Squamous dysplasia is the abnormal development of cells lining the cervix, often caused by HPV. It can lead to cervical cancer if left untreated. Treatment options include removal of affected tissue and may involve radiation and chemotherapy. Risk factors include smoking, multiple sexual partners, and compromised immunity.
Squamous dysplasia, also known as cervical dysplasia, is the abnormal development of the cells lining the cervix. Considered a precancerous condition, squamous dysplasia can be triggered by a variety of factors. Treatment depends on the degree of dysplasia and may involve destruction or removal of the affected tissue. The prognosis associated with cervical dysplasia depends on timely diagnosis and appropriate treatment. If ignored, squamous dysplasia can turn into cervical cancer.
Cervical dysplasia is most commonly caused by the presence of the sexually transmitted infection known as human papilloma virus (HPV). In general, a woman’s immune system is able to neutralize the virus and prevent the infection from progressing. In some women, the presence of HPV can negatively affect the development of cervical cells, leading to dysplasia and ultimately cervical cancer. Squamous cell carcinomas are considered to be the most common form of cervical cancer resulting from the presence of HPV.
Women who develop squamous dysplasia may remain asymptomatic, meaning they do not experience any symptoms. For some women, the presence of precancerous cells can lead to abnormal vaginal bleeding, pelvic discomfort, or a watery or bloody vaginal discharge with a foul odor. Abnormal cervical cells that produce no symptoms are usually detected during a routine Pap smear.
When abnormal squamous cells are found, further tests are usually done to assess the extent of cell development. Individuals may have a cervical exam, known as a colposcopy, which involves the use of a colposcope to evaluate the condition of the cervix. If abnormalities are found, a biopsy may be done to remove a sample of the abnormal cells and surrounding cervical tissue for further laboratory analysis. The biopsy can be performed as a punch or cone procedure, requiring circular or cone-shaped excision of cervical tissue, respectively.
After a cancer determination has been made, further tests may be conducted to determine the staging of the condition. A physical exam of the bladder and rectum may also be done, as well as imaging tests, including magnetic resonance imaging (MRI) and computed tomography (CT), to assess whether the cancer has metastasized or spread to tissues or organs surrounding . If the cancer remains noninvasive and confined to the cervix, it may receive staging of zero or one. Stages two and three are given when the cancer has spread to the uterus and pelvic wall, respectively. A stage of four is assigned to those tumors that are invasive and have metastasized to surrounding organs, such as the bladder or lungs.
Tumors determined to be noninvasive and confined to the cervix can be treated with a variety of procedures. During a loop electrosurgical excision (LEEP) procedure, an electric current is passed through a loop of wire which is used like a knife to excise cancerous cells from the cervical opening. Cancer cells can be frozen and removed in a procedure known as cryosurgery. Additional procedures include the use of conization, which is the cone-shaped removal of malignant cells with a scalpel, and laser surgery to remove cancerous cells.
Invasive cancers affecting the deeper layers of the cervix may require a hysterectomy. Considered major surgery, a hysterectomy that requires the removal of the uterus and cervix is known as a simple hysterectomy, while the additional removal of part of the vagina and surrounding tissue is called a radical hysterectomy. Women who undergo a hysterectomy may also require radiation and chemotherapy to kill any remaining cancer cells. Radiation therapy uses high-powered, finely focused beams of energy to target and eradicate malignant cells and can trigger side effects that include fatigue and inflammation at the site of administration. Chemotherapy involves the oral or intravenous administration of anticancer drugs and can induce nausea, vomiting and fatigue.
Individuals who undergo treatment for invasive cervical cancer become infertile as a result. Women who are diagnosed with early-stage cervical cancer may have a radical trachelectomy, which is the removal of the cervix and immediate lymphatic tissue, to prevent infertility. Those who undergo radical trachelectomy and later become pregnant should be monitored closely due to an increased risk of miscarriage. Factors that can increase a woman’s risk of developing squamous dysplasia include multiple sexual partners, smoking, and compromised immunity.
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