The consequences of Curative Surgery can be psychologically Devastating, as Vulvar Surgery can result in Lifelong Anatomic Alterations.

Sexual dysfunction is common because of loss of clitoris in some clinical situations and in general because of alteration in body image.

Lower extremity Lymphedema (Leg Swelling) can occur, causing difficulty Walking, Pain, Recurrent Infections and Disfigurement.

Therefore, all therapy includes Pretreatment counseling about sexual and physical function.

If the cancer has spread outside the vulva and the other Female Organs, the doctor may take out the lower Colon, Rectum or Bladder (depending on where the cancer has spread), along with the Cervix, Uterus and Vagina (pelvic exenteration).

Physicians have developed ways for patients to store and eliminate wastes after these procedures, and it is sometimes possible to reconstruct or reattach these organs so no external appliances are needed.

A patient may need to have skin from another part of the body added (grafted) and Plastic Surgery to make an Artificial Vulva or Vagina after these operations.

The choice of treatment for Cervical Cancer depends on the loCATion and the size of the tumor, the stage (extent) of the disease, the woman's age and general health, and other faCTors.

Gynecologic Oncologists have expertise in the diagnostic Evaluation and treatment of patients with cervical carcinoma. They also have surgical expertise in the procedures of radical Hysterectomy, pelvic and Paraaortic Lymphadenectomy, pretreatment surgical Staging procedures, and exenterations for patients with recurrent Cervical Cancer. Gynecologic Oncologists work closely with radiation therapists when this is the primary treatment modality. During that time, they funCTion as the patient's primary care Oncologist and continue to direCT their care after the Radiation Therapy is finished.

Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affeCTed. Blood and urine tests are usually done. The doCTor also may do a thorough pelvic exam in the operating room with the patient under anesthesia. During this exam, the doCTor may do procedures called Cystoscopy and Proctosigmoidoscopy.

In Cystoscopy, the doCTor looks inside the Bladder with a thin, lighted instrument. Proctosigmoidoscopy is a procedure in which a lighted instrument is used to check the Rectum and the lower part of the large intestine. Because Cervical Cancer may spread to the Bladder, Rectum, Lymph Nodes or Lungs, the doCTor also may order X-Rays or tests to check these areas. For example, the woman may have a series of X-Rays of the Kidneys and Bladder, called an Intravenous Pyelogram (IVP). The doCTor also may check the intestines and Rectum using a barium enema. To look for Lymph Nodes that may be enlarged because they contain cancer cells, the doCTor may order a CT or CAT scan, a series of X-Rays put together by a computer to make detailed piCTures of areas inside the body. Other procedures that may be used to check organs inside the body are Ultrasonography and MRI.

In a Pelvic Exam, the doctor checks the Uterus, Vagina, Ovaries, Fallopian Tubes, Bladder and Rectum. The doctor feels these organs for any abnormality in their shape or size. A speculum is used to widen the Vagina so that the doctor can see the upper part of the Vagina and the Cervix.

The Pap Test is a simple, painless test to detect Abnormal Cells in and around the Cervix. A woman should have this test when she is not menstruating; the best time is between 10 and 20 days after the first day of her Menstrual Period. For about two days before a Pap Test, she should avoid Douching or using Spermicidal Foams, Creams, or Jellies or Vaginal Medicines (except as directed by a Physician), which may wash away or hide any Abnormal Cells.

Women should have regular Checkups, including a Pelvic Exam and Pap Test, if they are or have been sexually active or if they are age 18 or older. Those who are at increased risk of developing cancer of the Cervix should be especially careful to follow their doctor's advice about Checkups. Women who have had a Hysterectomy (surgery to remove the Uterus, including the Cervix) should ask their doctor's advice about having Pelvic Exams and Pap Tests.

To find the cause of symptoms, the doCTor will ask about your personal and family medical history. He will do a physical exam, and may order laboratory tests. In addition to the exams discussed above, the doCTor may also order the following tests:

• Lower GI series – X-Rays of the Colon and Rectum (the lower gastrointestinal traCT). The X-Rays are taken after the patient is given an enema with a white, chalky solution containing barium. (This test is sometimes called a Barium Enema.) The Barium Outlines the Colon and Rectum on the X-Rays, helping the doCTor find Tumors or other abnormal areas. To make small Tumors easier to see, the doCTor may expand the Colon by carefully pumping in air during the test. This is called an air contrast or double-contrast Barium Enema.
• Colonoscopy – An examination of the inside of the entire Colon using a Colonoscope, an instrument similar to a flexible Sigmoidoscope, but longer.

If a Polyp or other abnormal growth is found, the doCTor can remove part or all of it through a Sigmoidoscope or Colonoscope. A Pathologist examines the Tissue under a Microscope to check for cancer cells. This procedure is called a biopsy. Most Polyps are benign, but a biopsy is the only way to know for sure.

If the Pathologist finds cancer, the patient’s doCTor needs to learn the stage, or extent of the disease. Staging exams and tests help the doCTor find out whether the cancer has spread and, if so, what parts of the body are affeCTed. Treatment decisions depend on these findings.

Staging may include X-Rays, Ultrasonography or CT (or CAT) scans of the Lungs and Liver, because Colorectal Cancer tends to spread to these organs. The doCTor may order blood tests to measure how well the Liver is funCTioning. The doCTor also may do a blood test called a CEA assay. This test measures the Blood Level of Carcinoembryonic Antigen (CEA), a Substance that is sometimes found in higher-than-normal amounts in people who have Colorectal Cancer, especially when the disease has spread.

Most health problems respond best to treatment when they are diagnosed and treated as early as possible.

This is especially true of Colorectal Cancer.

Treatment is most effective before the disease spreads.

People can take an active role in the early detection of Colorectal Cancer by following these guidelines:

• During regular Checkups, have a digital rectal exam. For this exam, the doctor inserts a Lubricated, gloved finger into the Rectum and feels for abnormal areas.
• Beginning at age 40, have an annual fecal Occult Blood Test. This test is a check for hidden (Occult) blood in the Stool. The test is done because Colorectal Cancer may cause Bleeding that cannot be seen. However, other conditions also may cause Bleeding, so having blood in the Stool does not necessarily mean a person has cancer.
• Beginning at age 50, have a Sigmoidoscopy/Colonoscopy every 3 to 5 years. (Speak with your doctor.) This is an exam of the Rectum and lower colon using a sigmoidoscope. The doctor looks through a thin, lighted tube to check for polyps, tumors or other Abnormalities.
• People who may be at a greater than average risk for Colon Cancer should discuss a schedule for these or other tests with their doctor.