Cervical Cancer: An Update on the Facts
http://www.countywomanmagazines.com/articles/352/1/Cervical-Cancer--An-Update-on-the-Facts/Page1.html
Howard M. Saul, DO, FACOOG
Howard M. Saul, D.O., FACOOG is a board certified gynecologic oncologist. He serves as Director of Gynecologic Oncology for The Center for Cancer and Hematologic Disease. Dr. Saul has been treating women with gynecologic cancer in South Jersey for the past 20 years. His philosophy of practice is to deliver the latest in cancer treatment to the women of South Jersey in the region in which they live. Dr. Saul has been involved in many pioneering cancer treatment studies, and is an active invited speaker at many medical meetings and cancer support groups. He is also experienced in the use of the daVinci Robotic Surgical System.
By Howard M. Saul, DO, FACOOG
Published on December 26, 2010
“I thought that cervical cancer was something out of the past. Why are we seeing so many cases of precancer and cancer of the cervix today?” Many women ask these and other questions about cervical cancer each day. In this article I will answer some of the most common questions and concerns women have about this all too common cancer.
How common is cervical cancer?
It is estimated that 12,200 women will get invasive cancer and 4,210 women will have died of this in 2010. Many more women will be diagnosed with Cervical Intraepithelial Neoplasia (Precancer/CIN) each year.
What are the causes and risk factors for cervical cancer?
We are constantly learning more about the causes of cervical cancer and we have a lot more to learn. It is currently believed that Human Papilloma Virus (HPV) is the major cause of cervical cancer. Most importantly, it is believed that HPV by itself is not enough to cause cervical cancer. There need to be co-factors before cancer can occur. The most important co-factor that we have learned about is cigarette smoking. Cigarette smoking, either actively or passively, can weaken the immune system of the cervix. This can, in ways not currently understood, lead to precancer, and possible cancer of the cervix. The message is clear — women should not smoke and should insist on working in a smoke free environment.
How common is HPV and how does one acquire it?
Human papilloma Virus is a very common virus. There are currently over 100 known subtypes of this virus. Most subtypes are not involved in cervical cancer. Most women who have this virus have no signs and symptoms of the virus. It sometimes may be diagnosed by Pap smears or by colposcopy (looking at the cervix under magnification). The virus may be contracted at one’s own birth. Most women who have this virus will never have a problem as a result of carrying it. Currently there is a preventive vaccine for HPV. Patients should talk with their doctors about this because a great deal of misinformation about HPV is found in women’s magazines, newspapers, television, radio and the internet.
I have precancer of the cervix. Will I eventually get invasive cervical cancer?
Most cases of precancer (CIN) do not progress into invasive cancer. Precancer of the cervix is a very common condition. It usually takes many years before untreated precancer progresses to cancer. This gives us time to screen for it by taking a pap smear. Most often, local treatment can be done to the cervix on an outpatient basis with little discomfort. Most women can have children after being treated for precancer of the cervix and most women do not require a hysterectomy for this condition.
With the introduction of the Pap smear, why are there still cases of cervical cancer?
The most common reason is that women are not going to their doctors for their yearly Pap smears. All women should have a baseline gynecological exam which should include a Pap smear at the time of sexual activity or by age 18. It is recommended that all sexually active women have yearly Pap smears. It is a common misconception that women who have gone through menopause or have had a hysterectomy do not need regular Pap smears. Nothing could be further from the truth. Regular routine yearly Pap smears should be continued in all women throughout their lifetime.
If I should get invasive cervical cancer, will I die of my disease?
Most women with early invasive cervical cancer will be cured of their disease by either radical hysterectomy
or radiation therapy. Most women with advanced cervical cancer will be treated by radiation therapy. Recent new studies have shown that the addition of chemotherapy to radiation can improve a woman’s chance of being cured of the disease. It is important to discuss your fears and concerns with your doctor.
I’ve heard a lot about Robotic Surgery. Is it science fiction or reality?
Robotic Surgery was refined by the military for wartime use, and is now used for advanced minimally invasive surgery. Healing time is improved with less pain. Patients often go home the same day and are back to work in 2-3 weeks. Robotic-assisted surgery gives the surgeon unprecedented dexterity with 3D vision to perform advanced surgery through small incisions using small wristed robotic instruments. We are proud to have been one of the pioneers in the use of Robotic Surgery in South Jersey. We have been on the forefront of the use of Robotic Surgery in gynecologic surgery.
Are there any new developments in the surgical and medical management of this disease?
Yes. Many women with cervical cancer may be candidates for minimally invasive Robotic Surgery. This may result in faster healing, less blood loss, less chance of infection and less pain. Women with recurrent cervical cancer may be candidates for Cyber Knife Radiation Therapy. This new pinpoint radiation therapy may be an option. We have been pioneers in both of these forms of treatment.
How can I participate in a clinical trial in cervical cancer?
There are many open clinical trials in cervical cancer. We at The Center for Cancer are actively involved in national cooperative research groups, such as the Gynecologic Oncology Group (GOG) as well as many industry trials. You may be eligible for participation in some of the latest trials. We would be glad to discuss research treatment options with you.
Do I have to go to a big medical center in Philadelphia to get the best treatment for cervical cancer?
No. Here in South Jersey, patients can receive the same exact state-of-the-art treatment for cervical cancer as in the major cancer centers without leaving the safety and security of their hometown. This approach makes cancer treatment easier for the patient and her family.
What is a Gynecologic Oncologist and how can one help me?
A gynecologic oncologist is a physician who has taken special fellowship training in the treatment of female pelvic cancers. They are trained in all surgical as well as medical aspects involved in the treatment of the patient with gynecologic cancer. The input of a gynecologic oncologist can be a very important addition to your medical team. They are also available for advice and second opinions.
Are there any dumb questions that I shouldn’t ask my doctor?
No. The only dumb questions are those that you did not ask. It is easy to forget an important question while you are in the doctor’s office, so I encourage patients and their family members to try and write down questions ahead of time and ask them as they pop in to your mind. Don’t ever be afraid to ask.
About Dr. Howard M. Saul
Dr. Howard Saul is a board certified gynecologist oncologist. He lives in Cherry Hill with his wife Gail. He has 2 children, Michael and Rochel, a son-in-law, Yisroel, two grandsons, Shneur Zalman and Dov Ber, and a granddaughter, Shoshana Bluma. He has been treating women with gynecologic cancer in South Jersey for over 20 years. His philosophy of practice is to deliver the latest in cancer care to the women of South Jersey. He is on the staff of many area hospitals. He has been involved in many pioneering cancer treatment studies, and is an active invited speaker at many medical meetings and cancer support groups. Most importantly, he believes in giving knowledge, hope, support, compassion and a friendly smile to the many women and their families facing cancer. Questions? Dr. Saul welcomes your questions on any area of gynecologic oncology. Email him at: HMSAUL@centerforcancer.com.
“I thought that cervical cancer was something out of the past. Why are
we seeing so many cases of precancer and cancer of the cervix today?”
Many women ask these and other questions about cervical cancer each day.
In this article I will answer some of the most common questions and
concerns women have about this all too common cancer.
“I thought that cervical cancer was something out of the past. Why are we seeing so many cases of precancer and cancer of the cervix today?” Many women ask these and other questions about cervical cancer each day. In this article I will answer some of the most common questions and concerns women have about this all too common cancer.How common is cervical cancer?
It is estimated that 12,200 women will get invasive cancer and 4,210 women will have died of this in 2010. Many more women will be diagnosed with Cervical Intraepithelial Neoplasia (Precancer/CIN) each year.
What are the causes and risk factors for cervical cancer?
We are constantly learning more about the causes of cervical cancer and we have a lot more to learn. It is currently believed that Human Papilloma Virus (HPV) is the major cause of cervical cancer. Most importantly, it is believed that HPV by itself is not enough to cause cervical cancer. There need to be co-factors before cancer can occur. The most important co-factor that we have learned about is cigarette smoking. Cigarette smoking, either actively or passively, can weaken the immune system of the cervix. This can, in ways not currently understood, lead to precancer, and possible cancer of the cervix. The message is clear — women should not smoke and should insist on working in a smoke free environment.
How common is HPV and how does one acquire it?
Human papilloma Virus is a very common virus. There are currently over 100 known subtypes of this virus. Most subtypes are not involved in cervical cancer. Most women who have this virus have no signs and symptoms of the virus. It sometimes may be diagnosed by Pap smears or by colposcopy (looking at the cervix under magnification). The virus may be contracted at one’s own birth. Most women who have this virus will never have a problem as a result of carrying it. Currently there is a preventive vaccine for HPV. Patients should talk with their doctors about this because a great deal of misinformation about HPV is found in women’s magazines, newspapers, television, radio and the internet.
I have precancer of the cervix. Will I eventually get invasive cervical cancer?
Most cases of precancer (CIN) do not progress into invasive cancer. Precancer of the cervix is a very common condition. It usually takes many years before untreated precancer progresses to cancer. This gives us time to screen for it by taking a pap smear. Most often, local treatment can be done to the cervix on an outpatient basis with little discomfort. Most women can have children after being treated for precancer of the cervix and most women do not require a hysterectomy for this condition.
With the introduction of the Pap smear, why are there still cases of cervical cancer?
The most common reason is that women are not going to their doctors for their yearly Pap smears. All women should have a baseline gynecological exam which should include a Pap smear at the time of sexual activity or by age 18. It is recommended that all sexually active women have yearly Pap smears. It is a common misconception that women who have gone through menopause or have had a hysterectomy do not need regular Pap smears. Nothing could be further from the truth. Regular routine yearly Pap smears should be continued in all women throughout their lifetime.
If I should get invasive cervical cancer, will I die of my disease?
Most women with early invasive cervical cancer will be cured of their disease by either radical hysterectomy
or radiation therapy. Most women with advanced cervical cancer will be treated by radiation therapy. Recent new studies have shown that the addition of chemotherapy to radiation can improve a woman’s chance of being cured of the disease. It is important to discuss your fears and concerns with your doctor.
I’ve heard a lot about Robotic Surgery. Is it science fiction or reality?
Robotic Surgery was refined by the military for wartime use, and is now used for advanced minimally invasive surgery. Healing time is improved with less pain. Patients often go home the same day and are back to work in 2-3 weeks. Robotic-assisted surgery gives the surgeon unprecedented dexterity with 3D vision to perform advanced surgery through small incisions using small wristed robotic instruments. We are proud to have been one of the pioneers in the use of Robotic Surgery in South Jersey. We have been on the forefront of the use of Robotic Surgery in gynecologic surgery.
Are there any new developments in the surgical and medical management of this disease?
Yes. Many women with cervical cancer may be candidates for minimally invasive Robotic Surgery. This may result in faster healing, less blood loss, less chance of infection and less pain. Women with recurrent cervical cancer may be candidates for Cyber Knife Radiation Therapy. This new pinpoint radiation therapy may be an option. We have been pioneers in both of these forms of treatment.
How can I participate in a clinical trial in cervical cancer?
There are many open clinical trials in cervical cancer. We at The Center for Cancer are actively involved in national cooperative research groups, such as the Gynecologic Oncology Group (GOG) as well as many industry trials. You may be eligible for participation in some of the latest trials. We would be glad to discuss research treatment options with you.
Do I have to go to a big medical center in Philadelphia to get the best treatment for cervical cancer?
No. Here in South Jersey, patients can receive the same exact state-of-the-art treatment for cervical cancer as in the major cancer centers without leaving the safety and security of their hometown. This approach makes cancer treatment easier for the patient and her family.
What is a Gynecologic Oncologist and how can one help me?
A gynecologic oncologist is a physician who has taken special fellowship training in the treatment of female pelvic cancers. They are trained in all surgical as well as medical aspects involved in the treatment of the patient with gynecologic cancer. The input of a gynecologic oncologist can be a very important addition to your medical team. They are also available for advice and second opinions.
Are there any dumb questions that I shouldn’t ask my doctor?
No. The only dumb questions are those that you did not ask. It is easy to forget an important question while you are in the doctor’s office, so I encourage patients and their family members to try and write down questions ahead of time and ask them as they pop in to your mind. Don’t ever be afraid to ask.
About Dr. Howard M. Saul
Dr. Howard Saul is a board certified gynecologist oncologist. He lives in Cherry Hill with his wife Gail. He has 2 children, Michael and Rochel, a son-in-law, Yisroel, two grandsons, Shneur Zalman and Dov Ber, and a granddaughter, Shoshana Bluma. He has been treating women with gynecologic cancer in South Jersey for over 20 years. His philosophy of practice is to deliver the latest in cancer care to the women of South Jersey. He is on the staff of many area hospitals. He has been involved in many pioneering cancer treatment studies, and is an active invited speaker at many medical meetings and cancer support groups. Most importantly, he believes in giving knowledge, hope, support, compassion and a friendly smile to the many women and their families facing cancer. Questions? Dr. Saul welcomes your questions on any area of gynecologic oncology. Email him at: HMSAUL@centerforcancer.com.