Is there any way the doctor can examine the cervix, the vulva, and the vagina without an operation?

Yes. The colposcope allows the doctor to look into parts of a woman's reproductive system the cervix, vulva, and vagina without operating. The colposcope is basically a microscope on a stand. It gives a lighted, magnified view showing greater detail than can be seen by the naked eye. Since using the colposcope properly requires special training, many doctors refer their patients to physicians who are specialized in this technique. Doctors can also biopsy the organs with this technique. No anesthesia is needed. The procedure usually takes only 10 or 15 minutes.

What is the Schiller test? 

The Schiller test, which is usually done in the doctor's office, is the staining of cervical cells on the cervix in order to locate possible cancerous cells.

Why must a biopsy be done? Doesn't the Pap smear indicate whether or not I have cancer? 

The Pap smear is only a screening tool. Although it is very accurate as a screening device, a biopsy must be done to give a definite diagnosis of cancer. The biopsy also is essential for staging the disease. If the cell samples from the Pap smear show abnormality, additional diagnostic tests are performed. They may include colposcopy or conization. What do the terms dysplasia and hyperplasia mean when used in reference to cancer of the uterus.

Dysplasia is a term used in describing a condition in the cervix. The cells covering the cervix usually go through mild to severe changes before becoming cancer. These changes are called dysplasia. Similar changes in the tissue lining the uterus are called hyperplasia. Dysplasia develops most often in women between the ages of 25 and 35, but it may also develop in women in their late teens or early twenties.

Does dysplasia or hyperplasia always lead to cancer? 

No. These precancerous conditions do not necessarily lead to cancer. It is important, however, that any woman with such a condition be treated and then examined by a physician at regular intervals.

What is carcinoma in situ? 

Carcinoma in situ is the earliest stage of cancer. It means that the cancer is confined to its original site. If not detected and treated properly, the cancer cells go into deeper layers of the uterus, then spread to neighboring organs such as the vagina, bladder, or rectum, and eventually metastasize to other parts of the body.

Does carcinoma in situ of the cervix usually become invasive cancer? 

Usually the process of carcinoma in situ becoming invasive cervical cancer is very slow. Some studies have shown that between 30 and 70 percent of in situ carcinomas will develop into invasive cancer over a period of 10 to 12 years. However, in a small percentage of patients, the in situ cancer can develop into invasive cancer of the cervix in under a year. Invasive cancer of the cervix may be preceded by early cervical conditions that usually don't cause symptoms. In fact, cervical cells may go through a series of changes from normal to abnormal (dysplasia) to very early cancer (cancer in situ) to invasive cancer.


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