Pregnancy and Birth

Cancer of the vagina is rare. It is almost always a squamous cell cancer. The exception is an adenocarcinoma that occurs in women who were exposed to DES (diethylstilbestrol) in-utero. One of the reasons that it is rare is that cancers of the vagina that also involve the vulva are considered to be vulvar cancers; if it involves the cervix it is considered to be a cervical cancer. Vaginal cancer may cause symptoms of abnormal bleeding and foul discharge. Bleeding after intercourse is a symptom of cancer of the vagina as well as cancer of the cervix.

The cervix is the part of the uterus connected to the upper vagina. It is the structure that dilates during childbirth to allow the baby to traverse the birth canal. There are two major types of cancer that develop from the cervix. Squamous cell cancers arise from the squamous epithelium that covers the visible part of the cervix. Adenocarcinomas arise from the glandular lining of the endocervical canal.

The uterus is the pelvic organ that holds the pregnancy and that bleeds each menstrual period. The cervix is that part of the uterus fixed at the top of the vagina. The normal size of the uterus is about that of a lemon. The uterus is divided into three parts. The great bulk of the uterus is composed of smooth muscle and forms a thick uterine wall.

The Pap test is a screening test for malignant and premalignant changes of the cervix. A positive result indicates that there may be a problem and that further diagnostic procedures must be done. The Pap test is not a diagnostic test. It cannot be used to exclude a cancer of the cervix for a person who has symptoms that could be due to a cervical cancer.

Ovarian cancer, long considered a silent killer because of the lack of warning signs, may not be so silent. A new consensus statement released by the Gynecological Cancer Foundation reveals that women who have developed ovarian cancer may have had common disease symptoms.

The challenge we face in interpreting Pap smears is to facilitate the assignment of smears into either a low-risk category (including "within normal limits" and "benign cellular changes") or a high-risk category (including "squamous intraepithelial lesion" and higher-grade categories).

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A list of key terms for gynecologists and patients dealing with cancer.

Women with cervical intraepithelial neoplasia now have a number of treatment options including cold-knife conization, laser ablation, and loop electrosurgery but, all too often, the physician s preference is the determining factor in selection of therapy. This detailed presentation of the advantages and disadvantages of electrosurgery will help the physician to decide whether this procedure truly fits the needs of a given patient.

A number of case-control and cohort studies have demonstrated a relationship between high intake of foods rich in carotenoids, Tocopherols, and vitamin C with a reduced risk of certain human malignancies.

The view that nuns have a very low risk of cervical cancer is questioned. The historical evidence for this view is reviewed, from the beginning of the eighteenth century to the present. An estimate of the actual mortality rate from cervical cancer suggests that risk of death from this neoplasm among nuns is little different from that among the general female population.

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.

Discussion between Mark Perloe, MD, and Bruno Lunefeld, MD, on the risks associated with ovulation induction in breast cancer and ovarian cancer.

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.

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)

OBGYN.net Broadcasting present Part VIII of a series on Weight Loss Surgery. This series is unique in that we follow the patient from pre-op to one year post-op.

OBGYN.net Broadcasting present Part VI of a series on Weight Loss Surgery. This series is unique in that we follow the patient from pre-op to one year post-op.

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OBGYN.net Conference CoverageFrom AIUM 44th Conference held in San Francisco, California - April, 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.

In light of ongoing threats of radiation exposure during the earthquake, tsunami, and nuclear crisis in Japan, OBGYN.net has put together a list of resources and information for doctors and patients who want to learn more about the dangers of radiation and exposure during pregnancy.

To review utilisation of elective embryo cryopreservation in the expectant management of patients at risk for developing ovarian hyperstimulation syndrome (OHSS), and report on reproductive outcome following transfer of thawed embryos.

The first vaccine to prevent human papillomavirus (HPV) and cervical cancer has been licensed, and in future, vaccination may be routinely offered to 10–14 year old girls. HPV is a sexually transmitted virus and some parents may refuse consent for vaccination.