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Cervical Cancer -The Cervical Smear Test

After the age of 20 years, women are invited by their GP to have a cervical smear test. The test is usually performed by the GP or practice nurse and involves visualization of the cervix with a speculum and sampling of the cells from the surface of the cervix - from the area around the cervical opening or os - this area is known as the transformation zone.
Cells on the surface of the cervix are collected on a wooden spatula and fixed onto a glass slide. The slides are subject to a staining process (by Papanicolau's method - hence the alternative name of Pap smear) in the laboratory and are then examined to detect the presence of pre-cancerous cells. Abnormal cells are termed dyskaryotic (meaning abnormal nucleus of the cell) and are graded as mild, moderate or severe, depending on the degree of abnormality present.

If the cells are normal then this is known as a negative smear. A positive smear is one where dyskaryotic cells are present. A high proportion of smears are neither negative nor positive. The sample may be unsatisfactory, or the cervical cells may be obscured by red or white blood cells, as may occur in the presence of infection. A smear may also be reported as borderline, which suggests minor cellular abnormalities, not amounting to dyskaryosis.

Negative smears are usually repeated every three to five years, unless there has been a recent abnormality. Positive smears are referred for colposcopy. Other grades of smear are usually repeated at three to six months.

Cervical Cancer - Screening

The cervical cancer screening program in the UK is one of the most effective in the world. Women between the ages of 20 - 64 are invited to have a cervical smear test at three to five year intervals. The percentage of the eligible population being screened has risen from 45% in 1988-89 to 83.7% in 1999-2000.
Although no screening program can be 100% effective, it is estimated that the screening program prevents between 1,100 and 3,900 cases of cervical cancer each year. The aim of cervical cancer screening is to detect abnormalities of the cervix at the pre-invasive stage of the disease. This is usually termed pre-cancer and implies an abnormality of the outer skin or epithelial layer of the cervix, which, if untreated may progress to invasive cancer. Cells shed from an area of pre-cancer may be detected by the cervical smear test.
Most (but probably not all) cancers of the cervix go through this pre-cancerous phase and its detection and treatment can effectively prevent the progression to invasive disease.It is believed that the majority of pre-cancerous changes are caused by infection with the human papilloma virus, or wart virus (HPV). Not all types of HPV cause pre-cancerous changes but certain strains of this virus are more prone to incorporate themselves into the nucleus of the cell and cause abnormal division of that cell which initiates the growth of the abnormal tissue. This process is called neoplasia (new growth).
The time scale from the initiation of the neoplastic process to the development of invasive cancer is usually over many years and therefore regular smear tests can detect this process before invasion occurs. When pre-cancerous cells are identified on a smear, the next step is an examination of the cervix to identify and, where appropriate, treat the abnormal area on the cervix. This examination is called colposcopy.

Cerviacal Cancer - Diagnosis and Treatment

Staging of the disease is by a careful examination under anaesthesia to determine the extent of local spread, with a cystoscopy (an endoscopic examination of the bladder) to exclude spread into the bladder, and, where warranted, a sigmoidoscopy (an endoscopic examination of the lower bowel) to exclude spread into the bowel. Most units will also perform an MRI scan to look at local disease and also to identify any enlargement of the draining lymph nodes (glands on the side wall of the pelvis to where the cancer cells will spread first).

Treatment of the disease is by surgery, chemotherapy and radiotherapy. These are administered alone, or in combination, and the main determining factor is the stage of the disease. For early stage disease surgery is usually recommended. The standard operation is a radical hysterectomy (also known as Wertheim's hysterectomy). Radiotherapy is given for later stages and when there is spread to the lymph glands (usually identified by the pathologist after the glands are removed at surgery). Increasingly, oncologists are using chemotherapy in combination with radiotherapy for advanced stage disease.

It should be emphasised that treatment of cervical cancer should be tailored to the needs of the individual, after a full and frank discussion with the patient and her relatives. All cervical cancer treatment (apart from cases of early microscopic invasion) should be delivered in recognized cancer centers by a team including a specialist gynaecological cancer surgeon, a clinical oncologist and a specialist nurse. They should be part of a large team, including a radiologist and pathologist with a major interest in gynaecological cancer.

Development of specialist teams has been recognized as the way forward to deliver an improved quality of care. This is also important, as, with a reduction in the number of cases of cervical cancer, fewer units will maintain the expertise to offer optimal treatment.
Cancer of the cervix is becoming a rare disease in the UK. This is largely attributable to the success of the cervical screening program. The main emphasis is now in the prevention of cervical cancer - by the detection and treatment of cervical cancer at its pre-invasive stage.

Signs and Symptoms of Cervical Cancer

As a cancer of the cervix grows and invades the surrounding tissues it may form a tumour or lump on the cervix slide photograph. Most commonly the growth causes ulceration, which means breaking down of the epithelium and deeper tissues. As the tumour grows, the ulcer enlarges and grows away from its original site, leaving dead tissue at that site. This is known as necrotic tissue and often becomes infected.
Early symptoms of a cervical cancer are abnormal bleeding and a watery or mucous discharge. The bleeding may occur between periods or after intercourse. If there is secondary infection of the cancerous area then the discharge usually becomes thick and offensive.
If any of these symptoms occur then the cervix should be visualized with a speculum (as in a smear test) to exclude a tumour or ulcer. It should be emphasised that abnormal bleeding and vaginal discharge are extremely common symptoms and cervical cancer is a rare cause of these symptoms.
Cervical cancer is diagnosed by examination of a sample of the tumour (a biopsy) by a histopatholgist. The biopsy may be taken in the clinic by the examining gynaecologist or it may be taken as part of an examination under anaesthetic when the stage of the disease is determined.

Cervical Cancer - an Introduction

Cervical cancer is a major health problem in the world today. In some developing countries it is the commonest female cancer. It is estimated that around 370,00 cases of cervical cancer are diagnosed in the world each year.

In the UK the situation continues to improve. In 1997 there were 2,740 cases of cervical cancer in England and Wales with 1,222 women dying of this disease. This represents a death rate of around 4 per 100,000. This compares with a death rate in 1979 of 7 per 100,000, which is an improvement of over 40%.

Invasive cancer of the cervix occurs when abnormally dividing cells, which arise in the outer layer (or epithelium), invade into the deeper tissue layers. The resulting mass (or tumour) of invading cells continues to divide and enlarge as it invades the surrounding tissue. Cells may break off from the primary tumour and spread (or metastasise) via the lymphatic or blood vessels to distant sites. The size and degree of invasion of the cancerous tissue will determine the stage of the disease. Accurate staging of cervical cancer is vital in determining the optimum treatment. There are two main types of cervical cancer; cancers arising from squamous epithelium (squamous carcinoma), which covers the outer cervix i.e. that portion which protrudes into the vagina, and glandular cancers (adenocarcinoma) arising from the gland bearing epithelium of the cervical canal (leading up to the cavity of the uterus). Squamous cancers are the most common type of cancer of the cervix and it is this type of cancer that the cervical screening programme is specifically designed to prevent, although adenocarcinoma may also be detected/prevented by cervical smears.
Cervical cancer is a disease of young women and most commonly occurs around the mid 40's. It can affect a wide age range and women in their 20's may develop the disease.

13th August 2009: Press Meet on Swine Flu Prevention Programme at Allahabad

News on the Internet
http://news.webindia123.com/news/articles/India/20090813/1318193.html

copy of media coverage coming soon.....

The Swine flu Prevention Programme from Herbalage

The formulations and herbs used in Swine flu prevention Programme have been researched by Shree Baidyanath Research Institute and have been spread all over through Herbalage Anti-Aging Network through its unique Direct2Consumer system. They are a blend of well-researched natural immunomodulators known to support and boost the immune system, fight flu infections, help heal injuries resulting from infections and control other conditions that lay the foundation for Swine flu and other diseases.

These immunomodulatory herbs in Ayurvedic terminology are called rasayanas (rejuvenating) i.e. they maintain the balance between all the doshas (humors) and also clarify all the srotas (body channels) through which nutrients are supplied. Due to proper functioning of srotas (body channels), doshas (humors) remain in their proper amount i.e. the samavastha (balanced condition) ultimately resulting in a balanced Immunity.

Emergency Warning Signs of H1N1 - Swine Flu

In children, emergency warning signs that need urgent medical attention include:
• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough

Basic Precautions to keep H1N1 - Swine Flu away

Swine flu in India is spreading like wildfire. Officials say there are currently more than 1000 cases of the H1N1 flu strain in India. The following prevention tips help.

1. Boost your immune system
Keeping your body strong, nourished, and ready to fight infection is important in flu prevention. So keep using immunomodulator herbs and formulations such as Immuno Plus, Guduchi, Tulsi etc.

2. Wash your hands frequently
Use the antibacterial soaps to cleanse your hands. Wash them often, at least 15 seconds and rinse with running water.

3. Get enough sleep
Try to get 8 hours of good sleep every night to keep your immune system in top flu-fighting shape.

4. Keep hydrated
Drink 8 to10 glasses of water each day to flush toxins from your system and maintain good moisture and mucous production in your sinuses.

5. Keep away from sick people
Flu virus spreads when particles dispersed into the air through a cough or sneeze reaches someone else’s nose. So if you have to be around someone who is sick, try to stay a few feet away from them and especially, avoid physical contact.

What precautions should one take at home?

Two things - soap and water can reduce the chance of infection by 20 % and boosting your immunity reduces the chance of infection by 50 %. All you need to do is keep washing your hand with soap and water frequently and boost up your immunity by doing regular exercise, taking herbs and eating healthy.

What precautions should one take at school?

Avoid close contact with people who are sick
People who are sick with an influenza-like illness should stay home and keep away from others as much as possible; including avoiding travel, for at least 24 hours after fever is gone except to get medical care or for other necessities. (Fever should be gone without the use of fever-reducing medicine). Cover your mouth and nose with a tissue when coughing or sneezing
Wash your hands often
Avoid touching your eyes, nose or mouth

How do Immuno Plus, Guduchi and Tulsi capsule work on H1N1 - Swine flu?

Modulation of immune functions by using medicinal plants and their products as a possible therapeutic measure has become fundamental principles of therapeutic approach. Plants and minerals have been used since ancient times for the treatment of many ailments and diseases. It is now being recognized that immunomodulation of immune response could provide an alternative to conventional chemotherapy for a variety of disease conditions, especially when host's defense mechanism have to be activated under the conditions of impaired immune responsiveness or when a selective immunosuppression has to be induced in situation like autoimmune disorders and organ transplantation

The formulations and herbs such as Immuno Plus, Guduchi and Tulsi capsule have been researched by Shree Baidyanath Research Institute. They are a blend of well-researched natural immunomodulators known to support and boost the immune system, fight flu infections, help heal injuries resulting from infections and control other conditions that lay the foundation for disease.

These immunomodulatory herbs in Ayurvedic terminology are called rasayanas (rejuvenating) i.e. they maintain the balance between all the doshas (humors) and also clarify all the srotas (body channels) through which nutrients are supplied. Due to proper functioning of srotas (body channels), doshas (humors) remain in their proper amount i.e. the samavastha (balanced condition) ultimately resulting in a balanced Immunity.

What does Ayurveda have to say about Swine Flu?

In Ayurveda, health ailments like swine flu are because of weakened immunity that the body cannot withstand against the attack of disease causing germs. Ayurveda, as always, believes in strengthening the body systems that fight and win the battle against H1N1 Virus. This is done by prescribing various immunomodulatory herbs such as Aswagandha (Withania somnifera), Pippali (Piper longum) ,Shatavari (Asparagus racemosus) , Sunthi (Zingiber officinale) , Vidarikand (Pueraria tuberosa), Bhallatak (Semecarpus anacardum), Guduchi and Tulasi (Holy Basil). They also act as antiviral and antibacterial too.

How does H1N1 - Swine Flu spread?

The new swine flu virus is highly contagious, that is it spreads from person to person. The virus is spread through the droplets that come out of the nose or mouth when someone coughs or sneezes. If someone coughs or sneezes and they do not cover it, those droplets can spread about one metre (3ft). If you are very nearby you might breathe them in.

Or, if someone coughs or sneezes into their hand, those droplets and the virus within them are easily transferred to surfaces that the person touches, such as door handles, hand rails, telephones and keyboards. If you touch these surfaces and touch your face, the virus can enter your system, and you can become infected.

What are the symptoms of Swine Flu?

Swine flu symptoms are similar to the symptoms of regular flu and include fever of over 100.4°F, fatigue, lack of appetite, and cold. Some people with swine flu have also reported runny nose, sore throat, nausea, vomiting and diarrhoea. Nearly everyone with flu has at least two of these symptoms

Why is novel H1N1 virus sometimes called “swine flu”?

This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs (swine) in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and bird (avian) genes and human genes. Scientists call this a "quadruple reassortant" virus.

What is novel H1N1 (swine flu)?

Novel H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. This virus is spreading from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization (WHO) signaled that a pandemic of novel H1N1 flu was underway.