Thread: Cancer sucks

Fortunately for armstrong and his wife he had the funds to use a recommended doctor and hospital.might be a good wake up call for the young bloke to up his insurance cover or just get some. bld tip#422 maybe cut back on the Leo's to help with that?

Steep decline in cervical cancer deaths among young women in US

HPV vaccination linked to a steep decline in cervical cancer deaths among U.S. women under 25, with mortality dropping by 62% from 2013-2021 and only 13 deaths reported in 2019-2021.

The HPV vaccine has been demonstrated to work together with screening and treatment strategies to bring down the incidence and mortality rates of cervical cancer. When taken between 9-14 years, HPV vaccination effectively prevents HPV infection and cervical cancer, as well as other HPV-related cancers.

HPV vaccination has been routinely used among American women since 2006. By 2021, about 78.5% of American women were covered by the vaccine, having taken one or more doses. The under-25 cohort is the first to presumably benefit on a large scale from the introduction of the vaccine.

Cervical cancer incidence fell dramatically among under-25 women between 2012 and 2019, by 12% per year, for a cumulative decrease in incidence of 65%.

The current study sought evidence that the decline in HPV infections and the observed drop in cervical cancer incidence was associated with reduced cervical cancer mortality rates in this cohort.

About the study

The data for mortality due to cervical cancer among women under 25 in America came from the National Center for Health Statistics. Using regression analysis, the researchers estimated the reduction in the number of cervical cancer deaths during this period compared to the continuance of the previous trend. This indirect inferential method was necessary as cancer registry data do not include the HPV vaccination status of the patient.

Changing trends in cervical cancer mortality

There were 398 cervical cancer deaths in this group of women between 1992 and 2021. From this period to the five years beginning in 2013, the rate began to slip down to 3,7% annually. This was probably because of the wider uptake of screening and the use of improved methods.

This reduction accelerated to 15.2% per year during 2015-2019, for an overall 62% decrease by 2019.

Taking two-year intervals, the number of cervical cancer deaths fell from 55 per 1,00,000 person-years during 1992-1994 to 35 in 2013-2015, to hit a low of 13 in 2019-2021. Comparing the trends, it appears that the number of deaths from this cause averted between 2016 and 2021 to 26, compared to the expected number.

Conclusions

The current study showed a drastic drop in cervical cancer deaths among American women below 25 years in the period 2016-2021. This suggests that “HPV vaccination affected the sequential decline in HPV infection prevalence, cervical cancer incidence, and cervical cancer mortality.”

Notably, the statistical power of this study is limited by the low number of cervical cancer deaths in some of the years covered due to the rarity of the condition in young women.

Whereas 79.3% of American adolescents received the HPV vaccination in 2022, coverage fell to 75.9% in 2023 rather than increasing further. This study's findings suggest the need to boost HPV vaccination coverage to stabilize and further reduce cervical cancer rates among young American women.



Think RFK Jr.

Steep decline in cervical cancer deaths among young women in US - https://x.com/cremieuxrecueil/status...05450771005916

PSEUDOMYXOMA PERITONEI.


About pseudomyxoma peritonei.


Pseudomyxoma peritonei (PMP) is a very rare type of cancer. It usually begins in your appendix as a small growth, called a polyp.
This is different to polyps that cause bowel cancer and is called a Low Grade Appendiceal Mucinous Neoplasm (LAMN).

More rarely, it can start in:
other parts of the bowel
the ovaries
the bladder

This polyp eventually spreads through the wall of your appendix or wherever else it starts. It then spreads cancerous cells to the abdominal cavity lining (the peritoneum). These cancerous cells produce mucus. The mucus collects in the abdomen as a jelly like fluid called mucin. PMP is sometimes called ‘Jelly Belly’.

Doctors often call PMP a borderline malignant condition. Malignant means cancerous. Cancers usually spread to other parts of the body through the lymphatic and blood system.

PMP doesn’t behave like this and it doesn’t spread to other parts of the body. But it does grow and spread inside the tummy (abdomen).

The appendix and peritoneum.
Your appendix is part of the digestive system. It’s on the right hand side of your abdomen and is attached to your colon (large bowel). The role of the appendix is unclear.


Diagram showing the position of the appendix
The sheet of tissue covering the organs of your abdomen is called the peritoneum. The peritoneum has 2 layers:

the parietal layer lines the abdominal wall
the visceral layer covers the organs.



Diagram showing the peritoneum and peritoneal fluid in the abdomen

The space between these layers is called the peritoneal space. The peritoneum also makes a lubricating fluid (peritoneal fluid). It helps the organs inside move smoothly against each other as you move around.

How does pseudomyxoma peritonei spread?

Pseudomyxoma peritonei doesn't act like most cancers. It rarely spreads through the bloodstream or the lymphatic system to any other part of the body.

Instead, it spreads inside the abdomen. The cancer cells generally spread by following the peritoneal fluid flow. They attach to the peritoneum at particular sites. Here they produce mucus which collects inside the abdomen and eventually causes symptoms. Without treatment, it will take over the peritoneal cavity. It can press on the bowel and other organs.

This condition develops very slowly. It might be years before you have any symptoms of this type of cancer.
Because of this, it has usually spread beyond the appendix before diagnosis.

What causes pseudomyxoma peritonei?
We don't know what causes this type of cancer. Most cancers are caused by a number of different factors working together.


What are the symptoms of pseudomyxoma peritonei?
Some people won't have any symptoms of pseudomyxoma peritonei. So it can be difficult to diagnose.

In women, this type of cancer can sometimes be confused with ovarian cancer. Ovarian cancer may also cause a swollen abdomen. Some types of ovarian cancer cells also produce mucin.

Symptoms can include:

abdominal or pelvic pain
not being able to become pregnant
abdominal swelling and bloating
changes in bowel habits
hernia (a bulge in the tummy wall or groin)
loss of appetite
feeling of fullness
Often, pseudomyxoma peritonei is only properly diagnosed after an operation to look into the tummy (abdomen). This is also called a laparotomy.

Tests
It can be difficult to diagnose PMP. Doctors sometimes find it by accident during treatment for other conditions.

Before you have treatment, your doctors will arrange for you to have tests. The tests include:
ultrasound scan
CT scan
MRI scan


Treatment for pseudomyxoma peritonei
The main treatments for pseudomyxoma peritonei (PMP) are surgery and chemotherapy. Your treatment depends on the size of the cancer and your general health.

You might not start treatment straight away. Your doctor closely monitors your cancer in case you need treatment in the future. This is called watch and wait.

If you need treatment you might have:

surgery combined with chemotherapy into the tummy (abdomen)
surgery to remove as much cancer as possible (debulking surgery)
chemotherapy
Watch and wait
Your doctor might decide to closely monitor your cancer if it’s small and slow growing and you don’t currently need treatment. Your doctor will check up on you regularly. Watch and wait can also sometimes be called active surveillance. They do this with blood tests and scans.

You might find it hard to cope with this and struggle with feeling that no action is being taken.


Surgery combined with chemotherapy into the abdomen
Where possible, you’ll have surgery combined with chemotherapy. This is given directly into your tummy (abdomen). It's called cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC)

You have to be well enough to have this intensive surgery.
And the surgeon needs to be able to remove the disease without affecting your vital organs.

It involves:

the surgeon removing any tissue affected by PMP
having heated chemotherapy drugs put directly into your abdomen during the surgery (HIPEC)

The surgery
The aim is to remove all of the visible PMP cells in your abdomen. So there will be no cancer cells left that could start to grow again. The surgeon strips out the lining of the abdomen (the peritoneum). They then remove any tissues affected by PMP.

The operation varies between people, but can include removing:

part of the bowel
the spleen
cancer attached to the surface of the liver
the fatty layers in the abdomen (the omentum)
the gallbladder
the lowest part of your bowel (rectum)
the womb and ovaries if you are a woman
the bellybutton
the affected lining of your abdomen (peritoneum)
Your spleen helps to fight infection. Some people need to have their spleen removed. So you might need to have some vaccinations before, or just after, the operation. And you will need to take antibiotics for the rest of your life because of changes to your immune system.

This can be major surgery. The operation can take around 10 hours and your recovery can be slow. Sometimes people need more than one operation, several months apart.

Chemotherapy during surgery (intraperitoneal chemotherapy)
The surgeon puts heated chemotherapy into the peritoneal space inside your tummy (abdomen). This happens during your operation. It is called hyperthermic intraperitoneal chemotherapy, or HIPEC.

Chemotherapy uses anti cancer drugs to destroy cancer cells. The aim is to kill any PMP cells that remain in the abdomen. Heating the chemotherapy can improve how well it works.

You usually have a chemotherapy drug called mitomycin C. You sometimes have other drugs, such as oxaliplatin.


After surgery
You might be in intensive care or a high dependency unit for 24 to 48 hours. You might also have:

a catheter (tube in the bladder)
an epidural (tube in the spine for pain relief)
a nasogastric tube (tube down your nose into your stomach to stop you being sick)
drains in the tummy
feeding through a drip into a vein (intravenous), also called parenteral nutrition (PN) for about 2 weeks
You’re likely to be in hospital for 2 to 3 weeks. Some people may also need a blood transfusion after the operation. It takes a long time to be able to recover from this operation. It can be at least 6 months before you are fully active again and able to work.

About 30 out of every 100 people (30%) have complications after treatment. This might be less in some treatment centres. About 20 out of 100 patients (20%) need a stoma after surgery. A stoma is where the bowel is brought out to the surface of the tummy. It is covered by a bag after surgery. About half of these people only need the stoma for 3 to 6 months, after which the bowel is put back together.

Read more about having a stoma
It is important that your surgeon discuss the treatment's risks and benefits with you. Only then you can consent to this surgery.

Read more general information about having surgery
Debulking surgery
Debulking surgery aims to remove as much of the cancer as possible. It does not remove the cancer completely.

Debulking surgery helps to make a diagnosis and get samples of the tumour. It can also remove mucin. It won’t cure PMP but might ease your symptoms. It could also mean that you can then have cytoreductive surgery with HIPEC.

Debulking surgery might mean removing part of your bowel. The surgeon might remove your womb and ovaries if you are a woman.

Unless the surgeon can remove the whole cancer, it's very likely to come back. Because of this, you might have debulking surgery more than once.

Chemotherapy
You might have chemotherapy if you can’t have surgery. You are more likely to have chemotherapy if:

your cancer is causing symptoms
CT scans show your cancer is growing quickly
You might have either mitomycin C into a vein with or without capecitabine as tablets. Doctors sometimes use other drugs.

It is important that you discuss the pros and cons of having treatment with your specialist. If your cancer is slow growing, the doctor might suggest that they monitor you. They will only suggest chemotherapy if your cancer is growing quickly or causing symptoms.

There hasn't yet been enough research into the benefits of systemic treatment.

Specialist centres for pseudomyxoma peritonei.
The National Institute for Health and Care Excellence (NICE) has produced guidance for PMP. The guidance is on cytoreductive surgery with intraperitoneal chemotherapy. They recommend that people with PMP have treatment in a specialist centre.

There are 2 designated UK specialist treatment centres. This is because pseudomyxoma peritonei is very rare. The centres are:

the Peritoneal Malignancy Institute at Basingstoke and North Hampshire NHS Foundation Trust
the Colorectal and Peritoneal Oncology Centre at The Christie NHS Foundation Trust in Manchester

Many people with pseudomyxoma peritonei have treatment at another hospital first. This is because PMP wasn't suspected. Even if you have already had surgery, your specialist might suggest further surgery. This might be followed by intraperitoneal chemotherapy.

Research into treatment for pseudomyxoma peritonei
Researchers around the world are trying to improve treatments for pseudomyxoma peritonei. But because this type of cancer is so rare, it is difficult to do trials.

Treatment for pseudomyxoma peritonei | Cancer Research UK





And, but not for the squeamish, a video of the surgical procedure, which starts 1.22 sec into the video.