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Content Map Terms
Illnesses & Conditions Categories
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Allergies
- Allergy to Natural Rubber (Latex)
- Jellyfish Stings: Allergic Reaction
- Allergies: Should I Take Allergy Shots?
- Non-Allergic Rhinitis
- Allergic Reaction
- Allergies
- Allergy Shots for Allergic Rhinitis
- Allergies: Rush Immunotherapy
- Over-the-Counter Medicines for Allergies
- Allergic Rhinitis
- Types of Allergens
- Allergies: Avoiding Indoor Triggers
- Allergies: Avoiding Outdoor Triggers
- Controlling Dust, Dust Mites, and Other Allergens in Your Home
- Controlling Pet Allergens
- Allergies to Insect Stings
- Allergies: Should I Take Shots for Insect Sting Allergies?
- Immunotherapy for Allergies to Insect Stings
- Types of Allergic Rhinitis
- Allergic Reaction to Tattoo Dye
- Drug Allergies
- Penicillin Allergy
- Hay Fever and Other Seasonal Allergies
- Allergies: Giving Yourself an Epinephrine Shot
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Arthritis and Osteoporosis
- Rheumatoid Arthritis: Finger and Hand Surgeries
- Rheumatoid Arthritis: Classification Criteria
- Rheumatoid Arthritis: Systemic Symptoms
- Comparing Rheumatoid Arthritis and Osteoarthritis
- Rheumatoid Arthritis: Neck Symptoms
- Osteoporosis in Men
- Psoriatic Arthritis
- Arthritis: Shots for Knee Pain
- Complementary Medicine for Arthritis
- Steve's Story: Coping With Arthritis
- Bev's Story: Coping With Arthritis
- Quick Tips: Modifying Your Home and Work Area When You Have Arthritis
- Coping With Osteoarthritis
- Arthritis: Should I Have Shoulder Replacement Surgery?
- Juvenile Idiopathic Arthritis: Stretching and Strengthening Exercises
- Juvenile Idiopathic Arthritis
- Capsaicin for Osteoarthritis
- Small Joint Surgery for Osteoarthritis
- Osteoarthritis: Heat and Cold Therapy
- Modifying Activities for Osteoarthritis
- Osteoarthritis
- Gout
- Rheumatoid Arthritis
- Juvenile Idiopathic Arthritis: Inflammatory Eye Disease
- Juvenile Idiopathic Arthritis: Range-of-Motion Exercises
- Juvenile Idiopathic Arthritis: Deciding About Total Joint Replacement
- Complications of Osteoarthritis
- Arthritis: Managing Rheumatoid Arthritis
- Arthritis: Should I Have Knee Replacement Surgery?
- Arthritis: Should I Have Hip Replacement Surgery?
- Juvenile Idiopathic Arthritis: Pain Management
- Osteoporosis Risk in Younger Women
- Osteoporosis Screening
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Asthma
- Asthma: Peak Expiratory Flow and Personal Best
- Asthma and Wheezing
- Asthma: Using an Asthma Action Plan
- Asthma: Measuring Peak Flow
- Asthma: Identifying Your Triggers
- Steroid Medicine for Asthma: Myths and Facts
- Asthma
- Inhaled corticosteroids for asthma
- Inhaled quick-relief medicines for asthma
- Classification of Asthma
- Challenge Tests for Asthma
- Asthma's Impact on Your Child's Life
- Asthma Action Plan: Yellow Zone
- Asthma Triggers
- Asthma Action Plan: Red Zone
- Asthma and GERD
- Occupational Asthma
- Asthma Attack
- Asthma: Symptoms of Difficulty Breathing
- Exercise-Induced Asthma
- Asthma Treatment Goals
- Asthma: Overcoming Obstacles to Taking Medicines
- Asthma in Older Adults: Managing Treatment
- Asthma: Controlling Cockroaches
- Asthma: Educating Yourself and Your Child
- Allergy Shots for Asthma
- Asthma: Taking Charge of Your Asthma
- Monitoring Asthma Treatment
- Omalizumab for Asthma
- Asthma: Ways to Take Inhaled Medicines
- Asthma: Overuse of Quick-Relief Medicines
- Asthma Diary
- Asthma Diary Template
- Asthma Action Plan
- Assessing Your Asthma Knowledge
- My Asthma Action Plan
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Bowel and Gastrointestinal Conditions
- Abdominal Fullness or Bloating
- Irritable Bowel Syndrome: Criteria for Diagnosis
- Gastritis
- Gas, Bloating, and Burping
- Irritable Bowel Syndrome (IBS)
- Constipation: Keeping Your Bowels Healthy
- Rectal Problems
- Mild, Moderate, or Severe Diarrhea
- Torn or Detached Nail
- Chronic Constipation
- Gas (Flatus)
- Dyspepsia
- Diverticulosis
- Bowel Obstruction
- Anal Fissure
- Bowel Disease: Caring for Your Ostomy
- Anal Fistulas and Crohn's Disease
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Cancer
- Lung Cancer and Other Lung Problems From Smoking
- Skin Cancer, Non-Melanoma
- Radiation Therapy for Non-Melanoma Skin Cancer
- Colorectal Cancer Test Recommendations
- Breast Cancer Screening: When Should I Start Having Mammograms?
- Lifestyle Changes That May Help Prevent Cancer
- Choosing a Prosthesis After Breast Cancer Surgery
- Hormone Treatment for Breast Cancer
- Cancer Staging and Grading
- Pancreatic Cancer
- Kidney (Renal Cell) Cancer
- Cancer Support: Managing Stress
- Cancer Support: When Your Cancer Comes Back or Gets Worse
- Cancer Support: Dealing With Emotions and Fears
- Cancer Support: Finding Out That You Have Cancer
- Cancer Support: Being an Active Patient
- Cancer Support: Coping With Cancer Treatments
- Cancer Support: Life After Treatment
- Cancer Support: Family, Friends, and Relationships
- Reducing Cancer Risk When You Are BRCA-Positive
- Anal Cancer
- Prostate Cancer: Should I Choose Active Surveillance?
- Lung Cancer Screening
- Basal Cell Skin Cancer: Should I Have Surgery or Use Medicated Cream?
- Tumour Markers
- Does Aspirin Prevent Cancer?
- Cancer
- Lung Cancer
- Oral Cancer
- Colorectal Cancer
- Metastatic Melanoma
- Radiation Treatment for Cancer
- Skin Cancer, Melanoma
- Cervical Cancer Screening
- Hepatitis B and C: Risk of Liver Cancer
- Inflammatory Bowel Disease and Cancer Risk
- Radiation Therapy for Prostate Cancer
- Prostate Cancer
- Cancer: Home Treatment for Mouth Sores
- Skin Cancer Screening
- Breast Cancer: Should I Have Breast Reconstruction After a Mastectomy?
- Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?
- Prostate Cancer Screening
- Side Effects of Chemotherapy
- Breast Cancer: Lymph Node Surgery for Staging Cancer
- Endometrial (Uterine) Cancer
- Cryosurgery for Prostate Cancer
- Breast Cancer
- Cancer: Home Treatment for Nausea or Vomiting
- Cancer: Home Treatment for Pain
- Cancer: Home Treatment for Diarrhea
- Cancer: Home Treatment for Constipation
- Breast Cancer Types
- Cancer: Home Treatment for Sleep Problems
- Cancer: Home Treatment for Fatigue
- Hair Loss From Cancer Treatment
- Body Image After Cancer Treatment
- Breast Cancer: Should I Have Breast-Conserving Surgery or a Mastectomy for Early-Stage Cancer?
- Breast Cancer, Metastatic or Recurrent
- Cancer Pain
- Leukemia
- Colorectal Cancer, Metastatic or Recurrent
- Thyroid Cancer
- Types of Thyroid Cancer
- Radiation Therapy for Cancer Pain
- Breast Cancer in Men (Male Breast Cancer)
- Breast Cancer Screening
- Breast Cancer: Should I Have Chemotherapy for Early-Stage Breast Cancer?
- Asbestos and Lung Cancer
- Cervical Cancer
- Ovarian Cancer
- Colon Cancer Genetic Testing
- Testicular Cancer Screening
- Skin Cancer: Protecting Your Skin
- Non-Melanoma Skin Cancer: Comparing Treatments
- Bladder Cancer
- Prostate Cancer, Advanced or Metastatic
- Active Surveillance for Prostate Cancer
- Urinary Problems and Prostate Cancer
- Cancer: Controlling Cancer Pain
- Heat and Cold Treatment for Cancer Pain
- Testicular Cancer
- Testicular Cancer: Which Treatment Should I Have for Stage I Non-Seminoma Testicular Cancer After My Surgery?
- Testicular Cancer: Which Treatment Should I Have for Stage I Seminoma Testicular Cancer After My Surgery?
- Cancer: Controlling Nausea and Vomiting From Chemotherapy
- Lymphedema: Managing Lymphedema
- Breast Cancer Risk: Should I Have a BRCA Gene Test?
- Inflammatory Breast Cancer
- Ovarian Cancer: Should I Have My Ovaries Removed to Prevent Ovarian Cancer?
- Family History and the Risk for Breast or Ovarian Cancer
- Breast Cancer: What Should I Do if I'm at High Risk?
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Cold and Flu
- Difference Between Influenza (Flu) and a Cold
- Colds and Flu
- Influenza (Flu) Complications
- Flu Vaccine Myths
- Influenza (Seasonal Flu)
- Whooping Cough (Pertussis)
- Productive Coughs
- Dry Coughs
- Influenza (Flu): Should I Take Antiviral Medicine?
- Flu Vaccines: Should I Get a Flu Vaccine?
- Relieving A Cough
- Colds
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COPD
- Cal's Story: Learning to Exercise When You have COPD
- Conserving Energy When You Have COPD or Other Chronic Conditions
- Nebulizer for COPD Treatment
- COPD Action Plan
- COPD: Help for Caregivers
- COPD: Keeping Your Diet Healthy
- COPD: Using Exercise to Feel Better
- COPD
- COPD Flare-Ups
- Bullectomy for COPD
- COPD and Alpha-1 Antitrypsin (AAT) Deficiency
- COPD and Sex
- Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease (COPD)
- COPD
- Oxygen Treatment for Chronic Obstructive Pulmonary Disease (COPD)
- COPD: Avoiding Weight Loss
- COPD: Avoiding Your Triggers
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Dementia
- Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?
- Alzheimer's and Other Dementias: Coping With Sundowning
- Dementia: Assessing Pain
- Medical History and Physical Examination for Dementia or Alzheimer's Disease
- Alzheimer's and Other Dementias: Making the Most of Remaining Abilities
- Dementia: Helping a Person Avoid Confusion
- Alzheimer's and Other Dementias: Maintaining Good Nutrition
- Dementia: Tips for Communicating
- Agitation and Dementia
- Dementia: Bladder and Bowel Problems
- Dementia: Support for Caregivers
- Dementia: Legal Issues
- Dementia: Understanding Behaviour Changes
- Dementia: Medicines to Treat Behaviour Changes
- Dementia
- Mild Cognitive Impairment and Dementia
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Diabetes
- Diabetes: Blood Sugar Levels
- Diabetes: Counting Carbs if You Don't Use Insulin
- Diabetes: Coping With Your Feelings About Your Diet
- Diabetes: Tracking My Feelings
- Diabetes: Taking Care of Your Feet
- Diabetes: Care of Blood Sugar Test Supplies
- Diabetes: Checking Your Blood Sugar
- Diabetes: Checking Your Feet
- Diabetes: Steps for Foot-Washing
- Diabetes: Protecting Your Feet
- Diabetes: Dealing With Low Blood Sugar From Medicines
- Diabetes: Dealing With Low Blood Sugar From Insulin
- Diabetes: How to Give Glucagon
- Low Blood Sugar Level Record
- Symptoms of Low Blood Sugar
- Diabetes: Preventing High Blood Sugar Emergencies
- Diabetic Ketoacidosis (DKA)
- High Blood Sugar Level Record
- Symptoms of High Blood Sugar
- Diabetes: Using a Plate Format to Plan Meals
- Diabetes: Giving Yourself an Insulin Shot
- Diabetes: Eating Low-Glycemic Foods
- Diabetes and Alcohol
- Continuous Glucose Monitoring
- Quick Tips: Diabetes and Shift Work
- Diabetes: How to Prepare for a Colonoscopy
- Type 2 Diabetes: Can You Cure It?
- Diabetes, Type 2: Should I Take Insulin?
- Prediabetes: Which Treatment Should I Use to Prevent Type 2 Diabetes?
- Diabetes: Making Medical Decisions as Your Health Changes
- Diabetes Care Plan
- Diabetes: Caregiving for an Older Adult
- Quick Tips: Smart Snacking When You Have Diabetes
- Testing Tips From a Diabetes Educator
- Gloria's Story: Adding Activity to Help Control Blood Sugar
- Andy's Story: Finding Your Own Routine When You Have Diabetes
- Jerry's Story: Take Prediabetes Seriously
- Linda's Story: Getting Active When You Have Prediabetes
- Diabetes
- Tips for Exercising Safely When You Have Diabetes
- Diabetes: Travel Tips
- Type 2 Diabetes
- Type 1 Diabetes
- Care of Your Skin When You Have Diabetes
- Care of Your Teeth and Gums When You Have Diabetes
- Non-insulin medicines for type 2 diabetes
- Metformin for diabetes
- Hypoglycemia (Low Blood Sugar) in People Without Diabetes
- Diabetic Retinopathy
- Laser Photocoagulation for Diabetic Retinopathy
- Diabetic Neuropathy
- Diabetic Focal Neuropathy
- Diabetic Neuropathy: Exercising Safely
- Diabetic Autonomic Neuropathy
- Criteria for Diagnosing Diabetes
- Diabetes-Related High and Low Blood Sugar Levels
- Diabetic Nephropathy
- Diabetes: Counting Carbs if You Use Insulin
- Diabetes: Cholesterol Levels
- Diabetes and Infections
- Diabetes: Tests to Watch for Complications
- Diabetes: Differences Between Type 1 and 2
- Diabetes Complications
- How Diabetes Causes Blindness
- How Diabetes Causes Foot Problems
- Reading Food Labels When You Have Diabetes
- Eating Out When You Have Diabetes
- Breastfeeding When You Have Diabetes
- Diabetes: Staying Motivated
- Sick-Day Guidelines for People With Diabetes
- Diabetes: Amputation for Foot Problems
- Prediabetes
- Prediabetes: Exercise Tips
- Type 2 Diabetes: Screening for Adults
- Diabetes: Should I Get an Insulin Pump?
- Diabetes: Living With an Insulin Pump
- Form for Carbohydrate Counting
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Disease and Disease Prevention
- Diseases and Conditions
- Osgood-Schlatter Disease
- Needle Aponeurotomy for Dupuytren's Disease
- Mitochondrial Diseases
- Disease and Injury Prevention
- Alzheimer's Disease
- Root Planing and Scaling for Gum Disease
- Kawasaki Disease
- Tay-Sachs Disease
- Von Willebrand's Disease
- Hirschsprung's Disease
- Complications of Paget's Disease
- Paget's Disease of Bone
- Celiac Disease
- Peptic Ulcer Disease
- Ménière's Disease
- Pelvic Inflammatory Disease: Tubo-Ovarian Abscess
- Pelvic Inflammatory Disease
- Addison's Disease
- Misdiagnosis of Lyme Disease
- Lyme Disease
- Parkinson's Disease and Freezing
- Parkinson's Disease: Other Symptoms
- Parkinson's Disease: Modifying Your Activities and Your Home
- Parkinson's Disease and Tremors
- Parkinson's Disease and Speech Problems
- Parkinson's Disease
- Disease-modifying antirheumatic drugs (DMARDs)
- Parkinson's Disease: Movement Problems From Levodopa
- Mad Cow Disease
- Handwashing
- Peyronie's Disease
- Stages of Lyme Disease
- Osteotomy and Paget's Disease
- Dupuytren's Disease
- Crohn's Disease
- Crohn's Disease: Problems Outside the Digestive Tract
- Pilonidal Disease
- Acquired Von Willebrand's Disease
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Down Syndrome, Autism and Developmental Delays
- Autism
- Down Syndrome: Helping Your Child Eat Independently
- Down Syndrome: Grooming and Hygiene
- Down Syndrome: Helping Your Child Learn to Walk and Use Other Motor Skills
- Down Syndrome: Helping Your Child Learn to Communicate
- Down Syndrome
- Dyslexia
- Conditions Related to Dyslexia
- Autism: Behavioural Training and Management
- Autism: Support and Training for the Family
- Unproven Treatments for Autism
- Caring for Adults With Autism
- Down Syndrome: Helping Your Child Avoid Social Problems
- Down Syndrome: Training and Therapy for Young People
- Down Syndrome: Helping Your Child Dress Independently
- Down Syndrome, Ages Birth to 1 Month
- Down Syndrome, Ages 1 Month to 1 Year
- Down Syndrome, Ages 1 to 5
- Down Syndrome, Ages 5 to 13
- Down Syndrome, Ages 13 to 21
- Eating Disorders
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Epilepsy
- Absence Epilepsy
- Juvenile Myoclonic Epilepsy
- Temporal Lobe Epilepsy
- Focal Epilepsy
- Epilepsy: Simple Partial Seizures
- Epilepsy
- Epilepsy and Driving
- Epilepsy: Generalized Seizures
- Epilepsy: Generalized Tonic-Clonic Seizures
- Epilepsy: Myoclonic Seizures
- Epilepsy: Atonic Seizures
- Epilepsy: Tonic Seizures
- Epilepsy: Complex Partial Seizures
- Epilepsy Medicine Therapy Failure
- Stopping Medicine for Epilepsy
- Questions About Medicines for Epilepsy
- Epilepsy: Taking Your Medicines Properly
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Fatigue and Sleep
- Sleep Apnea: Should I Have a Sleep Study?
- Sleep and Your Health
- Quick Tips: Making the Best of Shift Work
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Managing Your Energy
- Sleeping Better
- Sleep Problems
- Doxepin (Sleep) - Oral
- Improving Sleep When You Have Chronic Pain
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
- Chronic Fatigue: Changing Your Schedule
- Chronic Fatigue: Getting Support
- Snoring and Obstructive Sleep Apnea
- Coping With Changing Sleep Patterns as You Get Older
- Stages of Sleep
- Sleep Apnea: Fibre-Optic Pharyngoscopy
- Sleep Apnea: Oral Devices
- Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea
- Sleep Apnea
- Sleep Problems, Age 12 and Older
- Stages of Sleep Apnea
- Sleep Journal
- Shift Work Sleep Disorder
- Snoring
- Sleep Problems: Dealing With Jet Lag
- Insomnia
- Sleep and Your Body Clock
- Weakness and Fatigue
- Insomnia: Improving Your Sleep
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Heart Health and Stroke
- Peripheral Arterial Disease of the Legs
- Bradycardia (Slow Heart Rate)
- Types of Bradycardia
- Cardiac Device Monitoring
- Angioplasty for Peripheral Arterial Disease of the Legs
- Isolated Systolic High Blood Pressure
- Atrial Fibrillation: Should I Try Electrical Cardioversion?
- Change in Heartbeat
- Deep Vein Thrombosis
- Fast Heart Rate
- Heart Failure: Symptom Record
- Heart Failure: Compensation by the Heart and Body
- Heart Failure: Taking Medicines Properly
- Heart Failure: Watching Your Fluids
- Heart Failure: Avoiding Triggers for Sudden Heart Failure
- Heart Failure: Activity and Exercise
- Heart Tests: When Do You Need Them?
- Low Blood Pressure (Hypotension)
- Cardiac Arrest
- Heart Failure Daily Action Plan
- Premature Ventricular Contractions (PVCs)
- Heart Rate Problems: Should I Get a Pacemaker?
- Heart Rhythm Problems: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- What to Do if Your Cardiac Device Is Recalled
- Venous Insufficiency
- Carotid Artery Stenting
- ICD: Living Well With It
- Diabetes: Lower Your Risk for Heart Attack and Stroke
- Pacemaker for Heart Failure (Cardiac Resynchronization Therapy)
- Heart Attack: How to Prevent Another One
- Stroke: How to Prevent Another One
- Sex and Your Heart
- Supraventricular Tachycardia: Should I Have Catheter Ablation?
- Carotid Artery Disease
- Giant Cell Arteritis
- High Blood Pressure: Over-the-Counter Medicines to Avoid
- Postural Orthostatic Tachycardia Syndrome (POTS)
- Leg Aneurysm
- Pulmonary Hypertension
- Left Ventricular Hypertrophy (LVH)
- Heart Failure: Checking Your Weight
- Alan's Story: Coping With Change After a Heart Attack
- Coronary Artery Disease: Prevention Myths
- Quick Tips: Taking Charge of Your Angina
- Heart and Circulation
- High Blood Pressure
- Heartburn
- Angioplasty for Coronary Artery Disease
- Coronary Artery Disease
- Implantable Cardioverter-Defibrillator (ICD)
- Aortic Valve Regurgitation
- Aortic Valve Stenosis
- Secondary High Blood Pressure
- Hemorrhagic Stroke
- Stroke: Common Disabilities
- Self-Care After a Stroke
- Stroke: Dealing With Depression
- Stroke: Getting Dressed
- Stroke: Speech and Language Problems
- Stroke: Bladder and Bowel Problems
- Stroke: Preventing Injury in Affected Limbs
- After a Stroke: Helping Your Family Adjust
- Stroke: Behaviour Changes
- Stroke: Changes in Emotions
- Stroke: Perception Changes
- Stroke: Problems With Ignoring the Affected Side
- Stroke: Memory Tips
- Stroke: Your Rehabilitation Team
- Stroke
- Transient Ischemic Attack (TIA)
- Cardiac Rehabilitation: Lifestyle Changes
- Cardiac Rehabilitation: Hospital Program
- Cardiac Rehabilitation: Home Program
- Cardiac Rehabilitation: Outpatient Program
- Cardiac Rehabilitation: Maintenance Program
- Congenital Heart Defects
- Congenital Heart Defects: Caring for Your Child
- Coronary Artery Disease: Should I Have an Angiogram?
- Triggers of Sudden Heart Failure
- Classification of Heart Failure
- Heart Failure: Tips for Easier Breathing
- Heart Failure: Avoiding Colds and Flu
- Heart Failure
- Helping Someone During a Panic Attack
- Aortic Aneurysm
- High Blood Pressure
- Coronary Artery Disease: Family History
- Angina
- Using Nitroglycerin for Angina
- Heartburn: Changing Your Eating Habits
- Angiotensin II receptor blockers (ARBs)
- Beta-blockers
- Heart Rhythm Problems: Diary of Symptoms
- Vagal Manoeuvres for Supraventricular Tachycardia (SVT)
- Electrical Cardioversion (Defibrillation) for a Fast Heart Rate
- Catheter Ablation for a Fast Heart Rate
- Supraventricular Tachycardia
- Home Blood Pressure Log
- Blood Pressure Screening
- Heart Block
- Electrical System of the Heart
- Heart Rhythm Problems and Driving
- Heart Rhythm Problems: Symptoms
- Resuming Sexual Activity After a Heart Attack
- Risk Factors for Coronary Artery Disease
- Pacemaker for Bradycardia
- SPECT Image of the Heart
- Heart Attack and Stroke in Women: Reducing Your Risk
- Ventricular Tachycardia
- Aspirin to Prevent Heart Attack and Stroke
- Temporal Artery Biopsy
- Emergency First Aid for Heatstroke
- Heartburn Symptom Record
- Heart Attack and Unstable Angina
- Congenital Heart Defects in Adults
- Monitoring and Medicines for Heart Failure
- Ventricular Assist Device (VAD) for Heart Failure
- Cardiac Output
- Heart Failure Symptoms
- Heart Failure: Less Common Symptoms
- Heart Failure With Reduced Ejection Fraction (Systolic Heart Failure)
- Heart Failure With Preserved Ejection Fraction (Diastolic Heart Failure)
- High-Output Heart Failure
- Right-Sided Heart Failure
- Heart Failure Complications
- How the Heart Works
- Coronary Arteries and Heart Function
- Heart Failure Types
- Enjoying Life When You Have Heart Failure
- Heart Failure: Tips for Caregivers
- Medicines to Prevent Abnormal Heart Rhythm in Heart Failure
- Cardiac Cachexia
- Heart Failure Stages
- Cardiac Rehabilitation Team
- Cardiac Rehabilitation: Emotional Health Benefits
- Ischemia
- Coronary Artery Disease: Roles of Different Doctors
- Coronary Artery Disease: Helping a Loved One
- Manage Stress for Your Heart
- Intermittent Claudication
- Peripheral Arterial Disease: Pulse and Blood Pressure Measurement
- Heart Failure and Sexual Activity
- Joan's Story: Coping With Depression and Anxiety From Heart Failure
- Rheumatic Fever and the Heart
- Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve?
- Acute Coronary Syndrome
- Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
- Heart Failure: Should I Get a Pacemaker ?
- Heart Failure: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- Heart Valve Disease
- Myxoma Tumours of the Heart
- Aortic Dissection
- Heart Attack and Stroke Risk Screening
- High Blood Pressure: Checking Your Blood Pressure at Home
- Hypertensive Emergency
- Stroke Rehabilitation
- Treatment for Stroke-Related Spasticity
- Driving a Car After a Stroke
- Heart Failure: Avoiding Medicines That Make Symptoms Worse
- Stroke Recovery: Coping With Eating Problems
- Heart Murmur
- High Blood Pressure: Should I Take Medicine?
- Coronary Artery Disease: Should I Have Angioplasty for Stable Angina?
- Tyrell's Story: Taking Pills for High Blood Pressure
- Stroke Prevention: Should I Have a Carotid Artery Procedure?
- Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?
- Stroke: Should I Move My Loved One Into Long-Term Care?
- Atrial Fibrillation: Should I Take an Anticoagulant to Prevent Stroke?
- Smoking and Coronary Artery Disease
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Hepatitis
- Hepatitis C: Your Risk for Cirrhosis
- Hepatitis E
- Hepatitis B Immune Globulin - Injection
- Heparin - Injection
- Fulminant Hepatitis
- Protect Yourself From Hepatitis A When Travelling
- Hepatitis A
- Viral Hepatitis
- Hepatitis C
- Hepatitis D
- Hepatitis B: How to Avoid Spreading the Virus
- Hepatitis B
- Hepatitis Panel
- Hepatitis B Treatment Recommendations
- Hepatitis B: Should I Be Tested?
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HIV
- HIV Infection
- HIV Viral Load
- HIV: Stages of Infection
- Ways HIV Cannot Be Spread
- HIV and Exercise
- HIV: Giving Support
- HIV: Tips for Caregivers to Avoid Infection
- HIV: Preventing Other Infections When You Have HIV
- HIV Home Care
- Antiretroviral medicines for HIV
- Resistance to HIV Medicines
- HIV: Preventing Infections
- HIV: Antiretroviral Therapy (ART)
- Opportunistic Infections in HIV
- HIV: Taking Antiretroviral Drugs
- HIV: Non-Progressors and HIV-Resistant People
- HIV Screening
- HIV and Weight Loss
- HIV and Fatigue
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Infectious Diseases
- Anthrax
- Avian Influenza
- Avoiding Infections in the Hospital
- Bacterial Infections of the Spine
- Bites and Stings: Flu-Like Symptoms
- Boric Acid for Vaginal Yeast Infection
- Caregiving: Reducing Germs and Infection in the Home
- Central Venous Catheter: Flushing
- Chickenpox (Varicella)
- Chickenpox: Preventing Skin Infections
- Chikungunya Fever
- Complicated Urinary Tract Infections
- Complications of Ear Infections
- Cranberry Juice and Urinary Tract Infections
- Dengue Fever
- Ear Infection: Should I Give My Child Antibiotics?
- Ear Infections
- Ebola or Marburg Virus Infection
- Ebola Virus Disease
- Enterovirus D68 (EV-D68)
- Fever or Chills, Age 11 and Younger
- Fever or Chills, Age 12 and Older
- Fever Seizures
- Fever Temperatures: Accuracy and Comparison
- Feverfew for Migraines
- Fifth Disease
- Flu: Signs of Bacterial Infection
- Fungal Nail Infections
- Giardiasis
- Hand-Foot-and-Mouth Disease
- Kissing Bugs
- Measles (Rubeola)
- Middle East Respiratory Syndrome (MERS)
- Molluscum Contagiosum
- Monkeypox
- Mononucleosis (Mono)
- Mononucleosis Complications
- Mumps
- Nail Infection: Should I Take Antifungal Pills?
- Neutropenia: Preventing Infections
- Non-Surgical Nail Removal for Fungal Nail Infections
- Noroviruses
- Pleurisy
- Pneumonia
- Preventing Tetanus Infections
- Pseudomonas Infection
- Recurrent Ear Infections and Persistent Effusion
- Recurrent Vaginal Yeast Infections
- Respiratory Syncytial Virus (RSV) Infection
- Rotavirus
- Rubella (German Measles)
- Scarlet Fever
- Sexually Transmitted Infections
- Sexually Transmitted Infections: Genital Examination for Men
- Sexually Transmitted Infections: Symptoms in Women
- Sexually Transmitted Infections: Treatment
- Shingles
- Smallpox
- Sore Throat and Other Throat Problems
- Staph Infection
- Strep Throat
- Symptoms of Pelvic Infection
- Thrush
- Tick Bites: Flu-Like Symptoms
- Tinea Versicolor
- Tuberculosis (TB)
- Tuberculosis Screening
- Urinary Tract Infections (UTIs) in Older Adults
- Vaginal Yeast Infection: Should I Treat It Myself?
- Vaginal Yeast Infections
- Valley Fever
- West Nile Virus
- Zika Virus
- Informed Health Decisions
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Injuries
- Trapped Finger, Toe, or Limb
- Blister Care
- Exercises for Heel Pain or Tightness
- Broken Toe
- Broken Nose (Nasal Fracture)
- Preventing Blisters
- Hip Fracture
- Medial Collateral Ligament (MCL) Injury
- Pressure Injuries From Scuba Diving
- Pressure Injuries: Stages
- Pressure Injuries: Prevention and Treatment
- Calf Muscle Injury
- Avulsion Fracture
- Lateral Collateral Ligament (LCL) Injury
- Posterior Cruciate Ligament (PCL) Injury
- Frozen or Stuck Tongue or Other Body Part
- Fifth Metatarsal Jones Fracture
- Animal and Human Bites
- Blisters
- Burns and Electric Shock
- Choking Rescue Procedure: Heimlich Manoeuvre
- Cold Temperature Exposure
- Cuts
- Ear Problems and Injuries, Age 11 and Younger
- Elbow Injuries
- Elbow Problems, Non-Injury
- Facial Injuries
- Facial Problems, Non-Injury
- Fish Hook Injuries
- Toe, Foot, and Ankle Injuries
- Groin Problems and Injuries
- Finger, Hand, and Wrist Injuries
- Anterior Cruciate Ligament (ACL) Injuries
- Safe Hand and Wrist Movements
- Physical Rehabilitation for ACL Injuries
- Marine Stings and Scrapes
- Mouth Problems, Non-Injury
- Nail Problems and Injuries
- Puncture Wounds
- Shoulder Problems and Injuries
- Removing Splinters
- Swallowed Button Disc Battery, Magnet, or Object With Lead
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British Columbia Specific Information
Cervical cancer is a disease in which the cells of the cervix become abnormal and start to grow uncontrollably, forming tumors. A Pap test, also known as a Papanicolaou test or pap smear, is a test used to determine if there are abnormal cells in the cervix. If abnormal cells are found, steps can be taken to try to prevent them from developing into cervical cancer. In Canada, a Pap test is the most effective and recommended screening test for cervical cancer. In B.C., it is recommended women aged 25-69 be screened every 3 years. To learn more about the cervical cancer screening program in B.C., including guidelines on who should be tested, visit BC Cancer Agency - Cervix Screening.
Approximately 70 per cent of all cervical cancer is caused by the human papillomavirus (HPV) types 16 and 18. The HPV vaccines, Cervarix® (HPV2) and Gardasil® (HPV4), protect against infection from certain types of human papillomaviruses (HPV). Health Canada approves the HPV vaccine Gardasil® (HPV4) for use in women and men. Health Canada also approves the HPV vaccine Cervarix® (HPV2) for use in women; however it is not currently approved for use in men.
Some groups are eligible to receive the vaccine for free. Those not eligible to receive the vaccine for free may purchase it from a pharmacy or doctor’s office. For information about the vaccine, including who is eligible to receive it for free, see HealthLinkBC File #101b Human Papillomavirus (HPV) Vaccine.
For more information about HPV see HealthLinkBC File #101a Human Papillomavirus (HPV) Infection and Genital Warts. For information on other HPV vaccine programs in B.C., visit ImmunizeBC - HPV (Human Papillomavirus).
Topic Overview
Is this topic for you?
This topic talks about the testing, diagnosis, and treatment of cervical cancer. For general information about abnormal Pap test results, see the topic Abnormal Pap Test.
What is cervical cancer?
Cervical cancer occurs when abnormal cells on the cervix grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer can often be successfully treated when it's found early. It is usually found at a very early stage through a screening test, such as the Pap test.
What causes cervical cancer?
Most cervical cancer is caused by a virus called human papillomavirus, or HPV. You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.
Most adults have been infected with HPV at some time. An infection may go away on its own. But sometimes it can cause genital warts or lead to cervical cancer. That's why it's important for women to have regular cervical cancer screening tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.
What are the symptoms?
Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer. Symptoms of cervical cancer may include:
- Bleeding from the vagina that is not normal, such as bleeding between menstrual periods, after sex, or after menopause.
- Pain in the lower belly or pelvis.
- Pain during sex.
- Vaginal discharge that isn't normal.
How is cervical cancer diagnosed?
As part of a pelvic examination, you may have a Pap test. During a Pap test, the doctor scrapes a small sample of cells from the surface of the cervix to look for cell changes. If a Pap test shows abnormal cell changes, your doctor may do other tests to look for precancerous or cancer cells on your cervix.
Your doctor may also do a Pap test and take a sample of tissue (biopsy) if you have symptoms of cervical cancer, such as bleeding after sex.
How is it treated?
The treatment for most stages of cervical cancer includes:
- Surgery, such as a hysterectomy and removal of pelvic lymph nodes with or without removal of both ovaries and fallopian tubes.
- Chemotherapy.
- Radiation therapy.
Depending on how much the cancer has grown, you may have one or more treatments. And you may have a combination of treatments. If you have a hysterectomy, you won't be able to have children. But a hysterectomy isn't always needed, especially when cancer is found very early.
Finding out that you have cancer can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counsellor can really help. Ask your doctor about support groups. Or call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca.
Can cervical cancer be prevented?
The Pap test can find cervical cell changes that can lead to cervical cancer. Regular Pap tests almost always show these cell changes before they turn into cancer. It's important to follow up with your doctor after any abnormal Pap test result so you can treat abnormal cell changes. This may help prevent cervical cancer.
There are two HPV vaccines in BC. Cervarix® is approved for females ages 9 through 45 years. It protects against two types of HPV that cause most cases of cervical cancer. Gardasil®9 is approved for use in females 9 through 45 years of age, but is also approved for use in males 9 to 26.
HPV vaccine recommendations may be different in your province or territory. Check with your doctor or provincial ministry of health to find the HPV vaccine recommendations in your area.
The virus that causes cervical cancer is spread through sexual contact. The best way to avoid getting a sexually transmitted infection is to not have sex. If you do have sex, practice safer sex, such as using condoms and limiting the number of sex partners you have.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Cause
Cervical cancer is caused by severe abnormal changes in the cells of the cervix. Most precancerous or cancerous cell changes occur in the cervix at the transformation zone, because these cells normally undergo constant change. During this natural process of change, some cervical cells can become abnormal if you are infected with high-risk types of HPV.
Other things may play a role in causing cervical cancer, such as having more than one sex partner or smoking cigarettes.
Symptoms
Abnormal cervical cell changes rarely cause symptoms. If cervical cell changes progress to cancer, symptoms may include:
- Vaginal bleeding that isn't normal, such as between menstrual periods, after sex, or after menopause.
- Pain during sex.
- Vaginal discharge that isn't normal.
- A significant unexplained change in your menstrual cycle.
The symptoms of advanced cervical cancer may include:
- Anemia because of abnormal vaginal bleeding.
- Ongoing pelvic, leg, or back pain.
- Urinary problems because of blockage of a kidney or ureter.
- Leakage of urine or stool into the vagina. This can happen when an abnormal opening (fistula) has developed between the vagina and the bladder or rectum.
- Weight loss.
What Happens
Cervical cancer happens when abnormal cells on the cervix grow out of control. Cervical cancer can often be successfully treated when it's found early. It is usually found at a very early stage through a screening test, such as the Pap test.
If cervical cancer isn't treated, it may spread from the cervix to the vagina, and then into deeper tissue layers of connective tissue around the uterus. As it progresses, it may spread to the pelvic lymph nodes and other pelvic organs. Advanced-stage cancer may spread to lymph nodes; to other organs in the pelvis, causing problems with kidney and bowel function; or to other organs in the body, such as the liver and lungs.
Treatment of cervical cancer depends on the stage of your cancer and if it has spread.
What Increases Your Risk
A risk factor for cervical cancer is something that increases your chance of getting this cancer. Having one or more of these risk factors can make it more likely that you will get cervical cancer. But it doesn't mean that you will definitely get it. And many people who get cervical cancer don't have any of these risk factors.
Things that may increase your risk for cervical cancer include:
- Having an ongoing infection with a high-risk type of human papillomavirus (HPV) . HPV is a sexually transmitted infection (STI). It is the most common cause of cervical cancer.
- High-risk sexual behaviours. These include having more than one sex partner or having a sex partner who has more than one partner. Safer sex can reduce your risk.
- Having an impaired immune system . Some conditions such as HIV can make you more likely to get an HPV infection.
- Smoking cigarettes or breathing in second-hand smoke.
When should you call your doctor?
Call your doctor if you have:
- Unexpected bleeding between menstrual periods.
- Menstrual periods that are irregular or 1½ to 2 times longer than normal for 3 months in a row. For example, call if your periods usually last 6 days but have been lasting between 9 and 12 days for your last 3 periods.
- Severe vaginal bleeding that causes you to soak 1 or 2 pads or tampons in 1 or 2 hours, or passing clots of blood from the vagina.
- Unexpected bleeding after douching or sex.
- Pain during sex.
- Abnormal vaginal discharge containing mucus that may be tinged with blood.
If you are diagnosed
If you have been diagnosed with cervical cancer, be sure to follow your doctor's instructions about calling when you have problems, new symptoms, or symptoms that get worse.
Who to see
Health professionals who can evaluate your symptoms and your risk factors, and who can diagnose cervical cancer include:
- Family doctors or general practitioners.
- Gynecologists.
- Obstetricians.
- Nurse practitioners.
- Internists.
Doctors who can manage your cancer treatment include:
Examinations and Tests
Early detection
Screening tests can help your doctor find and treat cervical cell changes before they progress to cervical cancer.
The recommended screening schedule is based on your age and things that increase your risk. Talk to your doctor about how often to have this test.
Diagnostic tests
Tests to confirm a diagnosis of cervical cancer include:
- A colposcopy and cervical biopsy. This test can find out whether and where cancer cells are on the surface of the cervix.
- An endocervical biopsy (or curettage). This test is to find out whether cancer cells are in the cervical canal.
- A cone biopsy. This type of biopsy may be done to remove cervical tissue for examination under a microscope.
Tests to find out the stage and treatment
Tests to find the extent (stage) of cervical cancer include:
- A chest X-ray to check your lungs.
- A CT scan, which uses X-rays to look inside the body.
- An ultrasound, which uses sound waves to check internal tissues and organs.
- An MRI, which uses magnets to see inside the body.
- A PET scan to check for cancer that has spread (metastasized) to other parts of the body.
- A biopsy using fine-needle aspiration.
Treatment Overview
Cervical cancer found in its early stages can be successfully treated. The choice of treatment and the long-term outcome (prognosis) of cervical cancer depend on the type and stage of cancer. Your age, overall health, quality of life, and desire to be able to have children must also be considered.
Types of treatment
Treatment choices for cervical cancer may be a single therapy or a combination of therapies, such as:
- Surgery to remove the cancer. The type of surgery needed depends on the location and extent of cervical cancer and whether you want to have children.
- Radiation therapy, which uses high-dose X-rays or implants in the vaginal cavity to kill cancer cells. It is used for certain stages of cervical cancer. It is often used in combination with surgery. To learn more, see Other Treatment.
- Chemoradiation, which is a combination of chemotherapy and radiation. This is often used to treat both early-stage and late-stage cervical cancer.
- Chemotherapy, which uses medicines to kill cancer cells. Chemotherapy may be used to treat advanced cervical cancer.
You can find more information about cervical cancer online at the:
- Canadian Cancer Society website at www.cancer.ca.
- U.S. National Cancer Institute website at www.cancer.gov.
Coping with emotions during treatment
When you first find out that you have cancer, you may feel scared or angry. Or you may feel very calm. It's normal to have a wide range of feelings and for those feelings to change quickly. Some people find that it helps to talk about their feelings with family and friends.
If your emotional reactions to cancer get in the way of your ability to make decisions about your health, it's important to talk with your doctor. Your cancer treatment centre may offer psychological services. And a local chapter of the Canadian Cancer Society can help you find a support group.
Body image and sexual problems
Your feelings about your body and your sexuality may change following treatment for cancer. Managing body image issues may involve talking openly with your partner about your feelings and discussing your concerns with your doctor. Your doctor may be able to refer you to organizations that can offer additional support and information.
Treatment during pregnancy
Cancer treatment during pregnancy is the same as for non-pregnant women. But when you'll get treatment may depend on the stage of your cancer and what trimester you are in. For example, if you have early-stage cervical cancer and you are in your third trimester, your treatment may be delayed until after you deliver your baby. Treatment may cause problems such as an early delivery or even the loss of the baby.
Follow-up care
After treatment for cervical cancer, it is important to receive follow-up care. Your oncologist or gynecologic oncologist will schedule regular checkups that will include:footnote 1
- A pelvic examination and Pap test every 3 to 4 months for the first 2 years.
- After the first 2 years, a pelvic examination and Pap test every 6 to 12 months for another 3 to 5 years.
- After 5 years, a pelvic examination and Pap test every year.
Follow-up tests that may be recommended by your oncologist include an abdominal and pelvic computed tomography (CT) scan. This test is to see if cancer has spread to other organs in the belly or pelvis.
Cervical cancer that comes back
Cervical cancer can return, or recur, after treatment. The chance that your cancer will return depends on the stage of the initial cancer. Cancer found early is less likely to come back than cancer found at a later stage.
Your long-term outcome (prognosis) for recurrent cervical cancer depends greatly on how much the cancer has spread when the recurrence is diagnosed.
Treatments include surgery and chemoradiation or chemotherapy to relieve symptoms. Your doctor may talk with you about being in a clinical trial. Clinical trials for cervical cancer are studying therapies that target cancer cells.
Hospice palliative care
Cancer treatment has two main goals: curing cancer and making your quality of life as good as possible. Hospice palliative care can improve your quality of life by helping you manage your symptoms. It can also help you with other concerns that you may have when you are living with a serious illness.
For some people who have advanced cancer, a time comes when treatment to cure cancer no longer seems like a good choice. This can be because the side effects, time, and emotional stress of treatment are greater than the promise of cure or relief. But this isn't the end of treatment. Hospice palliative care providers will work to help manage pain and other symptoms or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
It can be hard to decide when to stop treatment aimed at prolonging your life and shift the focus to end-of-life care. You and your doctor can decide when you may be ready for hospice palliative care.
To learn about supportive care, see:
Prevention
You can treat early cervical cell changes (dysplasia), which can reduce your risk for cervical cancer. You can also reduce your risk for abnormal cell changes.
Have regular Pap test screening
The recommended Pap test schedule is based on your age and things that increase your risk. Talk to your doctor about how often to have this test.
Quit smoking
Women who smoke cigarettes or who breathe in second-hand smoke have a higher risk for cervical cell changes that can lead to cervical cancer.footnote 2 Quitting smoking may decrease this risk.
For information about quitting, see the topic Quitting Smoking.
Get the HPV vaccine
If you are a woman age 45 or younger, you may be able to get a HPV vaccine. HPV vaccines protect against HPV. There are many types of HPV. Some types of the virus can cause cervical cancer. HPV vaccines protect against the most common HPV types that can cause serious problems. For more information, see the topic Immunizations.
HPV vaccine recommendations may be different in your province or territory. Check with your doctor or provincial ministry of health to find the HPV vaccine recommendations in your area.
- HPV: Should My Child Get the Vaccine?
- HPV: Should I Get the Vaccine?
Reduce your risk of a sexually transmitted infection (STI)
Preventing an STI, including HPV, is easier than treating an infection after it occurs. HPV infection usually doesn't cause symptoms, so you or your partner may not know that you are infected.
To reduce your risk:
- Talk with your partner about STIs before beginning a sexual relationship. Find out if he or she is at risk for an STI. Remember that it's possible to be infected with an STI without knowing it. Some STIs, such as HIV, can take up to 6 months before they are detected in the blood.
-
Be responsible.
- Avoid sexual contact if you have symptoms of an STI or are being treated for an STI.
- Avoid all intimate sexual contact with anyone who has symptoms of an STI or who may have been exposed to an STI.
- The fewer sex partners you have in your lifetime, the better it is for your health. Your risk for an STI increases if you have several sex partners or if your sex partner has more than one partner.
- Use male or female condoms to reduce the risk of getting an STI. Using male condoms when you have sex has been shown to reduce your risk of getting HPV.footnote 3 Female condoms may help also, although there has been less study of this type of protection.
Not having sexual contact is the only certain way to prevent exposure to STIs. Sexually transmitted infections such as human papillomavirus (HPV) can be spread to or from the genitals, anus, mouth, or throat during sexual activities.
Home Treatment
The side effects of cancer treatment can be serious. Healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms. Your doctor may also give you medicines to help you with certain side effects.
- Home treatment for nausea or vomiting includes watching for and treating early signs of dehydration. Signs include a dry mouth, sticky saliva, and reduced urine output with dark yellow urine. Eating smaller meals may help. A little bit of ginger candy or ginger tea can help too.
- Home treatment for diarrhea includes resting your stomach and being alert for signs of dehydration. Check with your doctor before using any non-prescription medicines for your diarrhea.
- Home treatment for constipation includes making sure that you drink enough fluids and include fruits, vegetables, and fibre in your diet each day. Don't use a laxative without consulting your doctor.
Other symptoms that can be treated at home include:
- Sleep problems. If you find that you have trouble sleeping, learn ways to manage sleep problems, such as having a sleep routine and making sure your bedroom is dark and quiet.
- Fatigue. If you don't have any energy and tire easily, try some tips to help your fatigue. These include getting extra rest, eating a balanced diet, and reducing your stress.
- Urinary problems, which can be caused by both cervical cancer and its treatment. It may help to remove caffeinated drinks from your diet and to establish a schedule of urinating every 3 to 4 hours, whether you feel the need or not.
- Hair loss . Hair loss may be unavoidable. But using mild shampoos and avoiding damaging hair products will reduce irritation of your scalp.
- Stress. Managing stress may include expressing your feelings to others. Learning relaxation techniques may also be helpful. Relaxation techniques, such as meditation, and support groups may help too.
- Pain. Not all forms of cancer treatment cause pain. But if you do have pain, there are many home treatments that can help.
Problems after hysterectomy may include:
- Pelvic weakness. Kegel exercises can help strengthen the pelvic muscles.
- Vaginal dryness. Lubricants, such as Astroglide or K-Y Jelly, may help. Or talk to your doctor about a low-dose vaginal estrogen cream, ring, or tablet.
- Pain during sexual intercourse if your vagina was shortened during surgery. Changing positions may help make sex less painful. Talk with your doctor if you have any problems during sex that you think may be related to your surgery.
Having cancer can change your life in many ways. For support in managing these changes, see the topic: Getting Support When You Have Cancer.
Medications
Chemotherapy is used to shrink cervical cancer and decrease tumour growth. It may be used alone or along with radiation (chemoradiation).
Chemoradiation, compared with radiation alone, improves survival in early-stage cervical cancer.footnote 4 Chemoradiation can be used as the main treatment or after a hysterectomy.
Chemotherapy may be used to treat cervical cancer that has spread beyond the cervix.
Medicine choices
Chemotherapy medicines used to treat cervical cancer may include carboplatin, cisplatin, and paclitaxel.
Dealing with side effects of medicines
Most chemotherapy will cause some side effects, such as nausea, vomiting, and hair loss. Your doctor may also give you medicines to control and prevent nausea and vomiting. Home treatment may also help relieve other common side effects of cancer treatment.
Surgery
Surgery to remove the cancer depends on the location and extent of cervical cancer and your desire to be able to have children. You also may be given radiation therapy, chemotherapy, or a combination of the two (chemoradiation). These treatments may be given before or after surgery to try to destroy any cancer cells that may remain or to help control or shrink the tumour.
Surgery choices
Surgery for very early stages of cervical cancer may preserve your ability to have children. Surgeries include:
- Cone biopsy (conization) . This removes a wedge of cervical tissue that contains the cancer.
- Radical trachelectomy . This removes the cervix, part of the vagina, and the pelvic lymph nodes (lymph node dissection). But the uterus is left in place.
Surgery for most stages of cervical cancer does not preserve your ability to have children. Surgeries include:
- Hysterectomy . This is surgery to remove the uterus and cervix . During this surgery, the ovaries and fallopian tubes may also be removed to reduce the chances of recurrence.
- Pelvic exenteration (say "ig-ZEN-tuh-ray-shun"). This is the most serious pelvic surgery. It is done when cancer has spread throughout the lower belly and pelvis. In this surgery, the uterus, cervix, vagina, ovaries, fallopian tubes and lymph nodes are removed. The rectum, bladder, or both may also be removed. Artificial openings are made so urine and stool can pass from the body into a collection bag. An artificial vagina can also be created during this surgery.
Dealing with side effects of surgery
Side effects from a conization usually include mild cramping, soreness, spotting and bleeding, and dark-brown or yellow vaginal discharge. These symptoms can happen during the first few hours to the first few weeks. This surgery may be done in your doctor's office, at a colposcopy clinic or at a hospital.
A hysterectomy is major surgery with general anesthesia, so you will likely be in the hospital for a few days. As soon as you feel strong enough, get up and move around as much as you can. This helps prevent problems after surgery like blood clots, pneumonia, and gas pains.
Other side effects from hysterectomy may include:
- Pain or discomfort for a few days. Medicines can help with this, so talk with your doctor about pain medicines before your surgery.
- Short-term effects, such as feeling sick to your stomach or having trouble emptying your bladder. These problems usually go away on their own after a few hours.
- Early menopause, if you have not yet started menopause. You won't have menstrual periods any more. You may have hot flashes, vaginal dryness, night sweats, or other symptoms of menopause. Before your surgery, talk with your doctor about hormone therapy and other treatment options.
- Changes in sexual response. For some women, having a hysterectomy changes their sexual response. If you notice any sexual problems, talk with your doctor.
For more information, see the topic Sexual Problems in Women.
Other Treatment
Radiation therapy
Radiation therapy is used for certain stages of cervical cancer, often along with surgery. Chemotherapy may be given at the same time as radiation treatment (chemoradiation) to improve survival rates. Chemoradiation may be used as the main treatment or after a hysterectomy.
Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumours. Radiation may come from a machine outside the body (external beam radiation therapy). Or it may come from radiation material (radioisotopes) in thin plastic tubes inserted through the vagina into the cervical area where the cancer cells are found (brachytherapy).
Dealing with side effects of radiation
Radiation may cause many side effects, including diarrhea and irritation of the bladder (radiation cystitis). Home treatment may help relieve some common side effects of cancer treatment.
Your ability to have or enjoy sexual intercourse may also be affected. This is because radiation may cause changes to the cells lining the vagina (mucosa), making intercourse difficult or painful. A series of vaginal dilators, starting with a small one and progressing to a larger size, may be used after radiation therapy. Using the dilators can help by making the vaginal opening larger.
Radiation to treat cervical cancer may thin the bone and increase the risk of fractures in the pelvic area, including hip fractures. You can take steps to prevent thinning of the bone (osteoporosis), such as getting enough calcium and vitamin D. Also, try to prevent falls, which can lead to fractures. For more information, see the topic Osteoporosis.
Clinical trials
Some women who have cervical cancer may be interested in taking part in research studies called clinical trials. Clinical trials are designed to find better ways to treat cancer patients. They are based on the most up-to-date information. Women who don't want standard treatments or are not cured using standard treatments may want to take part in clinical trials. These are ongoing in many Canadian provinces and in some other countries for all stages of cervical cancer.
Complementary therapy
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the therapies that may be helpful include:
- Acupuncture. It can relieve pain and may help you deal with nausea and vomiting from chemotherapy.
- Meditation or yoga. These mind-body treatments relieve stress. They may help you feel better and cope with treatment.
- Light massage (not deep tissue or intense pressure) or biofeedback. These can ease tension.
- Breathing exercises or aromatherapy. They can help you relax and feel less anxious.
These mind-body treatments may help you feel better. They can make it easier to cope with treatment. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any of these therapies. They are not meant to take the place of standard medical treatment.
Related Information
References
Citations
- National Comprehensive Cancer Network (2012). Cervical Cancer, version 1. Available online: http://www.nccn.org/professionals/physician_gls/PDF/cervical.pdf.
- National Cancer Institute (2012). Cervical Cancer (PDQ): Prevention—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/prevention/cervical/HealthProfessional.
- Winer RL, et al. (2006). Condom use and the risk of genital human papillomavirus infection in young women. New England Journal of Medicine, 354(25): 2645–2654.
- Martin-Hirsch PL, Wood NJ (2011). Cervical cancer, search date October 2009. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
Other Works Consulted
- American Cancer Society (2011). Cancer Facts and Figures for African Americans 2011–2012. Atlanta. American Cancer Society. Available online: http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-027765.pdf.
- National Cancer Institute (2011). Cervical Cancer PDQ: Treatment—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/cervical/patient.
- National Cancer Institute (2012). Cervical Cancer PDQ: Treatment—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/cervical/HealthProfessional.
- U.S. Preventive Services Task Force (2012). Screening for cervical cancer: Summary of recommendations. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm.
Credits
Adaptation Date: 1/19/2023
Adapted By: HealthLink BC
Adaptation Reviewed By: HealthLink BC
Adaptation Date: 1/19/2023
Adapted By: HealthLink BC
Adaptation Reviewed By: HealthLink BC
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