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CERVICAL CANCER - TREATMENT
Patients w/ abnormal Pap smear are referred for colonoscopy to screen for presence of cervical cancer.
Colposcopic exam should include inspection of the transformation zone, definition of the extent of the lesion & biopsy of the most abnormal area for tissue diagnosis.
The earliest stages of cervical carcinoma are generally asymptomatic.
Watery vaginal discharge & postcoital bleeding or intermittent spotting may be present & are usually unrecognized by the patient.

Cervical Cancer - Treatment References

  1. Benedet JL, Pecorelli S. Staging classification and clinical practice guidelines of gynaecological cancers by the FIGO Committee On Gynecologic Oncology. Elsevier. 2000 Sep
  2. duPont NC, Monk BJ. Chemotherapy in the management of cervical carcinoma. Clin Adv Hematol Oncol. 2006 Apr;4(4):279-286. PMID: 16728939
  3. Keys HM, Bundy BN, Stehman FB, et al. Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med. 1999 Apr;340(15):1154-1161. http://www.ncbi.nlm.nih.gov. PMID: 10202166
  4. Fiorica JV. Update on treatment of cervical and uterine carcinoma: focus on topotecan. Oncologist. 2002;7(Suppl 5):36-45. http://www.ncbi.nlm.nih.gov. PMID: 12324632
  5. Gien LT, Covens A. Fertility-sparing options for early stage cervical cancer. Gynecol Oncol. 2010 May;117(2):350-357. doi: 10.1016/j.ygyno.2010.01.039. PMID: 20163850
  6. Haie-Meder C, Morice P, Castiglione M; ESMO Guidelines Working Group. Cervical cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010 May;21(Suppl 5):v37-v40. http://www.ncbi.nlm.nih.gov. PMID: 20555099
  7. Kudelka AP, Winn R, Edwards CL, et al. Activity of paclitaxel in advanced or recurrent squamous cell cancer of the cervix. Clin Cancer Res. 1996 Aug;2(8):1285-1288. http://www.ncbi.nlm.nih.gov. PMID: 9816298
  8. Lea JS, Lin KY. Cervical cancer. Obstet Gynecol Clin North Am. 2012 Jun;39(2):233-253. doi: 10.1016/j.ogc.2012.02.008. PMID: 22640713
  9. Lai CH, Yen TC, Ng KK. Surgical and radiologic staging of cervical cancer. Curr Opin Obstet Gynecol. 2010 Feb;22(1):15-20. doi: 10.1097/GCO.0b013e32833503e7. PMID: 19952745
  10. Peters WA III, Liu PY, Barrett RJ II, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early stage cancer of the cervix. J Clin Oncol. 2000 Apr;18(8):1606-1613. PMID: 10764420
  11. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009 May;105(2):103-104. PMID: 19367689
  12. McGuire WP, Blessing JA, Moore D, et al. Paclitaxel has moderate activity in squamous cervix cancer. A Gynecologic Oncology Group study. J Clin Oncol. 1996 Mar;14(3):792-795. PMID: 8622025
  13. Whitney CW, Sause W, Bundy BN, et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol. 1999 May;17(5):1339-1348. PMID: 10334517
  14. Scottish Intercollegiate Guidelines Network (SIGN). Management of cervical cancer: a national clinical guideline. Edinburgh EH2 1EN, UK: SIGN. 2008 Jan
  15. MedWormhttp://www.medworm.com/rss/index.php/OBGYN/29/http://www.medworm.com/rss/medicalfeeds/specialities/OBGYN.xml
  16. MedWormhttp://www.medworm.com/rss/index.php/Cancer-%26-Oncology/6/http://www.medworm.com/rss/medicalfeeds/specialities/Cancer-Oncology.xml
  17. Ministry of Health Malaysia, Academy of Medicine Malaysia. Clinical practice guidelines: management of cervical cancer. http://www.moh.gov.my. Apr 2003. Accessed 09 Aug 2010.
  18. American Cancer Society. Cervical cancer. http://www.cancer.org. 2012.
  19. Ministry of Health Singapore. Clinical practice guidelines. Cervical cancer. MOH (Singapore). http://www.moh.gov.sg. Jan 2003.
  20. National Cancer Institute. U.S. National Institutes of Health. Cervical cancer (PDQ): treatment health professional version. http://www.cancer.gov. 18 May 2006. Accessed 19 Sep 2012.
  21. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cervical cancer version 1.2012. http://www.nccn.org. Accessed 12 Sep 2012.
  22. Wiebe E, Denny L, Thomas G. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2012 Oct;119(Suppl 2):S100-109. doi: 10.1016/S0020-7292(12)60023-X. Accessed 28 Feb 2014. PMID: 22999501
  23. Tewari KS, Sill MW, Long HJ 3rd, et al. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med. 2014 Feb;370(8):734-743. doi: 10.1056/NEJMoa1309748. Accessed 22 Aug 2014. PMID: 24552320
  24. Domingo EJ, Germar MJV. Cervical cancer. In: Society of Gynecologic Oncologists of the Philippines (Foundation), Inc. Clinical Practice Guidelines. 6th ed. Makati City, Philippines: OVT-Graphic Line, Inc; 2012:1-14.
  25. Algoritme Penanganan Kanker Serviks. In: Himpunan Onkologi Medik Indonesia (HOGI). Pedoman Pelayanan Medik Kanker Ginekologi. Edisi 2. Jakarta: Badan Penerbit FKUI; 2011.
  26. World Health Organization (WHO). Comprehensive cervical cancer control: a guide to essential practice. 2nd ed. Geneva: WHO; 2014. http://www.ncbi.nlm.nih.gov. Accessed 04 Feb 2015:1-378.
  27. Frumovitz M. Invasive cervical cancer: staging and evaluation of lymph nodes. UpToDate. http://www.uptodate.com. 20 Jun 2014.
  28. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cervical cancer version 1.2016. NCCN. http://www.nccn.org. 25 Nov 2015. Accessed 6 Jan 2016.
  29. Ministry of Health Malaysia, Malaysian Gynaecological Cancer Society, Malaysian Oncological Society, Academy of Medicine Malaysia. Clinical practice guidelines: management of cervical cancer (second edition). Ministry of Health Malaysia. http://www.moh.gov.my. 2015.
  30. Chuang LT, Feldman S, Nakisige C, et al. Management and care of women with invasive cervical cancer: American Society of Clinical Oncology resource-stratified clinical practice guideline. Jul 05, 2016. J Clin Oncol. doi: 10.1200/JCO.2016.68.3789. PMID: 27382101
  31. Denny L, Quinn M. FIGO cancer report 2015. Int J Gynaecol Obstet. 2015 Oct;131(Suppl 2):S75. doi: 10.1016/j.ijgo.2015.06.024. Accessed 08 Dec 2016. PMID: 26433677
  32. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cervical cancer version 1.2017. NCCN. https://www.nccn.org. 10 Oct 2016.
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