Download Pap Smear Crucial for Early Detection Of Common Women`s Health

Pap Smear Crucial for Early Detection
Of Common Women’s Health Problems
A simple in-office test for women, called the Pap smear, can help doctors detect early signs of
what was once the most common cancer in women, cervical cancer. Regular Pap smear
screenings have diminished the cancer’s mortality rate and, today, cervical cancer has fallen to
seventh in the ranks of cancers in women.
The Pap test is standard in routine gynecological exams. By gently taking sample cells from the
cervix, gynecologists can detect abnormalities that warn them of the possibility of cancer.
“Removing these cells early is key,” said Dr. Ronald P. Portadin, of Vineland Gynecology
Associates. “Cervical cancer usually shows no symptoms and its progress is slow. It might be 10
years before the cancer goes from a group of abnormal, or dysplastic, cells to full blown invasive
cancer. The Pap is usually our only way of knowing something is amiss. And if we catch cervical
cancer early, while it is confined to the cervix, it is curable in virtually all cases.”
The Test
Gynecologists insert a speculum and a tiny spatula to scrape sample cells from the area of the
cervix that protrudes into the vagina. The doctor also uses a small brush in the endocervical
canal, the tunnel into the uterus, and picks up epithelial cells as an additional sample. The slides
containing the samples are sent to a laboratory for analysis.
“Ninety percent of all cervical cancers originate in the area from which we take a sample,” said
Portadin.
Results vary according to the types of cells detected. The classification system most widely used
is the Bethesda system, a program adapted by clinicians to standardize how cervical cell changes
are classified. “Abnormal cells don’t necessarily mean cancer; rather, they show a degree of
change. Measuring this degree allows doctors to determine the next steps to take,” said
Portadin
Atypical cells are least worrisome. These show some changes, but might result from a yeast or
bacterial infection, inflammations or normal tissue repair, and these are normally not cancerous.
Low-grade squamous intraepithelial lesions show mild dysplasia, which is an abnormal cell
growth that could signal cancer. High-grade squamous intraepithelial lesions send a warning to
doctors that a patient has moderate or severely dysplastic cells.
“While these lesions, in most cases, do not necessarily lead to cancer, they can be pre-cancerous
and, therefore, require careful monitoring and frequent testing and treatment,” said Portadin.
After an abnormal Pap
A woman found to have abnormal epithelial cells on a Pap smear sometimes undergoes a more
extensive procedure that gives doctors a detailed picture of what’s going on. The test, a
colposcopy, is an office procedure during which the doctor uses a lighted microscope near the
vagina to examine the cervix. The doctor then takes samples, or a biopsy, of tissue from
abnormal looking areas.
“In many cases, we’ll combine the colposcopy with endocervical curettage (scraping), to take a
thin layer of tissue from the endocervical canal. These biopsies can reveal and confirm the type
and degree of abnormality,” said Portadin.
At this early stage, the condition is still completely curable, even if the entire thickness of the
tissue is affected. It is when the disease affects the underlying tissue of the cervix or neighboring
tissue that doctors consider the patient to have more severe cancer. And, at this stage, the
cancer can be more difficult to cure.
“Cervical cancer treatment offers patients options based on the degree of cancer and our
patients’ preferences. Most women respond well to in-office procedures or laser therapy, but
some require more extensive treatment, primarily hysterectomies, radiation or chemotherapy,”
said Portadin.
According to the gynecologist, the less invasive treatments include cryotherapy, laser therapy,
and a procedure called the loop electrical excision procedure (LEEP). Cryotherapy, an in-office
treatment, involves destroying the abnormal tissue by freezing. With laser therapy, the
physician uses high-intensity light beams to evaporate abnormal tissue. Sometimes laser
therapy can be done in the office, but often it is performed in surgery centers or hospitals.
Doctors performing LEEP remove the abnormal tissue by inserting an electrically charged wire
loop. The loop removes the tissue without destroying it so the tissue can be examined later.
Patients with a severe degree of dysplasia or the possibility of invasive cancer might undergo
conization. This more extensive procedure involves removing a cone-shaped segment of tissue
in the operating room, under anesthesia. A hysterectomy is the surgical removal of the uterus
and cervix. Extensive cancer might also warrant the removal of the ovaries, fallopian tubes and
surrounding lymph nodes. Radiation and chemotherapy are also an option in widespread
uterine cancers. These therapies can help to destroy cancer cells that surgery misses.
“Women today should have regular Pap tests. These tests are generally covered by insurance,
usually involve little if any pain, and can be done in seconds in the doctor’s office. As with all
cancers, an ounce of prevention can make a difference between a curable and incurable
cancer,” said Portadin.
Ronald P. Portadin, M.D., earned his degree from Georgetown University in Washington, D.C. He
is board certified in obstetrics and gynecology and is a Fellow of both the American College of
Obstetrics and Gynecology and the American College of Surgeons. Dr. Portadin is also a member
of the American Society of Colposcopy and Cervical Pathology, the American Fertility Society,
New Jersey Obstetrical & Gynecology Society and The Society of Surgeons of New Jersey. He
practices gynecology and has expertise in colposcopy and cervical disease and laser surgery.
About the Pap Test
Dr. Portadin answers common questions about the Pap smear.
How often should women have Pap tests?
Women should start at age 18 or when they become sexually active with annual Pap test and
pelvic exams. However, women with HPV or HIV, who smoke, or who have multiple sexual
partners, or take the pill, should be screened at least semi-annually. Women with a history of
abnormal results should also be screened more often.
Do I need a Pap smear after hysterectomy?
Yes. Having a hysterectomy does not preclude a woman from getting gynecologic cancers.
What are the symptoms of uterine, or cervical, cancer?
Cervical cancer can be without noticeable symptoms; however, abnormal bleeding is sometimes
a symptom.
Who is most at-risk?
Women who become sexually active at an early age, and, also, those who smoke or use drugs,
and have multiple sexual partners are at increased risk.
VGA offers an exemplary tradition of women’s care based on years of medical
experience supported by a caring and knowledgeable staff in a modern office setting.
The board-certified physicians of VGA are Ronald Portadin, MD and Jonathan Gewirtz,
MD. Together with Nurse Practitioners Cindy Nevara and Rita Vastano, they bring
outstanding women’s health care to 1318 S. Main Road, Building 3, in Vineland.
For more information, or to schedule an appointment, visit www.VGAVineland.com or
call (856) 462-6350.