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At least 343 records · Page 19Linked to original sources
PubMed2006

Clusterin confers paclitaxel resistance in cervical cancer.

OBJECTIVE: To measure clusterin expression in cervical cancer tissues and cell lines and to evaluate whether clusterin confers resistance to paclitaxel in cervical cancer cells. METHODS: Immunohistochemical staining for clusterin was performed on 15 normal cervical tissues and 32 primary cervical cancer tissues, and clusterin expression in cervical cancer cell lines was quantified by Western blotting. The correlation between clusterin expression level and paclitaxel IC50 in cervical cancer cell lines was evaluated. The effect of clusterin siRNA on paclitaxel resistance was evaluated by XTT assays. RESULTS: Cervical cancer tissues expressed significantly higher levels of clusterin than did normal cervical tissues (4.08 vs. 1.35, P<0.05). Clusterin expression levels were correlated with paclitaxel resistance in cervical cancer cell lines, and transfection of clusterin siRNA into HeLaS3 cells significantly decreased their resistance to paclitaxel (P<0.05). CONCLUSION: Our finding that clusterin expression was significantly higher in cervical cancer than in normal cervical tissues suggests that clusterin may confer paclitaxel resistance in cervical cancer cells.

Adenocarcinoma↗
PubMed2005

The prevention of cervical cancer in developing countries.

Cervical cancer remains the commonest cancer cause of death among women in developing countries, largely due to the failure to establish cytologically based cervical cancer screening programmes. There are many barriers to the establishment of screening programmes in poor countries ranging from limited financial, human and health resources to the complex infrastructural requirements of traditional screening programmes. Alternative approaches to cervical cancer prevention are currently being investigated, including primary prevention with prophylactic vaccines against human papillomavirus to alternative screening tests and protocols. These will be explored in this review.

Adult↗
PubMed1996

Cervical cancer: a developmental perspective.

Cervical cancer is a disease that affects women worldwide. In some countries it is the leading cause of death among women. Although the incidence of cervical cancer has decreased with the advent of the Papanicolaou smear, it remains a problem in adult women. Cervical dysplasia most often affects women in their 20s; carcinoma in situ affects women 30 to 39 years of age; and invasive carcinoma affects women older than 40 years. These age groups fall into the final three of Erickson's eight stages of ego development. However, taking a developmental approach in planning nursing interventions for women with cervical cancer has its drawbacks. Much of developmental theory research has been conducted on nonrepresentative samples, with women being underrepresented. A template for exploring patient problems from a life stage (developmental) perspective has been developed within the context of three different nursing diagnoses (sexual dysfunction, spiritual distress, and alteration in family processes).

Adaptation, Psychological↗
PubMed1999

Pulmonary metastases from cervical cancer in Sri Lanka.

Cervical cancer is the second commonest malignancy in Sri Lankan women. The records of 2075 patients treated for cervical cancer from 1989 to 1993 were reviewed. Thirty-eight patients (1.8%) developed pulmonary lesions consistent with metastases. The median age at the time of presentation with metastases was 49.8 (range 24-73) years. Ten patients (26.3%) had pulmonary metastases at presentation. Twenty-eight (73.7%) developed metastases during follow-up. By the end of 2 years 27 (96.4%) of these patients had developed pulmonary metastases. The median time from diagnosis of cervical cancer to the detection of pulmonary metastases was 9 months. The commonest histological cell type was the large cell non-keratinising squamous carcinoma. Nine (23.7%) of these patients were asymptomatic. Two patients had lung metastases on initial staging chest X-ray while the other seven were detected during routine 3-monthly surveillance chest X-rays as follow up of primary treatment. This emphasises the importance of incorporating routine surveillance chest X-ray as part of the regular follow up. All patients with pulmonary metastases had abnormal shadows in chest X-rays. Nodular lesions were the commonest radiological findings. Local disease was controlled in 17 (55.3%) of the patients who developed metastases during follow-up, while 11 (28.9%) had active disease. There were 24 patients with spread to other sites at the time of diagnosis of pulmonary metastases. The discovery of effective chemotherapy agents is anticipated.

Journal Article↗
PubMed2004

Cervical cancer control, priorities and new directions.

Cervical cancer is caused by infection with a range of high risk "oncogenic" human papillomavirus (HPV) types, and it is now accepted that >99% of cervical cancer is initiated by HPV infection. The estimated lifetime risk of cervical cancer is nevertheless relatively low (less than 1 in 20 for most community based studies). Although sensitivity and specificity of the available diagnostic techniques are suboptimal, screening for persistent HPV infection is effective in reducing the incidence of cervical cancer. Infection can be detected by molecular techniques or by cytological examination of exfoliated cervical cells. Persistent infection is the single best predictor of risk of cervical cancer. The latest findings of HPV and cervical cancer research need to be widely disseminated to the scientific and medical societies that are updating screening and management protocols, public health professionals, and to women and clinicians. This report reviews current evidence, clinical implications and directions for further research in the prevention, control and management of cervical cancer. We report the conclusions of the Experts' Meeting at the EUROGIN 2003 conference.

Female↗
PubMed1993

The role of psychological processes in the aetiology and treatment of cervical cancer: a biopsychological perspective.

Cervical cancer is one of the most serious illnesses affecting women today, particularly in developing societies. Despite medical advances in treatment and the success of cervical screening programmes in detection, the incidence of the disease is increasing. In this paper it is argued that one of the reasons for this is that the aetiological model employed for cervical cancer takes little account of psychological and psychophysiological factors. Both of these factors are now thought to play important roles in disease processes. Research in these areas is reviewed and a new aetiological model for cervical cancer described. This model incorporates existing epidemiological and medical formulations into a new multifactor framework. The implications of this model for treatment are explored and it is suggested that psychological interventions could play a much greater role than they have in the past.

Adaptation, Psychological↗
PubMedDate not supplied

The role of steroid contraceptive hormones in the pathogenesis of invasive cervical cancer: a review.

Invasive cervical cancer remains a leading cause of morbidity and mortality, especially among women in the developing world where screening is either deficient or absent. Of all agents linked to the causation of this disease, high-risk human papillomavirus (HPV) appears to be the strongest factor. However, not all women with HPV develop cervical cancer. Steroid contraception has been postulated to be one mechanism whereby HPV exerts its tumorigenic effect on cervical tissue. Steroids are thought to bind to specific DNA sequences within transcriptional regulatory regions on the HPV DNA to either increase or suppress transcription of various genes. Although some earlier studies were reassuring as no increased incidence of cervical cancer was observed, subsequent research has shown a causative association, especially among long-term users. The role of steroids was further enhanced by the discovery of hormone receptors in cervical tissue. Some earlier studies of oral contraceptive steroids found no increased risk, even after controlling for other risk factors, including smoking and number of partners. However, prospective studies have shown a greater progression of dysplasia to carcinoma-in-situ with more than 6 years of oral steroid contraceptive use. Similar findings were also evident from other work, including the Royal College of General Practitioners Oral Contraception Study. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives showed a relative risk of 1.2 for invasive cancer in users of the long-acting progestational contraceptive, depo-medroxyprogesterone acetate. However, in users of more than 5 years duration, an estimate of 2.4 was reported. The upstream regulatory region (URR) of the HPV type 16 viral genome, mediates transcriptional control of the HPV genome and is thought to contain enhancer elements that are activated by steroid hormones. It has been shown that steroid hormones bind to specific glucorticoid-response elements within HPV-DNA. Experimental evidence has revealed that high-risk type HPV 16 are able to stimulate the development of vaginal and cervical squamous cell carcinomas in transgenic mice exposed to slow-release pellets of 17 beta-estradiol in the presence of human keratin-14 promoter. Squamous cell carcinomas developed in a multi-stage pathway only in transgenic mice and not in nontransgenic mice. The E6 oncoprotein of HPV 16 has been shown to bind to the p53 tumor suppressor gene and stimulate its degradation by a ubiquitin-dependent protease system. Steroid hormones are thought to increase the expression of the E6 and E7 HPV 16 oncogenes, which in turn bind to and degrade the p53 gene product, leading to apoptotic failure and carcinogenesis. However, the molecular basis of this remains to be proven.

Contraceptives, Oral, Hormonal↗
PubMed1992

Endoluminal ultrasound staging of cervical cancer.

Clinical staging of cervical cancer is incorrect in approximately one-third of patients who undergo surgical staging. Pretreatment laparotomy is the staging method of choice for patients with cervical cancer at Memorial Sloan-Kettering Cancer Center. We performed transabdominal, transvaginal, and transrectal ultrasound staging on 12 patients. In 5 of 6 patients undergoing radical hysterectomy, clinical ultrasound and surgical staging were consistent. One patient could not tolerate rectal probe sonography. Ultrasound staging was correct in 1 of 6 patients with advanced disease. A new technique of cervical imaging with transrectal ultrasound and vaginal douche is described. We believe it unlikely that ultrasound will improve the accuracy of clinical staging in patients with cervical cancer.

Female↗
PubMed1987

Endometrial cancer following radiation therapy for cervical cancer.

The clinical and histologic features of eight cases of carcinoma of the endometrium which developed following radiation therapy for squamous cell carcinoma of the cervix are described. No patient had a well-differentiated tumor and significant myometrial invasion was present in all cases. Three of the eight tumors were papillary serous adenocarcinoma. Five of the eight patients developed recurrent tumor and died of their disease. The risk of endometrial cancer in patients previously radiated for cervical cancer is evaluated.

Adenocarcinoma, Papillary↗
PubMed2005

Management of locally advanced cervical cancer.

PURPOSE OF REVIEW: Cervical cancer is a significant global public health problem. In underdeveloped countries where screening programs are not widely available and in underserved populations in developed countries, women commonly present with locally advanced disease that is not curable by any extent of radical hysterectomy. This review will critically evaluate the evidence supporting the available treatment modalities for locally advanced cancer of the uterine cervix. RECENT FINDINGS: Concurrent cisplatin-based chemotherapy and radiation have demonstrated significant survival improvement for patients with locally advanced cervical cancer. Advances in imaging and radiotherapy technologies, the inclusion of newer agents to the chemoradiation regimens, the use of new hypoxic cell radiosensitizers and monoclonal antibodies that inhibit cell growth, with consequent increase in malignant cell kill fractions, are some of the new therapeutic options that may be used to improve the survival of these patients. SUMMARY: Continued improvement in understanding the natural history of cervical cancer, the limitations of the current staging system, and these newer therapeutic options will increase the efficacy of chemoradiation and improved the survival of these patients.

Antineoplastic Agents↗
PubMed1984

Epidemiological aspects of cervical cancer in tropical Africa.

Cervical cancer is one of the most common malignant tumours in tropical Africa accounting, for example, for nearly one-quarter of female cancer cases overall in Uganda. The disease is likely to be under-reported and available incidence rates are probably gross underestimates. Spread is through sexual contacts. Both female and male promiscuity and a low standard of sexual hygiene lead to a high incidence within a given community. A number of investigations show that the risk of cervical cancer varies little, whether or not the male partner has been circumcised, but these findings seem to indicate only that extreme cleanliness is more effective than circumcision alone. Populations of Uganda who practise male circumcision have a lower incidence than those who do not, favouring the view that partial protection is provided by this custom. Herpes simplex virus type 2 remains a candidate oncogenic agent, but the results of comparative seroepidemiological surveys of titres among cases and controls are inconsistent, not only in Uganda, but also in other areas of the world. Human papillomaviruses are clearly more important. Analyses of the geographical and age distribution of cancer in Uganda, based on the results of a country-wide biopsy service, show that cervical cancer and cancer of the vulva, vagina, and penis share common causes and are related to genital warts. Recently, a number of different papillomaviruses have been found in various forms of squamous-cell neoplasia of the genital tract, and similar studies would be worthwhile in tropical Africa.

Adolescent↗
PubMed2006

Pelvic exenteration for recurrent or persistent cervical cancer: experience of five years at the National Cancer Institute in Mexico.

Cervical cancer constitutes a major health problem in Mexico and other developing countries. The purpose of our study was to assess the experience of a comprehensive national oncological reference center on pelvic exenteration for post-radiotherapy recurrent or persistent cervical cancer, describing the prognostic value of time to recurrence, procedure complications, and survival. Medical records from 42 patients with post-radiotherapy recurrent or persistent cervical cancer who underwent a pelvic exenteration with curative purposes from 1984 to 1989 were retrospectively reviewed. Histological diagnoses were squamous cell carcinoma (32 patients), adenosquamous carcinoma (9 patients), and adenocarcinoma (1 patient). Average follow up was of 56.3 mo after the procedure and global survival at 5 yr was 65.8%. Survival for patients with early recurrence was 56.9% vs 78% for patients with late recurrence (p = 0.05). Complications were observed in 65.3% of the cases with a surgical mortality of 4.8%. Pelvic exenteration is a surgical procedure with high morbidity in spite of the recent medical advances. Pelvic exenteration should not be indicated with palliative purposes owing to the high rate of complications. Patients with tumor persistence or early recurrence have a worse prognosis. In well-selected cases, exenteration may provide a survival benefit.

Adenocarcinoma↗
PubMed1990

Dietary vitamins A, C, and E and selenium as risk factors for cervical cancer.

The relation between cervical cancer and dietary intake of vitamins A, C, and E, beta-carotene, and selenium was examined in a population-based case-control study in Utah. Cervical cancer cases (n = 266) and population-based controls (n = 408) were interviewed between 1984 and 1987. Protective effects were observed for vitamins A, C, and E and beta-carotene but were attenuated by age, level of education, and lifetime cigarette use. Associated risk (comparing highest with lowest quartiles of intake) went from 0.53 (crude) to 0.71 (adjusted) for vitamin A; from 0.55 (crude) to 0.82 (adjusted) for beta-carotene; from 0.45 (crude) to 0.55 (adjusted) for vitamin C; from 0.58 (crude) to 0.60 (adjusted) for vitamin E; and from 0.95 (crude) to 0.70 (adjusted) for selenium. Adjustment for number of sex partners and church attendance, factors significantly related to cervical cancer risk, only slightly attenuated these adjusted risk estimates.

Adult↗
PubMed2004

Correlation of viral factors with cervical cancer in Taiwan.

The correlation of viral factors with cervical cancer was investigated. 27 cervical cancer biopsies and 29 normal cervical scrapings were determined by polymerase chain reaction method for 6 viruses, including human papillomavirus (HPV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV)-1, HSV-2, and human herpes virus (HHV)-8. Among 27 biopsies of cervical cancer, HPV was identified in 18. Of these HPV-positive specimens, 9 cases of HPV type 16 were identified, 2 cases of HPV type 18 and 1 case of mixed infection with HPV types 16 and 18 were identified. Among the HPV types detected, type-16 is the most closely associated with cervical cancer and type-18 ranks second. Of the remaining 6 cases, 1 case of HPV-45, 1 case of mixed infection with HPV type 35, CMV and HSV-2, and 4 cases of unidentified HPV type were also found. EBV, HSV-1 and HHV-8 were not found in the cervical cancer samples and might have no or little relationship with cervical cancer. Among the 29 specimens in the normal female control group, no viral infection was detected. The correlation of HPV with cervical cancer was significantly different between frozen tissues and paraffin-embedded tissues. Other viruses such as HSV-2 and CMV are not predictive of cervical cancer. They might not be involved in the oncogenic processes directly but might enhance the possibility of oncogenesis or infect cancer tissues opportunistically.

Base Sequence↗
PubMed1995

Role of the nurse practitioner in breast and cervical cancer prevention.

Breast and cervical cancer claim the lives of more women in the U.S. each year than all other forms of cancer of the female reproductive tract combined. Early detection and aggressive treatment of these malignancies could save many women's lives, yet U.S. women often do not follow recommended screening guidelines. Nurse practitioners (NP) have important roles in primary and secondary prevention of breast and cervical cancer because their holistic perspective and advanced practice skills enable them to intervene for clients at all levels of health care. NPs are capable of not only assessing the health of their female clients, but also the system that serves client needs. They use their advanced knowledge and practice skills to educate women about cancer risk factors, and to initiate screening programs aimed at early detection and intervention. NPs monitor screening and treatment services extended to women clients, and promote high quality care by educating both professional and non-professional care givers to health care needs. Advocacy in behalf of women's health issues impacting breast and cervical cancer screening and care is an additional facet of the NP's role.

Breast Neoplasms↗
PubMed2005

Advances in the surgical management of invasive cervical cancer.

PURPOSE OF REVIEW: Cervical cancer is the second most frequent cancer in women in the world. Surgery plays a major role, particularly in patients with early-stage disease. This review focuses on the evaluation of important papers published since January 2003 on the management of invasive cervical cancer. RECENT FINDINGS: Patients are classified as having early-stage (stage IB1) or advanced-stage (stage IB2 or greater) disease. Several papers are devoted to the evaluation of prognostic factors in patients with early-stage disease and negative nodes. Several recurrences after radical trachelectomy have been reported that remind us that strict selection criteria are mandatory for conservative management. The development of sentinel node and laparoscopic procedures has gained momentum. For patients with advanced-stage disease, the place of staging procedures in para-aortic areas or pelvic surgery after chemoradiation therapy continues to be debated and is currently being investigated in randomized studies. Several papers also continue to debate surgical treatment modalities for recurrent disease (the place of laparoscopy and reconstructive surgery). SUMMARY: Several interesting papers have been published since 2003 about the surgical treatment of cervical cancer. Laparoscopic surgery and the sentinel node procedure have developed considerably, particularly for the surgical management of early-stage disease. The results of ongoing studies are awaited to determine the value of pelvic surgery (after neoadjuvant treatment) in patients with advanced-stage disease.

Carcinoma↗
PubMed2004

Human papillomavirus vaccine as a new way of preventing cervical cancer: a dream or the future?

Cervical cancer is the major cause of death in women of reproductive age in parts of the developing world. Thanks to the effectiveness of national screening programs, the incidence and mortality rates for cervical cancer have declined dramatically in developed countries. According to many researchers, human papillomavirus (HPV) infection has an important role in the development of cervical neoplasm. The effects of HPV infection on the oncogenesis of cervical carcinoma can be explained to a large degree by the regulation and function of the two viral oncogenes, E6 and E7. About 25 of >80 types infect the genital tract. HPV types are stratified into low, intermediate- and high-risk categories. Today, vaccines are available against many serious human pathogens. It is accepted worldwide that cervical carcinoma is a consequence of infection with HPV viruses. Therefore it is reasonable to assume that vaccine that prevents infection will reduce the incidence of cervical cancer. Virus-like particles are empty viral capsids, and are the leading candidate vaccines for the treatment or prevention of cervical cancer in humans. The HPV type 16 (HPV16) L1 virus-like particle vaccines have been shown to be generally well tolerated and they generate high levels of antibodies against HPV16. Since approximately 50% of cervical cancers are associated with HPV16 infection, the administration of this type of vaccine to young women could reduce the incidence of HPV16 infection, which is related to cervical dysplasia and cervical neoplasm. Vaccination against HPV infection could reduce the risk of infection and, most importantly, decrease the incidence of cervical cancer. A vaccine for cervical cancer is not a dream in the far future, it is happening today.

Cell Transformation, Neoplastic↗
PubMed1981

Epidemiological evidence for two components of cervical cancer.

Incidence rates for cervical cancer were analyzed for Finland in 1953 to 1974. The age-specific incidence rates fit an age-incidence curve based on the assumption of two epidemiological components. The time trends give support to the hypothesis that one of the components occurs at a lower age and is preceded by a carcinoma in situ stage. The risk of cervical cancer originating from the component occurring in younger women showed a decreasing trend which correlated with the organized mass screening programme. The other component occurred later in life and was not influenced by the screening programme. It was estimated that the proportion of the cases in the earlier category decreased from 53% in the 1950s to 17% in 1973 to 1974 of all cases of cervical cancer diagnosed in the Finnish population.

Adult↗