Gynecologic Oncology

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In this column, subject experts have been invited to provide an annotated guide to some of the most useful health sites on the Internet. In this issue Hans van der Slikke, Consultant Obstetrician at Zaandam Hospital, The Netherlands, and Chairman of the International Council of OBGYN.net, provides a guide to some of the best women's health resources now available on the Internet.

Although sperm and embryos (fertilized eggs) have been successfully frozen and subsequently thawed to create healthy children for decades, it is only recently that successful human egg freezing has become a reality.

Susan is a 58-year-old woman who saw her family physician after a few weeks of mild abdominal pain and bloating. The examination of her abdomen was normal, as was a pelvic and rectal exam. Blood tests for infection, liver and gall bladder problems were also normal.

There are many ways to treat cervical dysplasia (CIN). Factors influencing the choice of treatment for cervical dysplasia include the extent and severity of the dysplasia, the age of the woman, and whether or not she has any other gynecological problems.

Sarcomas constitute less than 1% of all cervical malignancies. With over 150 reported cases, rhabdomyosarcomas represent the most commonly reported sarcoma at this location. In this report, a select group of the more uncommon sarcomas of the uterine cervix are reviewed, including all previously reported examples of leiomyosarcoma, liposarcoma, alveolar soft part sarcoma, Ewing sarcoma/primitive neuroectodermal tumor, undifferentiated endocervical sarcoma, and malignant peripheral nerve sheath tumor (MPNST).

The Early-7 (E7) protein of HPV binds to the underphosphorelated form of the tumor suppressor protein - pRb and displaces the E2F transcription factor that is normally bound by pRb. The latent membrane protein-1 (LMP-1) of EBV prevents apoptosis of B cells by up regulating the expression of bcl-2, and it activates growth promoting pathway that are normally triggered by T cell - derivate signal.

Human Papillomavirus has emerged as a distinct cause of cervical changes in young women. Its prevalence is continuously growing and is considered at epidemic proportions with 20 million Americans already infected and 5.5 million new cases reported annually. (2) (Center for Disease Control and Prevention, Tracking the Hidden Epidemics., Trends in STDs in the U.S. 2000, Atlanta, Georgia, 2000)

Prophylactic human papillomavirus vaccines have been shown to be effective in reducing the disease burden of cervical cancer, but the three dose regimen can be expensive and difficult to complete. With that in mind, Dr Aimée R. Kreimer, investigator in the division of cancer epidemiology and genetics at the National Cancer Institute, the National Institute of Health, and colleagues sought to determine if less than three doses of the vaccine would be effective. The results are published in the Journal of the National Cancer Institute.