Small cell cervical cancer usually has poor prognosis

New York, NY

Small cell carcinoma of the cervix is rare compared to other cervical cancers, but the outlook for patients with this disease is poor, Utah-based researchers report in the June issue of Obstetrics and Gynecology.

Dr. Jergin Chen and colleagues at Huntsman Cancer Institute in Salt Lake City note that while recent decades have brought advances in screening and treatment of cervical cancer, most reported series of the unusual small cell cancers have been small and prognostic factors have been unclear.

To investigate further, the researchers examined data from 1997 to 2003 on women with cervical cancers: 290 women with small cell carcinoma, 5231 with adenocarcinoma, and 27,527 with squamous cell carcinoma.

The corresponding mean annual incidences per 100,000 women were 0.06, 1.2 and 6.6. Five-year survival was 35.7% in small cell cancer, 69.7% in adenocarcinoma and 60.5% in squamous cell carcinoma.

There was no improvement in survival over time in those with small cell cancer, although there was a trend toward reduced mortality in the other groups.

Multivariate analysis showed age, stage, race and treatment with hysterectomy alone were significant prognostic indicators of survival in women with small cell carcinoma.

The investigators also found that patients present with more advanced disease and have higher rates of nodal and distant metastasis compared with the other cancers.

"Because of the high rates of nodal involvement even at early stages," the team concludes, "adjuvant chemotherapy and pelvic radiotherapy should be strongly considered."

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New detection tool pinpoints virus behind cervical cancer

Nahariya, Israel

The Western Galilee Hospital in Nahariya is the first hospital in Israel to implement a new method of detecting the human papilloma virus (HPV), which causes cervical cancer.

Dr. Yaakov Borenstein, who runs the hospital's women's health unit, described the HPV test Tuesday at a gynecologists' conference at the Dan Carmel Hotel in Haifa.

The test, which characterizes the virus' genetic material - the most precise way to test for the virus - is 97 percent accurate, compared to just 50 percent for the more familiar Pap smears. The method also allows far earlier detection, because it diagnoses the presence of the virus instead of looking for pre-cancerous changes, as do Pap smears.
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Cervical cancer is the second most common form of cancer - after breast cancer - affecting women around the world, said Borenstein. HPV has been shown over recent years to be closely related to cervical cancer and pre-cancerous states.

The Israel Society of Obstetrics and Gynecology recommends that women between the ages of 25 and 60 be tested every three years.

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Merck's Gardasil not cleared by FDA for older women

New York, NY

U.S. regulators have told Merck & Co they cannot yet approve Merck's application to expand marketing of its cervical cancer vaccine Gardasil to an older group of women, the drugmaker said on Wednesday.

Merck had applied for the use of Gardasil in women ages 27 through 45. The U.S. Food and Drug Administration said in a letter regarding the application that it has completed its review and there are "issues" that preclude approval within the expected review time frame, Merck said.

"It's hard to get a feel for if this is a dead issue or if this is delayed," said Linda Bannister, an analyst for Edward Jones. "At the minimum, it's going to be delayed."

Merck said it also failed to win FDA approval to expand Gardasil to protect against more strains of the Human Papillomavirus that causes cervical cancer. The company for now is dropping plans to pursue that expansion, a spokeswoman said.

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J. Matthews, MD: Pap Test Explained

Muskogee, OK

If you were asked to conjure up one phrase to represent what gynecologists do with their time day in and day out, what could you come up with? If you’re like most of my patients, you would immediately reply “Pap smear.”

How many of you, though, could explain just what a Pap smear consists of, or what its purpose is? This just isn’t a topic that often gets tossed around at casual lunches or over coffee.

The Pap smear is a medical test which is actually one of the most effective cancer-screening methods ever devised. It’s done by removing some cells from the surface of the cervix with a plastic “spatula” or brush. These cells are then sent to a pathologist, a doctor who specializes in microscopic examinations of tissue.

What the pathologist looks for are changes in the cells that are abnormal, changes that are referred to as dysplasia, which is significant because it can signal the first steps in a transformation to cervical cancer. That is what makes this test so useful: it detects changes in cells before cancer has begun.

Many women, when contacted by a doctor about an abnormal Pap smear, incorrectly conclude that they already have cervical cancer. Fortunately, this is very rarely the case. Cervical cancer tends to develop very slowly, and so women who have annual Pap smears can find precancerous changes early and get treatment before cancer strikes.

The Pap smear has been around for many decades, and for most of that time it has been our best weapon against the fifth most deadly women’s cancer worldwide. The incidence of invasive cervical cancer has dropped more than 50 percent since Pap smears began to be widely used.

In just the last few years, though, two new weapons have appeared which may eventually make the Pap smear obsolete. That doesn’t mean that your gynecologist can start throwing away all of those speculums, but we may be able to drive the number of deaths from cervical cancer even lower than it already is.

Doctors now know that cervical cancer is almost exclusively caused by a virus, called the human papilloma virus: HPV for short. This fact makes it fairly unique among cancers. Unlike breast cancer, ovarian cancer, colon cancer, or almost any other cancer, cervical cancer could potentially be defeated.

In the meantime, you should be checking your memory for the date of your last encounter with that speculum. If it’s been more than a year, give your doctor a call.

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J. Matthews, M.D."

If you were asked to conjure up one phrase to represent what gynecologists do with their time day in and day out, what could you come up with? If you’re like most of my patients, you would immediately reply “Pap smear.”

How many of you, though, could explain just what a Pap smear consists of, or what its purpose is? This just isn’t a topic that often gets tossed around at casual lunches or over coffee.

The Pap smear is a medical test which is actually one of the most effective cancer-screening methods ever devised. It’s done by removing some cells from the surface of the cervix with a plastic “spatula” or brush. These cells are then sent to a pathologist, a doctor who specializes in microscopic examinations of tissue.

What the pathologist looks for are changes in the cells that are abnormal, changes that are referred to as dysplasia, which is significant because it can signal the first steps in a transformation to cervical cancer. That is what makes this test so useful: it detects changes in cells before cancer has begun.

Many women, when contacted by a doctor about an abnormal Pap smear, incorrectly conclude that they already have cervical cancer. Fortunately, this is very rarely the case. Cervical cancer tends to develop very slowly, and so women who have annual Pap smears can find precancerous changes early and get treatment before cancer strikes.

The Pap smear has been around for many decades, and for most of that time it has been our best weapon against the fifth most deadly women’s cancer worldwide. The incidence of invasive cervical cancer has dropped more than 50 percent since Pap smears began to be widely used.

In just the last few years, though, two new weapons have appeared which may eventually make the Pap smear obsolete. That doesn’t mean that your gynecologist can start throwing away all of those speculums, but we may be able to drive the number of deaths from cervical cancer even lower than it already is.

Doctors now know that cervical cancer is almost exclusively caused by a virus, called the human papilloma virus: HPV for short. This fact makes it fairly unique among cancers. Unlike breast cancer, ovarian cancer, colon cancer, or almost any other cancer, cervical cancer could potentially be defeated.

In the meantime, you should be checking your memory for the date of your last encounter with that speculum. If it’s been more than a year, give your doctor a call.

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Merck advertises Gardisil cervical cancer vaccine in theaters before Sex and the City

You can get a steady diet of all things ASCO (American Society of Clinical Oncology) on CNBC and here at CNBC.com, so I'm gonna blog about something totally different.

Well, it does have to do with cancer prevention. Specifically, staving off cervical cancer and/or the sexually transmitted disease known as HPV, which is the leading cause of cervical cancer.

While sitting through the trailers and commercials leading up to a screening of "Sex and the City," up pops a drug commercial. Yep, not even in the movie theater can you escape pharmaceutical direct-to-consumer advertising.

It was a spot for Merck's
Merck & Co Inc vaccine Gardasil. Moviehouses everywhere were packed with mostly females last weekend to see SATC, so I'm thinkin' maybe it's not a bad marketing effort aimed at a targeted, captive demo.

A Merck spokesperson says the company has made a national theater "buy" from May 30th through June 26th. The commercial will run not only during the trailers before "SATC," but also at screenings of "The Incredible Hulk," "Get Smart," "The Happening," and "You Don't Mess with the Zohan," among others. They're all films, the spokesperson says, that will attract the 19 to 26-year-old females who could get the Gardasil shots.

Merck is hoping the Food and Drug Administration will soon approve Gardasil for women into their 40s, so I wonder if the SATC campaign is also intended for them.

And in the near future the company plans to file for the FDA okay of Gardasil for young men and boys who can carry and transmit HPV. So, given their selection of summer movies Merck's marketers have made, here too, I suspect the commercials are an attempt to raise awareness among guys as well.

But again, the Merck spokesperson says it's the 19 to 26-year-old females (the FDA-approved group) that it's going for.

Gardasil costs around $300-$400 for the three shots (combined) that are given over six months. It's a major sales and profit growth engine for MRK and, so far, it is a big success.

And Merck is making a box-office bet that Carrie, Miranda, Charlotte, Samantha and Big will make it even bigger.

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Pap test awareness: Pap-A-Thon promotes women's health

South Bend, IN

It's an important test that could save a woman's life, a pap smear. But many don't have the tests done either because their too busy or don't have healthcare.

That's why the Women's Task Force at St. Joseph Regional Medical Center held a "pap-a-thon" Wednesday.

They performed free pap tests and enrolled women in need in a federal program that provides free healthcare.

Joan Lennon from the Women's Task Force says, "We are helping woman, many woman, young mothers often, who just don't have the resources or they have to put their children first and are not able to come in and get their screenings or other woman who find themselves without health insurance which happens to be a large population of our society today.

The tests were held at eight different sites across Michiana Wednesday. Nearly a thousand woman were tested.

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