“Ovarian cancer is the second most common gynecologic cancer in the United States. Ovarian cancer causes more deaths than any other cancer of the female reproductive system.  In 2020, the latest year for which incidence data are available, in the United States, 18,518 new cases of Ovarian cancer were reported among women, and 13,438 women died of this cancer. For every 100,000 women, 9 new Ovarian cancer cases were reported and 6 women died of this cancer.

Cancer is the second leading cause of death in the United States, exceeded only by heart disease. One of every five deaths in the United States is due to cancer.”

Centers for Disease Control and Prevention – CDC  (https://gis.cdc.gov/Cancer/USCS/#/AtAGlance/)

“In Lower Manhattan, the plane crashes—which resulted in the collapse of the Twin Towers—created massive dust clouds that filled the air and left hundreds of highly populated city blocks covered with ash, debris, and harmful particles, including asbestos, silica, metals, concrete, and glass. Fires within the debris pile and the collapse of 7 WTC burned through the end of December 2001 with continued flare-ups in 2002, releasing carcinogenic combustion by-products. These contaminants remained in Lower Manhattan and parts of Brooklyn for an undetermined amount of time after 9/11.”

Center for Disease Control and Prevention – CDC (https://www.cdc.gov/wtc/exhibition/toxins-and-health-impacts.html)

MEMORY OF 9/11

“Duchenne muscular dystrophy (DMD) is a genetic disorder characterized by progressive muscle degeneration and weakness due to the alterations of a protein called dystrophin that helps keep muscle cells intact. DMD is one of four conditions known as dystrophinopathies.  It is the most common type of muscular dystrophy.

DMD symptom onset is in early childhood, usually between ages 2 and 3. The disease primarily affects boys, but in rare cases it can affect girls.

In Europe and North America, the prevalence of DMD is approximately 6 per 100,000 individuals.DMD was first described by the French neurologist Guillaume Benjamin Amand Duchenne in the 1860s, but until the 1980s, little was known about the cause of any kind of muscular dystrophy. In 1986, MDA-supported researchers identified a particular gene on the X chromosome that, when flawed (mutated), leads to DMD. In 1987, the protein associated with this gene was identified and named dystrophin”

Muscular Dystrophy Association – MDA (https://www.mda.org/disease/duchenne-muscular-dystrophy)

The most common form of muscular dystrophy – Duchenne muscular dystrophy – typically affects young boys, but other variations can strike in adulthood.

Currently, there is no cure for muscular dystrophy, but certain physical and medical treatments can improve symptoms and slow the disease’s progression.

is a group of diseases that make muscles weaker and less flexible over time. It is caused by a problem in the genes that control how the body keeps muscles healthy. For some people, the disease starts early in childhood. Others don’t have any symptoms until they are teenagers or middle-aged adults.

How muscular dystrophy affects you or your child depends on the kind. Most people’s condition will get worse over time, and some people may lose the ability to walk, talk, or care for themselves. But that doesn’t happen to everyone. Other people can live for many years with mild symptoms.

There are more than 30 kinds of muscular dystrophy, and each is different based on:

• The genes that cause it
• The muscles it affects
• The age when symptoms first appear
• How quickly the disease gets worse

People usually get one of nine major forms of the disease:

• Duchenne muscular dystrophy (DMD) is the most common form. It mainly affects boys, and starts between ages 3 and 5.
• Becker muscular dystrophy is like Duchenne, except milder. It also affects boys but the symptoms start later — between ages 11 and 25.
• Myotonic muscular dystrophy is the most common form in adults. People who have it can’t relax their muscles after they contract. It can affect both men and women, and it usually starts when people are in their 20s.
• Congenital muscular dystrophy starts at birth or shortly afterwards.
• Limb-Girdle muscular dystrophy often starts in a person’s teens or 20s.
• Facioscapulohumeral muscular dystrophy affects the muscles of the face, shoulders, and upper arms. It can affect anyone from teenagers to adults in their 40s.
• Distal muscular dystrophy affects the muscles of the arms, legs, hands, and feet. It usually comes on later in life, between ages 40 and 60.
• Oculopharyngeal muscular dystrophy starts in a person’s 40s or 50s. It causes weakness in the muscles of the face, neck, and shoulders, and droopy eyelids (ptosis), followed by difficulty swallowing (dysphagia).
• Emery-Dreifuss muscular dystrophy affects mainly boys, usually starting around age 10. People with this form often have heart problems along with muscle weakness.

“Cervical cancer screening tests are usually done during a pelvic exam, which takes only a few minutes. During the exam, you lie on your back on an exam table, bend your knees, and put your feet into supports at the end of the table. The health care provider uses a speculum to gently open your vagina to see the cervix. A soft, narrow brush or tiny spatula is used to collect a small sample of cells from your cervix.

Cervical cancer is highly preventable and highly curable if caught early. Nearly all cervical cancers could be prevented by HPV vaccination, routine cervical cancer screening, and appropriate follow-up treatment when needed.

HPV commonly caused by multiple sex partners and unprotected sex. People who become sexually active at a young age, especially before age 18, or have multiple sexual partners are more likely to become infected with a high-risk type of HPV.”

National Cancer Institute (https://www.cancer.gov/types/cervical/causes-risk-prevention)

1-Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.

Know this about screening:

Scientists are trying to better understand which people are more likely to get certain types of cancer.

Cervical dysplasia occurs more often in women who are in their 20s and 30s. Death from cervical cancer is rare in women younger than 30 years and in women of any age who have regular screenings with the Pap test. The Pap test is used to detect cancer and changes that may lead to cancer. The chance of death from cervical cancer increases with age. In recent years, deaths from cervical cancer have been slightly higher in Black women younger than 50 years than in White women younger than 50 years. Deaths from cervical cancer are almost twice as likely in Black women older than 60 years than in White women older than 60 years.

Human papillomavirus (HPV) infection is the major risk factor for cervical cancer.

2.If cervical cancer is suspected, your doctor is likely to start with a thorough examination of your cervix. A special magnifying instrument (colposcope) is used to check for abnormal cells.

During the colposcopic examination, your doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, your doctor may use:

• Punch biopsy, which involves using a sharp tool to pinch off small samples of cervical tissue.
• Endocervical curettage, which uses a small, spoon-shaped instrument (curet) or a thin brush to scrape a tissue sample from the cervix

If the punch biopsy or endocervical curettage is worrisome, your doctor may perform one of the following tests:

• Electrical wire loop, which uses a thin, low-voltage electrified wire to obtain a small tissue sample. Generally this is done under local anesthesia in the office.
• Cone biopsy (conization), which is a procedure that allows your doctor to obtain deeper layers of cervical cells for laboratory testing. A cone biopsy may be done in a hospital under general anesthesia.

Staging the cervical cancer:

Cervical Cancer. Carcinoma of Cervix. Malignant neoplasm arising from cells in the cervix uteri. Vaginal bleeding. Vector diagram

If your doctor determines that you have cervical cancer, you’ll have further tests to determine the extent (stage) of your cancer. Your cancer’s stage is a key factor in deciding on your treatment.

Staging exams include:

• Imaging tests. Tests such as X-ray, CT, MRI and positron emission tomography (PET) help your doctor determine whether your cancer has spread beyond your cervix.
• Visual examination of your bladder and rectum. Your doctor may use special scopes to see inside your bladder and rectum.

“Several risk factors can increase your chance of developing cervical cancer. People without any of these risk factors rarely develop cervical cancer. Although these risk factors can increase the odds of developing cervical cancer, many with these risks do not develop this disease.

When you think about risk factors, it helps to focus on those you can change or avoid (like smoking or human papillomavirus infection), rather than those you cannot (such as your age and family history). However, it is still important to know about risk factors that cannot be changed, because it’s even more important for those who have these factors to get regular screening tests to find cervical cancer early.”

American Cancer Society (https://www.cancer.org/cancer/types/cervical-cancer/causes-risks-prevention/risk-factors.html)

Cervical cancer risk factors

GENERAL

• Pregnancy: Women who have had three or more full-term pregnancies, or who had their first full-term pregnancy before age 17, are twice as likely to get cervical cancer.

GENETICS

• Family history: Women with a sister or mother who had cervical cancer are two to three times more likely to develop cervical cancer.

LIFESTYLE

• Sexual history: Certain types of sexual behavior are considered risk factors for cervical cancer and HPV infection. These include: sex before age 18, sex with multiple partners and sex with someone who has had multiple partners. Studies also show a link between chlamydia infection and cervical cancer.
• Smoking: A woman who smokes doubles her risk of cervical cancer.
• Oral contraceptive use: Women who take oral contraceptives for more than five years have an increased risk of cervical cancer, but this risk returns to normal within a few years after the pills are stopped.

OTHER CONDITIONS

• Weakened immune system: In most people with healthy immune systems, the HPV virus clears itself from the body within 12-18 months. However, people with HIV or other health conditions or who take medications that limit the body’s ability to fight off infection have a higher risk of developing cervical cancer.
• Diethylstilbestrol (DES): Women whose mothers took DES, a drug given to some women to prevent miscarriage between 1940 and 1971, have a higher risk of developing cervical cancer.
• HPV: Though HPV causes cancer, having HPV does not mean you will get cancer. The majority of women who contract HPV clear the virus or have treatment so the abnormal cells are removed. HPV is a skin infection, spread through skin-to-skin contact with a person who has the virus.

Additional facts about HPV:

• There are more than 100 types of HPV, 30-40 of which are sexually transmitted.
• Of these, at least 15 are high-risk HPV strains that can cause cervical cancer. The others cause no symptoms or genital warts.
• Up to 80 percent of women will contract HPV in their lifetime. Men get HPV, too, but there is no test for them.
• A healthy immune system will usually clear the HPV virus before there is a symptom, including the high-risk types of HPV.
• Only a small percentage of women with high-risk HPV develop cervical cancer.

Understanding risk factors:

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer. Not having risk factors doesn’t mean that you will not get cancer. If you think you may be at risk, you should discuss it with your doctor.

Regarding symptoms of cervical cancer:

In most cases, cervical cancer does not cause noticeable symptoms in the early stages of the disease. Routine Pap screening is important to check for abnormal cells in the cervix, so they can be monitored and treated as early as possible. Most women are advised to get a Pap test starting at age 21.

The Pap test is one of the most reliable and effective cancer screening methods available, and women should have yearly exams by an OB-GYN. However, the Pap test may not detect some cases of abnormal cells in the cervix. The HPV test screens women for the high-risk HPV strains that may lead to cervical cancer. It is approved for women over age 30.

Although screening methods are not 100 percent accurate, these tests are often an effective method for detecting cervical cancer in the early stages when it is still highly treatable. Talk with your doctor about which type of cervical cancer screening is right for you.

When present, common symptoms of cervical cancer may include:

• Vaginal bleeding: This includes bleeding between periods, after sexual intercourse or post-menopausal bleeding.
• Unusual vaginal discharge: A watery, pink or foul-smelling discharge is common.
• Pelvic pain: Pain during intercourse or at other times may be a sign of abnormal changes to the cervix, or less serious conditions.

All of these cervical cancer symptoms should be discussed with your doctor.

Signs of advanced stages of cervical cancer:

Cervical cancer may spread (metastasize) within the pelvis, to the lymph nodes or elsewhere in the body. Signs of advanced cervical cancer include:

• Weight loss
• Fatigue
• Back pain
• Leg pain or swelling
• Leakage of urine or feces from the vagina
• Bone fractures

“Cervical cancer begins when healthy cells in the cervix develop changes in their DNA. A cell’s DNA contains the instructions that tell a cell what to do. The changes tell the cells to multiply quickly. The cells continue living when healthy cells would die as part of their natural life cycle. This causes too many cells. The cells might form a mass called a tumor. The cells can invade and destroy healthy body tissue. In time, the cells can break away and spread to other parts of the body.

Most cervical cancers are caused by HPV. HPV is a common virus that’s passed through sexual contact. For most people, the virus never causes problems. It usually goes away on its own. For some, though, the virus can cause changes in the cells that may lead to cancer.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/cervical-cancer/symptoms-causes/syc-20352501)