Does preoperative serum squamous cell carcinoma antigen level predict occult extracervical disease in patients with stage Ib invasive squamous cell carcinoma of the cervix?
The incidence of invasive squamous cell cancer of the cervix has decreased in the US. The lack of methods to detect disease spread (metastasis) has inhibited efforts to improve survival rates in women with cervical cancer. Tumor antigens can be measured in the blood to detect the presence of certain cancer cells. A measurement of the squamous cell carcinoma antigen has been studied in patients with invasive cancer of the cervix, that is, cancer that has invaded underlying tissue. Over half of the patients with invasive cervical cancer have high squamous cell carcinoma antigen at initial diagnosis. This measurement can also be used to assess the effectiveness of cancer treatments. The usefulness of the squamous carcinoma antigen measurement in early, pre-invasive cervical cancer is unclear. Sixty-five women with stage Ib disease were studied before scheduled hysterectomy (surgery to remove the uterus). The usefulness of the antigen measurement in predicting the spread of disease to other areas of the body was also studied. Cancer appeared limited to the cervix without evidence of disease spread after surgery in 45 (69 percent) of the patients. Of these 45, 41 had normal squamous cell carcinoma antigen levels and four had abnormal levels. Of the 20 with evidence of disease spread at the time of surgery, 13 (65 percent) had high tumor antigen levels. There was no relationship between the degree of tumor antigen increase and the location of disease spread. It is concluded that the measure of squamous cell carcinoma antigen was not sensitive enough to be used as a screening method for hidden cancer spread. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Use of serum CA 125 measurement in posttreatment surveillance of early-stage endometrial carcinoma
The level of CA 125, a cancer antigen or protein found in the blood, is used to monitor patients with advanced ovarian and endometrial cancer. The measurement is a way of assessing whether the cancer cells have spread to other areas of the body or if the disease has regressed. To determine the value of CA 125 measurements for monitoring the status of early endometrial cancer once treatment has been initiated, patients treated for endometrial adenocarcinoma (stages I and II) were studied. Of the 125 patients with early endometrial cancer, 123 had normal CA 125 levels before treatment. The disease returned in 13 patients. All the patients with cancer cells that had spread to the pelvis (one patient), abdomen (four patients), and lungs (two patients), had high CA 125 levels. None of the six patients with cancer cells recurring in the vagina had high CA 125. Intestinal blockage occurred in four patients receiving pelvic radiation as part of the cancer treatment. They, too, had high CA 125 but no evidence that cancer had returned. CA 125 is a useful measurement when monitoring patients after treatment for early endometrial cancer. However, a high CA 125 may be mistaken for return of cancer when radiation treatment has caused intestinal injury. Conversely, cancer cells appearing in the vagina may not produce an elevated CA 125. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Squamous carcinoma of the cervix complicating pregnancy: recurrence in episiotomy after vaginal delivery
Cancer (squamous carcinoma) of the cervix recurred in a woman who had previously been treated for the disease. The cancer was found in the scar of the vaginal incision (episiotomy) made to prevent tearing during delivery. When her entire uterus was surgically removed (hysterectomy), no tumor cells were found in the uterus. The results indicate that the cells had been reimplanted during delivery. In three other recorded cases of recurrence following episiotomy, Pap smears did not detect any cancer during pregnancy. Early treatment and careful monitoring increase the chance for recovery of squamous carcinoma of the cervix.
Publication Name: Obstetrics and Gynecology
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