Cervical Cancer
National Cancer Society National Cancer Institute World Health Organization IARC
BMJclinical Evidence AP John Institute
Cervical cancer is the second most common cancer in women worldwide. Cervical cancer accounted for an estimated 11.070 new cases and 3870 deaths in the USA for 2008. Nearly 1/3 of patients who present with invasive cervical cancer will die of their disease.
The recurrence rate of cervical cancer is between 10% and 20% for FIGO stages Ib-IIa and 50-70% in locally adevanced cases (stages IIb-IVa). Patients with recurrent disease or pelvic metastases have a poor prognosis with a 1 year survival rate between 15% and 20%. (see Chemotherapy for recurrent cervical cancer, Pectasides et al. Cancer Treatment Reviews (2008)).
Causes: Infection with high risk types of human papillomavirus is the main cause of cervical cancer.
Prevention: Vaccination as well as screening are the primary ways to prevent cervical cancer.
symptoms: certical cancer usually originates in the transformation zone of the cervix, and spreads to regional lymph nodes. Clinical presentation depends mainly on the location and extent of diseas.
Precancerous changes or very early stage disease are usually asymptomatic and are detected on a cervical smear.
Symptoms usually appear when the tumour causes spontaneous or contact bleeding, or pain if lymph nodes are involved. Other symptoms include serosanguineous foul smelling vaginal discharge or backache.
Diagnosis: When a lesion is visible with the naked yee, conisation is contraindicated, and a cervical biopsy will usually provide the diagnosis. Conisation is indicated when frank invasion cannot be ruled out by a colposcopically directed biopsy, or when colposcopy is unsatisfactory and the results of a smear test show a high grade lesion.
Pathology:Squamous (thin, falt cells that form the surface of the cervix) cell carcinoma accounts for about two thirds of all cervical cancers. Adenocarcinoma has many histological variations and is found in 15-25% of cases. Unusual histological variants include clear cell carcinoma, neuroendocrine carcinoma, and adeno-squamous carcinoma.
Tumour grade (wee differentiated, moderately differentiated, and prooly differentiated), depth and width of invasion, and presence (or absence) of invasion of lymphovascular space are prognostic factors that should be adequately assessed.
Patents:
Artemisinin: US Patent Publication No. US2007/0142459 discloses methods of treating proliferative cervical disorders by administering a therapeutically effective amount of artemisinin-related compounds. In some embodimetnes, artemisinin or an artemisinin derivative, combined with other anti-viral or anti-cancer therapies such as radiation theraphy are used. Other agents known for their use in the inhibition of cervical cancer include interleukin-2,5'-fluorouracil, nedaplatin, methotrexate, vinblastine, doxorubicin, carboplatin, paclitaxel (Taxol), cisplatin, 13-cis re-moic acid, pyrazoloacridine, and vinorelbine.
Artemisinin (Oinghasosu) is a naturally occuring substance, obtainec by purificatoin from sweet wormwood, Artemisia annua. Artemisinin and its analogs are sesquiterpene lactones with a peroxide bridge. The very low toxicity of these compoudns to humans is a majro benefit.
Formulations of the artemisinin-related compounds suitable for oral administration may be in the form of capsules, pills, pwoders, etc. The topical formulations may include one or more of the wide variety of agents known to be effective as skin or stratum corneum penetration enhancers. Examples include 2-pymolidone, N-methyl-2-pyrrolidone, dimethylacetamide, dimethylformamide, propylene glycol, methyl or isopropyl alcholo, dimethyl sulfoxide and azone.
N,N-dimethylglycine: US Patent Publication Number 2006/0183801A1(Assignee, FoodScience, Corporation, Essix Junction, VT) discloses a method of treating, inhibiting the metasis of, or preventing cervical cancer by administering to a patient an effective amount of N,N-dimethylglicine or a pharmaceutically acceptable salt thereof.
