Biomedical subjects

T P Canavan

Publications and source records attributed to T P Canavan.

5 recordsLinked to original sources

PubMed2000

Cervical cancer.

Cervical cancer is the second most common type of cancer in women worldwide, after breast cancer. A preponderance of evidence supports a causal link between human papillomavirus infection and cervical neoplasia. The presence of high-risk human papillomavirus genital subtypes increases the risk of malignant transformation. Widespread use of the Papanicolaou smear has dramatically reduced the incidence of cervical cancer in developed countries. Accurate and early recognition of abnormal cytologic changes prevents progression of the disease from preinvasive to invasive. Research is under way to determine if efforts to reduce the false-negative rate of the Papanicolaou smear should include rescreening programs and fluid-based technology. Once cervical cancer is diagnosed, clinical staging takes place. Early-stage tumors can be managed with cone biopsy or simple hysterectomy. Higher stage tumors can be treated surgically or with radiotherapy. Advanced metastatic disease may respond to radiation therapy and concurrent chemotherapy. Protein markers for detection of recurrence and vaccines for prevention of cervical cancer are under investigation.

Adenocarcinoma↗

PubMed2000

Managing endometriosis. Strategies to minimize pain and damage.

Endometriosis is a common condition affecting a significant number of women of childbearing age. The diagnosis is clinical and thus can be difficult to make. History taking is generally most helpful, and diagnostic tests have a limited role. Diagnostic laparoscopy remains the "gold standard" for diagnosis of endometriosis. Treatment is geared toward improving fertility and controlling pain and is often not curative. However, both medical and surgical therapies are of value in controlling the disease. Attention to the psychosocial needs of the patient are also critical. Future therapies will be based on a further understanding of the pathogenesis of endometriosis and the effect of hormones on the disease. For the primary care physician who may not be comfortable prescribing GnRH analogs or other medical therapies, referral to a gynecologist or endocrinologist should be considered.

Danazol↗

PubMed2000

Dyspareunia in women. Breaking the silence is the first step toward treatment.

Dyspareunia is a heterogeneous disorder that has a number of potentially overlapping causes. It can be a source of great conflict and anxiety for many women. The primary care physician who takes the time to obtain a complete and careful sexual history and perform a comprehensive physical examination can help the majority of these patients. When dysfunction is complicated or refractory to treatment, gynecologic and psychosocial consultation may be necessary.

Dyspareunia↗

PubMed1999

Endometrial cancer.

Endometrial cancer is the fourth most common cancer in women, accounting for approximately 6,000 deaths per year in the United States. It is more common in women who are older, white, affluent obese and of low parity. Hypertension and diabetes mellitus are also predisposing factors. Because any condition that increases exposure to unopposed estrogen increases the risk of endometrial cancer, tamoxifen therapy, estrogen replacement therapy without progestin and the presence of estrogen-secreting tumors are all risk factors. Smoking and the use of oral contraceptives appear to decrease the risk. Women with an increased risk and those with postmenopausal bleeding should be screened for endometrial cancer. Endometrial sampling is currently the most accurate and widely used screening technique, but ultrasonographic measurement of endometrial thickness and hysteroscopy have also been studied. Patients with endometrial specimens that show atypia have about a 25 percent likelihood of progressing to carcinoma, compared with less than 2 percent in patients without atypia. Endometrial cancer is usually treated surgically, but in patients with appropriate pathologic findings who decline surgical treatment, progestin therapy may be satisfactory.

Algorithms↗

PubMed1998

Appropriate use of the intrauterine device.

The intrauterine device, a common form of birth control in the early 1970s, is now avoided by American physicians and women because of concern about complications. This concern is largely the result of the problems reported with use of an intrauterine device that is no longer manufactured. More recent intrauterine devices have an improved design, and reevaluation has shown them to be a safe, efficacious and cost-effective form of birth control. Careful patient selection and preinsertion counseling are crucial to success with the device. Recent studies conclude that the intrauterine device poses no increased risk of pelvic inflammatory disease or infertility when used by appropriately selected patients.

Contraception↗