changes Screening Test: HPV DNA

12. How do we take the Smear?

13. How can it be more accurate? Not to do during menses Don’t use tampons or vaginal cream or medicines Don’t douche 2 to 3 days before Don’t have vaginal sex 2 days before

14. HOW OFTEN TO SCREEN?

15. How do you know you have Cervical Cancer?

16. ABNORMAL VAGINAL DISCHARGE ABNORMAL VAGINAL BLEEDING (Bleeding after sex or Bleeding after menopause, heavier bleeding) UNCOMFORTABLE URINATION SEX IS LESS ENJOYABLE PELVIC PAIN UNEXPLAINED WEIGHT LOSS & FATIGUE LEG PAIN WITH SWELLING SIGNS YOU SHOULDN’T IGNORE

17. Late Signs & Symptoms Dull backache Continuous dribbling of urine Diarrhoea , or pain or bleeding from the rectum A swollen abdomen, nausea, vomiting, & constipation

18. Commonest Report: INFLAMMATION Atypical cells, CIN, LSIL , HGSIL, Carcinoma

19. If your pap test is abnormal Cervix looks abnormal during a pelvic exam Tests show you have HPV You have unexplained bleeding Diagnosis: Colposcopy

20. Only if your doctor finds something that doesn’t look normal during your colposcopy Do you need a Cervical Biopsy?

21. Cone biopsy - cone-shaped piece of tissue from your cervix to remove any precancerous cells. This surgery can treat very small cervical cancers that haven't spread. Cryotherapy - liquid  gas  to freeze abnormal cells from your cervix Loop Electrosurgical Excision Procedure (LEEP) Treatment Options

22. HPV & Other Cancers

23. Targets types 16 and 18 HPV virus The ideal time : before you’re sexually active Upto 26 yrs (US & UK), Upto 45 years (India) HPV Vaccine

24. HPV VACCINES

25. Have fewer sex partners Work to keep your  weight  healthy Eat lots of  fruits & vegetables Not use  birth control pills  for an extended time Not smoke (Smokers are twice as likely to get cervical cancer) What else can u do?

26. Don’t worry

27. STAGING & TYPE OF CANCER A ge & Parity Diagnosis: Cervical Cancer? Just know that it’s usually very treatable. It will relieve your symptoms, and help you live longer

28. Surgery Radiotherapy Chemotherapy Targeted therapy Take time to review all your options. Make sure you understand how each treatment works. If you're not sure about something, ask questions. What are the treatments for Cervical Cancer?

29. Main treatment for small cancers that haven't spread outside your cervix Abdominal hysterectomy Laparoscopic   hysterectomy Hospital stay - 1 to 5 days Surgery: Total Hysterectomy Hysterectomy: Simple or Radical +/- LN Sampling

30. TYPES OF HYSTERECTOMY

31. For early-stage cervical cancer or post surgery High-energy X-rays kill cancer cells & stop their growth A small device is placed near your cervix Radiation: Brachytherapy

32. 5 days a week, for 5 to 6 weeks Side effects Fatigue, loose stools,  diarrhoea Nausea, Vomiting Pain during  sex Skin  changes Discomfort and urge to urinate often Menstrual changes Swollen legs (if lymph nodes are irradiated ) Radiation: External Beam  

33. Drugs kill or slow the growth of cervical cancer cells Chemoradiation . Adding chemo makes the radiation work better. Chemotherapy is good if cancer has spread Side effects Changes in your periods Fatigue, hair loss Increased risk for infection Loss of appetite, mouth  sores Nausea & vomiting Chemotherapy

34. It kills cancer cells but spares healthy cells It can slow down tumor growth in advanced cervical cancer, because tumors need new  blood vessels for nourishment Side effects - high blood pressure, fatigue, loss of appetite, &  blood clots or bleeding Targeted Therapy

35. To stimulate a person’s own immune system to recognize & destroy cancer cells more effectively To treat cervical cancer that has spread or come back (recurred ) It can shrink some tumors or slow their growth   Immunotherapy

36. I take care of myself, so I can take care of my family

37. TOGETHER…………….. We can prevent more than 30,000 cancers each year!

38. How can you prevent cancer or find it early? Pay attention to your body & know what is normal for you Make healthy lifestyle choices Know your family health history Get the HPV Vaccine Get regular pap tests  

39. IF YOU CAN PREVENT IT YOU DON’T NEED TO CURE CERVICALCANCER

40. What is your risk of getting a Gyne Cancer? When should you have next pap test? What do your pap test results mean? Is the HPV test right for you? When should you stop getting pap test? Any other tests you need based on personal health & family cancer history When should you visit based on new symptoms & what should you do next? Questions you can ask your Doctor

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