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If the biopsy test result is negative but the patient is at high risk of uterine cancer, the patient may need to have a D&C (Berek JS et al 2000). In this procedure, the physician dilates the woman's cervix and removes a sample of uterine tissue. The physician or a technician examines the tissue sample under a microscope for the presence of cancerous cells. A D&C is more accurate at diagnosing uterine cancer than is an endometrial biopsy (Lotfallah H et al 2005). laptop battery

Pap Test

The Pap (short for Papanicolaou) test detects cervical cancer but is not a good test for detecting uterine cancer. A Pap test will fail to diagnose uterine cancer about 87 percent of the time (Nassar A et al 2003). Occasionally, uterine cells shed and appear on a Pap test. When this occurs in a postmenopausal woman, further evaluation is required. About 25 percent of postmenopausal women with abnormal uterine cells on their Pap tests will have uterine cancer (Berek JS et al 2000). However, about 6 percent of postmenopausal women whose Pap test results show normal uterine cells actually have uterine cancer (Ng AB et al 1974). thinkpad

Predicting the Prognosis

Once uterine cancer has been diagnosed, magnetic resonance imaging ( MRI ) is often performed to evaluate the extent of disease. MRI is particularly useful in determining the depth of cancer invasion within the uterus (Robert Y et al 2002). Patients thought to have more advanced disease may be referred to a gynecologic cancer center for extensive surgery and treatment (Berek JS et al 2000; Purdie DM et al 2001). microsoft

Understanding the Staging System

Approximately 75 percent of women with uterine cancer have stage I (mild) disease. Of these women, almost 90 percent have no sign of cancer 5 years after surgery (Juretzka MM et al 2005). The possibility of curing the disease decreases as the cancer becomes more advanced (Juretzka MM et al 2005). Advanced disease has a poor prognosis; the 5-year survival rate for stage III is 29 percent and declines to 10 percent for stage IV (Magrina JF et al 2004). laptop computers

Table. International Federation of Gynecologists and Obstetricians (FIGO) Uterine Cancer Staging System

Stage I (mild) laptop computer

Cancer found only in uterus desktop computer

Stage II notebooks

Cancer in uterus and cervix, but not outside uterus lenovo

Stage III hard drive

Cancer in uterus and beyond, but not outside pelvis travelstar

Stage IV (most advanced stage) gateway

Cancer beyond pelvis, in bladder, bowel, or other areas of the body laptop parts

(Berek JS et al 2000) software

Decoding the Pathology Report

After the surgeon removes the uterine cancer tissue, it is sent to the pathology laboratory for analysis. A technician examines the tissue for the absence or presence of hormone receptors (places where hormones can attach) within the tumor (Martin R et al 1993). Most uterine cancer cells possess receptors for estrogen or progesterone, or for both (Gurpide E 1981; Kedzia W 1996). This is why uterine cancer is often classified as a hormonally responsive cancer. hard drives

Patients who have tumors that test positive for progesterone and/or estrogen receptors typically have longer survival rates than patients whose tumors lack these hormone receptors (Creasman WT 1993; Friberg LG et al 1993). However, progesterone receptors appear to be a stronger predictor of long-term survival than estrogen receptors (Dai D et al 2002). Tumors with progesterone receptors have a much greater response to progestin therapy than do tumors without progesterone receptors (Dai D et al 2005; Ehrlich CE et al 1988). electronics

If the cancerous tissue contains estrogen and/or progesterone receptors, it may be responsive to hormonal therapy, particularly if the cancer recurs (Ayoub J et al 1988; Bokhman I et al 1987; Lotze W et al 1982; Martin R et al 1993). Therefore, it is recommended that the cancerous tissue be analyzed for the presence of estrogen and/or progesterone receptors at the time of surgery (Ayoub J et al 1988; Bokhman I et al 1987; Martin R et al 1993; Thurzo L 1990). canon

Medical Treatment

The following surgeries and therapies are used to treat uterine cancer. desktop pc

Surgery

Removing the cancer in an operation is the most common treatment of uterine cancer. During surgery, the physician evaluates the extent of the cancer and uses a staging guide to assess each patient's cancer stage. The following surgical procedures may be used: desktop computers

• Radical hysterectomy

  —The primary treatment of uterine cancer is a hysterectomy in which the uterus, fallopian tubes, cervix, ovaries, surrounding tissue, and lymph glands are removed. A radical hysterectomy is usually done through the abdomen. think pad

• Total hysterectomy

  —This type of hysterectomy involves removal of just the uterus and cervix. It can be done through the abdomen or through the vagina. Sometimes a total vaginal hysterectomy can be done with the aid of a laparoscope (a viewing instrument passed through a small incision in the abdomen). repair

• Bilateral salpingo-oophorectomy

  —A bilateral salpingo-oophorectomy is the removal of both ovaries and both fallopian tubes via surgery. It is used in conjunction with a hysterectomy. data recovery

Radiation

If the cancer is confined to the uterine lining, usually no additional treatment after surgery is needed. However, if the cancer has spread further, then radiation treatment after surgery may be indicated (McMeekin DS et al 2003). cisco

Depending on the results of the surgical staging and the existence of high-risk factors, radiation may be recommended immediately after surgery (postoperative) to minimize the possibility of the cancer returning (Kao MS 2004). Radiation has been shown to decrease the incidence of both pelvic and vaginal cancer recurrences (Berek JS et al 2000). Radiation appears to benefit women who have cancer in their para-aortic lymph nodes (Kao MS 2004; Morrow CP et al 1991) and improves 5-year survival rate by nearly 40 percent (Murphy KT et al 2003). Brachytherapy is a one-time intravaginal radiation treatment that produces a high dose of radiation close to the cancer and a lesser dosage in healthy tissues, thus producing fewer adverse effects. keyboard

Treatment of recurrent cancer

The likelihood that uterine cancer may recur depends on the extent of the disease and the success of the initial treatment (Kao MS 2004). Approximately 34 percent of all recurrences are detected within 1 year and 76 percent within 3 years of primary treatment. The cancer usually recurs in the pelvis (i.e., locally), not in distant parts of the body (Mariani A et al 2004). monitor

Chemotherapy and hormonal therapy are not recommended as standard treatment when uterine cancer is initially diagnosed (Lewis GC Jr et al 1974; Mariani A et al 2004; Yahata H et al 2004). However, they are sometimes recommended if the cancer recurs after surgery and radiation (Kao MS 2004; Yahata H et al 2004). desktop

Hormonal therapy

Endometrial cancer is a hormone-dependent disease. Therefore, hormonal therapy added to standard treatments may improve the outcome in the early stages of the disease (Li CZ et al 2003; Montz FJ et al 2002; Piver MS 1988; Urbanski K et al 1993). Hormonal therapy is not usually recommended as standard treatment when uterine cancer is diagnosed; however, it has been used after hysterectomy with some success (Bokhman I et al 1987; Li CZ et al 2003). Hormonal therapy has also been demonstrated to be useful in treating selected patients who have widespread uterine cancer that has returned after treatment; it is used primarily to relieve symptoms (Kao MS 2004; La Vecchia C et al 1986). infosys

Uterine cancer with progesterone receptors is more responsive to progestin therapy than if progesterone receptors are lacking (Ehrlich CE et al 1988). Therefore, future therapeutic regimens targeted at enhancing progesterone receptor expression have the potential to improve outcomes in women with uterine cancer (Dai D et al 2005; Gurpide E 1981). Progestin therapy is most commonly prescribed in pill form, but intramuscular injection of medroxyprogesterone acetate (MPA; a synthetic progestin) and intravaginal forms are also available (Li CZ et al 2003; Thurzo L 1990). Adverse effects of progestins are usually minor and include weight gain, edema (swelling), and headache; however, blood clots can occur (Benagiano G et al 2004; Neumann F 1978; Warren MP et al 1999). Unlike synthetic progestins (such as MPA), micronized progesterone has been reported to cause only fatigue and sleepiness. refurbished laptops

Heading Toward Hormones

Therapy with one of a number of progestational agents has been the conventional approach to the management of endometrial carcinoma in cases where surgery or radiation therapy is not recommended, particularly in obese women. Progestins such as MPA in particular are considered useful in treating uterine cancer (Urbanski K et al 1993). MPA has been widely used both intramuscularly and orally in a variety of doses and schedules. wipro

While the role of MPA in the palliative treatment of advanced disease is well accepted, opinion is divided on its role in the adjuvant setting (treatment given after surgery to increase the chances of a cure). The commonly used progestational agents megestrol acetate, hydroxyprogesterone, and MPA all produce similar response rates, and the antiestrogen tamoxifen produces responses in 10 percent to 25 percent of patients in the final phase of medical treatment. lap top

Natural progesterone is obtained primarily from plant sources and is currently available in oral and injectable forms and in topical gels. An oral micronized progesterone preparation is also available. It has improved bioavailability and fewer reported adverse effects when compared with synthetic progestins (Apgar BS et al 2000). Natural progesterone is used to prevent uterine cancer. However, currently there is little evidence that progesterone can be used to treat uterine cancer once it has been diagnosed (Apgar BS et al 2000). refurbished

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Periodontitis and Cavities Updated: 02/15/2006

There are many good reasons to keep your teeth and gums healthy. Healthy teeth and gums not only look better, but they also promote better eating habits and nutrition. By contrast, unhealthy, inflamed gums are associated with various diseases, including coronary heart disease and an elevated risk for heart attack, while tooth loss is linked to malnutrition. as400

In a healthy mouth, the teeth are intact and anchored in pink, firm gums that do not bleed during brushing. A regular tooth care program should include flossing and brushing twice daily, as well as regular visits to the dentist for cleaning and examination. averatec

Gum disease and tooth loss are especially common among the elderly. Some researchers believe that the malnutrition that afflicts older people may be in part due to poor dentition (the type, number, and arrangement of a set of teeth). In fact, some researchers believe that the short life span of early humans was related to tooth loss that caused starvation (Goodman AH 1989; Story R 1986). hardware

The three most common problems in the oral cavity are dental caries (cavities) and the periodontal diseases gingivitis and periodontitis. These are caused by multiple factors, including plaque buildup, diet, oral hygiene, genetics, environment, and lifestyle factors. For more information on gingivitis, the most common dental disease, see the chapter titled Gingivitis . Dental caries and periodontitis are discussed in this chapter. dual xeon

Cavities

Dental caries, or cavities, occur when microorganisms build up in deposits of dental plaque and ferment dietary sugars. The byproduct of this fermentation, lactic acid, lowers the pH at the junction of the plaque layer and tooth enamel, and eventually the enamel is eroded (Geddes DA 1991). storage

The layer of plaque in the mouth has recently been redefined as “biofilm” (Rudney JD 2000). Biofilm develops in a predictable pattern, whereby oral bacteria colonize areas of the gums and teeth, then spread and eventually link with other organisms in a cohesive film. This film can occur both above and below the gum line. If left intact, it may form a hard, mineralized mass called calculus (tartar) (Bernimoulin JP 2003). This is the hard, yellow substance that dentists scrape off with specialized equipment. Tartar contains masses of bacteria that produce lactic acid and promote tooth decay. Brushing and flossing alone cannot penetrate or remove the tartar. seagate

One novel hypothesis for disrupting the creation of biofilm and preventing tartar involves oral vaccines that may protect the mouth against Streptococcus mutans ( S. mutans ), the bacteria most commonly responsible for dental cavities. Human studies have shown encouraging results with antibodies designed to suppress colonization of S. mutans in the biofilm (Michalek SM et al 2004). computer sales

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Based on the nourishing ingredients and UV protection in this product, Maui SolarMax can be considered a healthy skin guard. It’s also safer for sensitive skin—it has no PABA or benzophenone. printers

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