CANCER SCREENING 4

DOC DO I NEED TO GO FOR CANCER SCREENING 4

Cancer screening :

F.Cervical Cancer

Cervical Cancer is the sixth most common cancer in women in Singapore but can be prevented and treated early if regular screening is done.

Women who are at high risk of cervical cancer are those with:
1.sexual intercourse at an early stage


2.sexual intercourse with multiple partners


3.history of sexually transmitted infections


4.infection with certain high risk strains of human papilloma virus (HPV)


5.weakened immune system such as HIV infection


6.prolonged use of combined oral contraceptive (birth control)pills

Cancer screening procedures includes:
1.Pap smear test should be done yearly in women who has sexual intercourse or abnormal vaginal bleeding.
The Pap smear test involve a simple procedure in which the doctor obtains some scraping from the neck of the womb or cervix to detect abnormal cell changes.
Early detection of cancer of the cervix means early treatment and cure.
Patients who had HPV vaccination should also continue to go for regular Pap smear every 3 years


2.Yearly vaginal examination and pelvic examination which involve the Pap smear

G.Nasopharyngeal Cancer

Nasopharyngeal Cancer or NPC is a common cancer of the head and neck region especially common in Chinese men between the age of 40-65.

People who are at risk of developing Nasopharyngeal Cancer or NPC are:
1.family history of nasopharyngeal cancer -common in Chinese males, less so in other races and females


2.Viral infection of the nose-Epstein-Barr (EBV) virus has been shown to be present in most cases of nasopharyngeal cancer

3.Smoking with its 40 or more toxic chemicals in cigarette smoke can stimulate abnormal cells in the nose to mutate and become cancerous

Cancer screening procedures of nasopharyngeal cancer includes:
1.Blood test-tumor marker EBV. Blood is tested for raised level of EBV IgA antibodies against Viral Capsid Antigen(VCA) and Early Antigen).
Patients with raised EBV IgA antibody have a higher risk of developing NPC.
If these antibodies are seen to rise significantly, there is an indication of possibility of NPC in which case an endoscope examination of the upper nose and nasal biopsy can be done to exclude NPC.


VCA IgA test is more sensitive than EBV but remains high for 6 months following a viral upper respiratory tract infection.


EA IgA test is more specific in diagnosing NPC but the levels are also high in cancers of salivary glands, lung and stomach.


2.nasoendoscopy for patients with family history of of nasopharyngeal cancer or NPC.

A Simple Guide to Cervical Cancer

A Simple Guide to Cervical Cancer
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What is Cervical Cancer?
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Cervical cancer is a common cancer in women which affects the cervix (the neck of the womb).

What are the types of Cervical Cancer?
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There are 2 main types:

1. Squamous cell carcinoma

2. Adenocarcinoma

Squamous cell carcinorma is more common in the younger woman whereas the adenocarcinoma is more common in the older woman.

Who is at risk of Cervical Cancer?
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All women aged between 25 and 69 who had:
1. Sex intercourse at early age

2.Multiple sexual partners

3.Sexually transmitted infections (STI) e.g. genital herpes and human papillomavirus infection (HPV)

4.Any medical condition or treatment which affects the immune system eg. auti-immune disease

5.Smoking

What are the symptoms of cervical cancer?
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The following are symptoms of cervical cancer:

1.Vaginal bleeding after sexual intercourse

2.Irregular bleeding in between periods or after menopause

3.Foul-smelling vaginal discharge

4.Non-specific pain in the pelvic area or lower back

5.Tiredness or loss of weight

The initial stages of cervical cancer are usually symptomless, so women may not know it.
Regular Pap smear screening detects abnormal changes in the cervical cells and prevents cancer.

How is Cervical Cancer Screening done?
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To check if you may have cervical cancer, go for a Pap smear test.
This is simple, quick, safe and is usually painless procedure.
If you have had sex before or are sexually active, you should go for a Pap smear once every 2 years.
Pap smears are available at all hospitals, most private clinics and the local Cancer Society.

If the Pap smear is positive, a colposcopy (examination of the inner lining of the womb) followed by cone biopsy of any suspicious area may be done.

What is the treatment of Cervical Cancer?
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In the pre-cancerous stage and Early Cancer Stage(carcinoma-in-situ) of the cervix, removal of all the abnormal tissues can be done by a cone biopsy.

Repeated Pap smears must be done to confirm that there is no recurrence of the cancer.

In all cases of established cancer of the cervix(stage II - IV), surgery is done with removal of the womb followed by radiotherapy( external or internal) and if necessary chemotherapy.

Reviews of the woman's condition is done regularly.
Sexual intercourse should be avoided temporarily after treatment.
Normal physical and social activities may be resumed in 2-3 month after treatment.

How do you prevent Cervical Cancer?
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A Pap smear screening test is the best prevention against Cervical Cancer.
A newly developed vaccine for HPV has been shown to be able to reduce the incidence of cervical cancer.
Avoid multiple sexual partners.
Use condoms for protection against sexually transmitted idsease especially HPV.
As usual keep a healthy lifestyle and have a well balanced diet

So take steps now to protect yourself against cancer.
Encourage your loved ones to go for screening if they have not done so.
Bear in mind that a pro-active approach with regular clinical screening is to prevent common cancers like breast and cervical cancers from affecting your lives.


Added 4th October 2008
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Cervical Cancer
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The most common HPV types causing 70% of all cervical cancers are the HPV 16,18, 31 and 45.

Both new vaccines against HPV Cervarix and Gardasil are equally effective in producing high antibodies against HPV 16 and 18 and preventing these infections over a 5 year period.

However prevention of the HPV 16 and 18 does not mean the cervical cancer can be abolished totally.