Concept Tanzania

Concept Tanzania is a health research project which is in progress at Ocean Road Cancer Institute, Dar es Salaam Tanzannia. You are invited to participate in this research aimed to find the appropriate means for prevention of cervix cancer.

Cancer of cervix is the most common cancer among young and middle-aged women in our country. It develops mainly due to infection with viruses called Human Papilloma Virus (HPV). This virus causes changes of the superfical cells of the cervix which in the long run may turn out to be cancer

The Cervical cancer is cancer that starts in the cervix, the narrow opening into the uterus from the vagina. The normal “ectocervix” (the portion of the uterus extending into the vagina) is a healthy pink color and is covered with flat, thin cells called squamous cells. The “endocervix” or cervical canal is made up of another kind of cell called columnar cells. The area where these cells meet is called the “transformation zone” (T-zone) and is the most likely location for abnormal or precancerous cells to develop.
Most cervical cancers (80 to 90 percent) are squamous cell cancers. Adenocarcinoma is the second most common type of cervical cancer, accounting for the remaining 10 to 20 percent of cases. Adenocarcinoma develops from the glands that produce mucus in the endocervix. While less common than squamous cell carcinoma, the incidence of adenocarcinoma is on the rise, particularly in younger women.
Cervical Cancer Occurs when abnormal cells on the cervix grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer can often be successfully treated when it's found early. It is usually found at a very early stage through a Pap test.
Most cervical cancer is caused by a virus called Human Papilloma Virus, HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.
Most adults have been infected with HPV at some time. An infection may go away on its own. But sometimes it can cause genital warts or lead to cervical cancer. That's why it's important for women to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.

Cervical Cancer: Symptoms

Precancerous cervical cell changes and early cancers of the cervix generally do not cause symptoms. For this reason, regular screening through Pap and HPV tests can help catch precancerous cell changes early and prevent the development of cervical cancer.
Possible symptoms of more advanced disease may include abnormal or irregular vaginal bleeding, pain during sex, or vaginal discharge. Notify your healthcare provider if you experience:

Abnormal bleeding, such as;
Bleeding between regular menstrual periods
Bleeding after sexual intercourse
Bleeding after douching
Bleeding after a pelvic exam
Bleeding after menopause
Bleeding between periods
Discomfort during sexual intercourse
Smelly vaginal discharge
Vaginal discharge tinged with blood
Pelvic pain.
Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor
Increased urinary frequency
Pain during urination
These symptoms could also be signs of other health problems, not related to cervical cancer. If you experience any of the symptoms above, talk to a healthcare provider.

Cervical Cancer: Causes

Cervical Cancer is caused by a virus called Human Papilloma Virus, HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.
Human papillomavirus (HPV) is found in about 99% of cervical cancers. There are over 100 different types of HPV, most of which are considered low-risk and do not cause cervical cancer. High-risk HPV types may cause cervical cell abnormalities or cancer.
HPV is estimated to be the most common sexually transmitted infection. In fact, by age 50 approximately 80% of women have been infected with some type of HPV. The majority of women infected with the HPV virus do NOT develop cervical cancer. For most women the HPV infection does not last long; 90% of HPV infections resolve on their own within 2 years. A small number of women do not clear the HPV virus and are considered to have “persistent infection. A woman with a persistent HPV infection is at greater risk of developing cervical cell abnormalities and cancer than a woman whose infection resolves on its own. Certain types of this virus are able to transform normal cervical cells into abnormal ones. In a small number of cases and usually over a long period of time (from several years to several decades), some of these abnormal cells may then develop into cervical cancer.
Most adults have been infected with HPV at some time. An infection may go away on its own. But sometimes it can cause genital warts or lead to cervical cancer. That's why it's important for women to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.
Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. 

Cervical Cancer: Preventition

There are a number of measures that can be taken to reduce the chances of developing cervical cancer.

Safe sex
The HPV vaccine only protects against two HPV strains. Using a condom during sex helps protect from HPV infection. HPV is a sexually transmitted infection.

Cervical screening
Regular cervical screening will make it much more likely that signs are picked up early on and dealt with before cancer develops at all or too far.

Have few sexual partners
The more sexual partners a woman has the higher is her risk of developing cervical cancer.

Delay first sexual intercourse
The younger a female is when she has her first sexual intercourse the higher is her risk of developing cervical cancer. The longer she delays it, the lower her risk.

Do not smoke
People who smoke have a higher risk of developing cervical cancer than people who do not. If you are concerned about the anxiety and stress of quitting smoking, ask your doctor to help you. There are many help groups - research indicates that quitting smoking can be achieved more successfully if you have support

Cervical Cancer: Treatment

Cervical Cancer Treatment options include;
Surgery
Radiotherapy
Chemotherapy, or combinations.
Deciding on the kind of treatment depends on several factors, such as the stage of the cancer, as well as the patient's age and general state of health.
Treatment for early stage cervical cancer - cancer that is confined to the cervix - has a success rate of 85% to 90%. The further the cancer has spread out of the area it originated from, the lower the success rate tends to be.

Early Stage Cancer Treatment Options

Surgery is commonly used when the cancer is confined to the cervix. Radiotherapy may be used after surgery if the doctor believes there may still be cancer cells inside the body. Radiotherapy may also be used to reduce the risk of recurrence (cancer coming back). If the surgeon wants to shrink the tumor in order to make it easier to operate, the patient may receive chemotherapy - however, this is not so common.
The options for surgery in the early stages may include:

Cone biopsy (conization) - this procedure may also be used to remove any abnormality. The surgeon uses a scalpel to remove a cone-shaped piece of cervical tissue Laser surgery - a narrow beam of intense light destroys cancerous and precancerous cells.

Advanced Cancer

When the cancer has spread beyond the cervix surgery is not usually an option. Advanced cancer is also referred to as invasive cancer because it has invaded other areas, not just where it started off.
This type of cancer requires more extensive treatment. 

Radiotherapy and Radiology - Imaging

Radiotherapy is also known as radiation therapy, radiation oncology and XRT. It is used for treating cancer, thyroid disorders and some blood disorders. Approximately 40% of cancer patients undergo some kind of radiotherapy.
It involves the use of beams of high-energy X-rays or particles (radiation) to destroy cancer cells. Radiotherapy works by damaging the DNA inside the tumor cells, destroying their ability to reproduce.