What is a radical neck dissection? when is it done?

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What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

Can a pap smear detect cancer of the uterus

A Pap smear can accurately detect cancer of the cervix, but it is substantially less accurate for detecting cancer of the body of the uterus (endometrium), the fallopian tubes, or the ovaries. In cases where these types of cancer are discovered through a Pap smear it is because the cancer cells have passed down through the tube into the cavity of the uterus and continued out through the cervix and into the vaginal discharge.

In other words, the Pap test is really designed only to detect cervical cancer? 

That is correct. Regular Pap smears help make cervical cancer a preventable disease. Since cells from the cervix are continually being sloughed off into the normal discharge from the cervix and vagina, the Pap smear makes it possible for most cervical cancer to be detected before it has had an opportunity to invade or spread. The use of the Pap smear has helped to drop the death rate for women with cervical cancer by 60 percent in the last 30 years.

Is it painful to have a Pap smear? 

No. There is little or no discomfort and most doctors include it as a part of the regular pelvic examination. It is a good idea for all women over the age of 20 and most especially for women of menopausal age to have regular Pap smears. If you have a special, high risk situation, your physician may require a smear to be taken more often than once a year.

How can I be sure I'm getting an accurate Pap smear? 

The accuracy of your Pap smear depends on the quality of the laboratory interpreting the glass slide which is sent by the doctor and so it is important to have a doctor who is fussy about the lab he uses.

However, women themselves can ensure a more accurate reading if they follow these suggestions:

• Don't douche for at least 3 days before your Pap test. If you do, there won't be enough loose cells in your vaginal fluid for an accurate test.

• Use shower instead of tub bath for at least 48 hours before the test.

• Don't use tampons or birth control foams or jellies for 5 days before your appointment.

• Try to arrange your appointment between days 15 and 20 of your menstrual cycle.

Is It necessary to have a Pap smear after a woman has had a hysterectomy? 

That depends upon why the hysterectomy was done and what was removed. If the cervix is still present, Pap tests are necessary. If the hysterectomy was done because of cancer, it is absolutely necessary to have a regular Pap test. You should discuss this with your doctor.

I usually douche before going to the doctor for a gynecological exam. Is this wise? 

No, it is not. Since the Pap smear is based on an examination of the actual vaginal discharge, a smear would not be accurate if you have douched during the few days prior to the examination. You should not douche for at least 3 days prior to the day of your examination, because a douche washes away the vaginal discharge which is examined in the Pap smear.


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