Gynecologic Oncology

On October 6, 2000 the Health Care Financing Administration (HCFA) announced that it was initiating a national policy for coverage of biofeedback treatments of urinary incontinence (UI). This is a significant development both for physicians already using biofeedback and for those contemplating adding conservative therapies to their practice.

Pantaleoni first performed hysteroscopy in 1869, but it was not until the early 1970s that hysteroscopy became part of the gynecologist's armamentarium. The need for visual appraisal of the endocervix and endometrial cavity and technical advances in instrumentation increased the awareness of, and interest in, the advantages of hysteroscopic sterilization techniques.

The National HPV & Cervical Cancer Campaign is a public education campaign whose goal is to reduce the number of preventable deaths each year by cervical cancer through increased education, outreach and communication between women and their health care providers.

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).

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

Patient safety is finally being institutionalized due to growing concern over the terrible cost of inadvertent human error. Medicine's punitive perfectibility model in dealing with unintended injury is slowly evolving to accept error during surgery, as an inevitable yet manageable reality of operations (Leap, 1994).

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.

With the media attention focused on cancer genes and registries aimed at tracing hereditary cancers, many women with a family history of cancer and some with no such history are asking their physicians for advice and testing. This article explains the nature of breast and ovarian cancer inheritance and gives recommendations for screening and intervention based on the latest findings in this fast-changing field.

During colposcopy the practitioner must determine the surface extent of the lesion; identify the most abnormal colposcopic area(s) for biopsy(ies); and identify any areas suspicious for invasive cancer. After histological reporting, correlation determines whether the lesion can be safely ablated or if it must be excised to ascertain if a microinvasive or frankly invasive cancer is present. Patients usually present with abnormal cytology suggesting squamous disease of some grade.

We are coming out of a dust bowl. When I was asked to write an article on the recent history of biofeedback for treating incontinence and the reimbursement associated with it, my first thought was that it's been a dust bowl. For the last five years we have been working with OB/GYNs, urogynecologists, and urologists from across the country who provide biofeedback.

Epithelial ovarian carcinoma claims more lives than any other gynecologic malignancy, largely because it frequently escapes detection after it has metastasized [1]. Ovarian carcinoma initially metastasizes primarily to the serosal surface of the peritoneal cavity and abdominal organs.

Ovarian carcinomas from 30 BRCA1 germ-line carriers of two distinct high penetrant founder mutations, 20 carrying the 1675delA and 10 the 1135insA, and 100 sporadic cases were characterized for somatic mutations in the TP53 gene. We analyzed differences in relation to BRCA1 germline status, TP53 status, survival and age at diagnosis, as previous studies have not been conclusive.

Despite being a preventable disease, annually cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year.

The first carefully described abdominal supracervical hysterectomy was performed by Wilhelm Alexander Freund in 1878 and it was the leading technique for over 80 years (1). Tervilä (2) described the danger of cervical cancer to be 0.3-1.9% following supracervical hysterectomy.

Vitamin E (alpha-tocopherol) is thought to play a role in several stages of carcinogenesis through its contribution to immunocomptence, inhibition of mutation formation and repair of membranes and DNA.

Epithelial Coli Uteri Carcinoma

Five-year Results

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.

Pre-op Diagnosis of Ovarian Cancer in Patients Presented with Adnexal Mass using the Risk of Malignancy Index

The aim of this study was to investigate the occurrence of (pre)neoplastic lesions in overtly normal Fallopian tubes from women predisposed to developing ovarian carcinoma. The presence of (pre)neoplastic lesions was scored in histological specimens from 12 women with a genetically determined predisposition for ovarian cancer, of whom seven tested positive for a germline BRCA1 mutation.

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.

A fast, fully automated bio-chemical system for detecting cervical cancer, developed by Ampersand Medical Corp. (OTC BB: AMPM), is capable of identifying the disease with greater accuracy than is routinely reported by Pap testing, concludes a presentation made today here at the 14th International Congress of Cytology.

With more than 24 million U.S. women diagnosed annually with human papillomavirus (HPV), the cause of virtually all cervical cancer, Ampersand Medical Corp.’s new screening technique shows promise to identify those patients that truly need to be monitored.

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.

The innervation of the pelvic structures has an important role in the surgical knowledge, especially when the surgeon is dealing with radical surgery for cancer and with extensive surgical procedures for deep infiltrating endometriosis.

Laparoscopy succeed in overcoming technical difficulties and poor outcome of traditional open ureteroureteral distal anastomosis. A technique for laparoscopic repair of injury involving the distal ureter has been successfully developed.

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.

There are many ways to treat cervical dysplasia (CIN). Factors influencing the choice of treatment for cervical dysplasia include the extent and severity of the dysplasia, the age of the woman, and whether or not she has any other gynecological problems.