Billing Services (local): 443-997-3370
8 a.m. - 5 p.m.
Tuesday: 8 a.m. - 5 p.m.
Wednesday: 8 a.m. - 7 p.m.
Thursday: 8 a.m. - 7 p.m.
Friday: 8 a.m. - 5 p.m.
The cervix is the lower, narrow part of the uterus (womb) located between the bladder and the rectum. It forms a canal that opens into the vagina, which leads to the outside of the body.
Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Considered a precancerous condition, it is caused by a sexually transmitted infection with a common virus, the Human Papillomavirus (HPV). Cervical dysplasia affects between 250,000 and one million women throughout the United States every year. Though women of any age can develop cervical dysplasia, the condition occurs most frequently in those between ages 25 and 35. With proper management and treatment, the condition may revert or improve before becoming cancerous. Although doctors have been able to screen for cervical cancer for more than half a century, it is the second leading cause of cancer deaths among women.
Cervical cancer, or invasive cervical cancer, occurs when abnormal cells on the surface of the cervix spread deeper into the cervix, or to other tissues or organs. Cervical cancer occurs most often in women over the age of 40. It is different from cancer that begins in other parts of the uterus and requires different treatment. Most cervical cancers are squamous cell carcinomas and adenocarcinomas.
HPV infection and cervical dysplasia generally cause no symptoms. Regular gynecological visits including a pelvic exam and Pap test can identify the conditions. Then your physician can help manage them before they turn cancerous. In some cases, the body clears HPV infection on its own.
Symptoms of cervical cancer usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue. The most common symptom is abnormal bleeding that starts and stops between regular menstrual periods, or that occurs after sexual intercourse, douching, or a pelvic exam. Other symptoms may include:
These symptoms may resemble other conditions or medical problems. Consult a physician for diagnosis.
There are two commercially available vaccines that help protect adolescents and women from HPV: Gardisil and Cervarix. Gardasil, administered in three injections over six months, is recommended for 11- and 12-year-old girls, or for females aged 13 through 26 who have not yet been vaccinated or completed the vaccine series. This vaccine targets the types of HPV that most commonly cause cervical cancer (16 and 18), as well as the two strains of HPV that most commonly cause genital warts (6 and 11). Cervarix, which is FDA-approved for females aged 10 to 25, also is administered in a series of three shots and protects against two strains of HPV (16 and 18) that cause cervical cancer. Ideally, females should get the vaccine before they become sexually active, when they may be exposed to HPV.These vaccines do not protect against all types of HPV; about 30 percent of cervical cancers will not be prevented by the vaccine. The vaccines also do not protect against other sexually transmitted infections, and cannot treat existing HPV. Therefore, it is still important for those who get the vaccines to continue regular screenings for cervical cancer through gynecological checkups and Pap tests.
Regular gynecological checkups, including a pelvic exam and Pap tests, will help detect any abnormal changes to the cervix as early as possible.
All women who are or have been sexually active, or are age 18 or older, should have regular gynecological checkups, including a pelvic exam and Pap test, to detect any abnormal changes to the cervix as early as possible. As with many types of cancer, cervical cancer is more likely to be successfully treated if it is detected early. Pap tests can also detect inflammation caused by yeast infections; bacterial infections such as trichonomas, gonorrhea, or Chlamydia; other viruses; medications or other chemicals; hormones; and pregnancy.
During a Pap exam, cells are collected with a cervical brush from the so-called “transformation zone” of the cervix (the most likely location for lesion development). The cells collected are used to detect any changes that may be cancerous or may lead to cancer, and to show noncancerous conditions such as infection or inflammation. The gynecologist or other health care practitioner performing the exam will spread the cells onto a slide and send them to a lab for further analysis.
If the Pap test shows an ambiguous or minor abnormality, the test is usually repeated to ensure accuracy. If the test shows a significant abnormality, your doctor may perform a procedure called a colposcopy to further examine the vagina and the cervix. For this test, performed in the gynecologist’s office, you will be positioned on the examining table like for a Pap smear, and an acetic acid will be placed on the cervix. The doctor will position an instrument called a colposcope – an electric microscope – close to your vagina. A bright light on the end of the colposcope lets the doctor clearly see the cervix. Abnormal cervical changes appear as white areas -- the whiter the area, the worse the cervical dysplasia. Your doctor may also perform a biopsy, in which a small amount of cervical tissue is removed and sent to a lab for analysis. This is the only sure way to determine whether the abnormal cells indicate cancer. You may want to take Motrin right before your appointment. Expect to have some spotting afterwards, so bring a sanitary napkin with you.
Depending on the results of your colposcopy exam and biopsies, your physician will discuss your treatment options.
A normal Pap smear shows healthy squamous cells (flat cells that look like fish scales) from the surface of the cervix. There are no signs of infection and no abnormal cells. Even if your Pap results are healthy, you should be tested regularly. The tests screen for infectious agents that may be harmful if allowed to persist. Early detection of any infection will allow for better treatment and will help you maintain your health.
Abnormal Pap test results include:
ASCUS ~ Atypical squamous cells of undetermined significance
This diagnosis means that some of the cells on your Pap smear did not look entirely normal but did not meet diagnostic criteria for a lesion. Your doctor may either repeat your Pap smear, or perform a colposcopy. The lab may test your Pap smear specimen for HPV.
LSIL ~ Low-grade squamous intraepithelial lesion
This diagnosis means there are early changes in the size and shape of the cells. LSILs are often associated with HPV, which may also cause genital warts. These lesions, in women with intact immune systems, often resolve without intervention within 18 to 24 months. Low-grade lesions may also be called mild dysplasia, or CIN1. If it is your first abnormal Pap smear, your doctor will likely recommend a colposcopy.
HSIL ~ High-grade squamous intraepithelial lesion
This diagnosis means the cells appear very different from normal cells. These precancerous lesions are more severe than with LSIL, but involve cells on the surface of the cervix. They may also be called moderate or severe dysplasia, or CIN 2 or 3. The treatment for HSIL is to remove the abnormal tissue. This can be done in several ways. See the treatment section for more information.
The link between HPV and cervical cancer is bigger than the link between smoking and lung cancer."-Dr. Connie Trimble, in her TedX Talk, Kicking Cancer's Butt
We are interested in how immune responses occur in the cervix. The focus of our translational research is on developing immune therapies for disease caused by human papillomavirus (HPV). HPV infection causes more cancers than any other virus in the world.
Cervical cancer is the most common cancer caused by HPV, and although we have known how to screen for it for over half a century, it remains the second most common cause of cancer death in women. Although the preventive vaccines are a public health milestone, they prevent HPV infections, but are not designed to make immune responses to treat HPV.
We are testing different strategies to make immune responses that could treat HPV disease.
Artesunate intravaginal inserts or ointment for the treatment of high grade dysplasia in patients with persistent recurrence of HPV disease of the lower ano-genital tract
This is a compassionate use protocol for patients with persistent recurrence of HPV-associated disease of the lower ano-genital tract, and/or who have high grade squamous intraepithelial lesions (HSIL) at multiple body sites after standard-of-care surgical treatments can be enrolled in this expanded-access protocol.
This expanded access protocol includes two categories of patients: (1) patients who have already undergone multiple surgical procedures, and still have recurrence of their high grade dysplasia; and (2) patients who have extensive high grade dysplasia (HSIL) at more than one anatomic site, including vaginal, vulvar, cervical, or peri-anal.