Take steps to detect, prevent cervical cancer: Final Days

Alabama Nurse,  Mar-May 2005  by Justice, Haley

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A new year brings a fresh start, a time of promises and commitments to take better care of ourselves. January is Cervical Cancer Awareness Month. When considering which resolutions to make, the department wants every woman to consider the following factors that may increase her risk of developing cervical cancer.

Human Papillomavirus (HPV): This is the most important risk factor for cervical cancer. HPV is a sexually transmitted disease that can cause changes in the cervix. The changes can be detected through a simple Pap test. There are no symptoms associated with HPV and most people never know they have it. At this time there is no treatment available for HPV.

Smoking: Women who smoke are twice as likely as those who do not to develop cervical cancer. Tobacco smoke produces chemicals that .may damage the DNA in cells of the cervix and make cancer more likely to occur.

Family History: Recent studies suggest that women whose mother or sister had cervical cancer are more likely to develop the disease themselves.

Between 1999 and 2002, 302 Alabama women died from, cervical cancer. Women who are properly screened should not die from cervical cancer. Routine Pap testing is not only the best way to reduce deaths from cervical cancer by detecting cancer in its earlier and most treatable stage, but can also reduce incidence by identifying pre-cancerous conditions that are treatable. Although the rates of developing this disease have decreased over the years, African American and Hispanic women continue to be diagnosed with cervical cancer at a higher rate than Caucasian women.

The following are the American Cancer Society recommendations for cervical cancer screening: Cervical cancer screening should begin about three years after a woman initiates vaginal intercourse, but no later than 21 years of age. Cervical screening should be done every year with regular Pap tests.

At or after age 30, women who have had three normal test results in a row may get screened every two or three years. A doctor may suggest getting the test more often if a woman has certain risk factors such as human immunodeficiency virus (HTV) infection or a weakened immune system.

Women 70 years of age or older who have had three or more normal Pap tests results and no abnormal results in the past 10 years may choose to stop cervical cancer screening.

Screening after a total hysterectomy, with removal of the cervix, is usually not necessary unless the surgery was done as a treatment for cervical cancer or pre-cancer. Some other special conditions may require continued screening. Women who have had a hysterectomy without the removal of the cervix should continue cervical cancer screening at least until age 70.

For additional information about cervical cancer please call one of the following toll-free numbers:

1-800-ACS-2345 American Cancer Society

1-8004-C ANCER National Cancer Institute's Cancer Information Service

Reprinted with permission from Alabama Department of Public Health

A Cleveland hospice offers advice.

The staff of Hospice of the Western Reserve supports you in the provision of care to your loved one during the last stage of life. As each person's life is unique, so is each one's journey toward death; but it is always a difficult time and people may not know what to expect.

We hope this information will help you to be better informed and prepared, but remember that it is natural to feel confused and upset anyway. Do not reproach yourself for that.

It is common for the dying to focus inward, beginning about one to three months before death. This withdrawal from the exterior world does not reflect unfavorably on anyone. Rather, it reflects the patient's need to turn his attention inward in thought and contemplation. Dying is hard. Your presence during the process is very important.

Signs and symptoms of Imminent Death

As the patient enters the final stage of life, you may notice physical changes. They do not all occur at the same time and some may not occur at all. Your hospice team will help you to identify and understand them in the effort to support you through this trying period.

Call when you observe the following signs of impending death:

* The patient has a decreasing need for food and drink as body functions slow down gradually. There may be difficulty in swallowing. The mouth may become dry and should be kept moist. The patient is not hungry - the body has its own sense of what it needs. Gradually, the patient spends more time sleeping during the day and at times is difficult to arouse. This symptom is a result of a change in the body's metabolism. Try to spend more time with the patient at points of greatest consciousness.

* It is common for the dying patient to become restless and to pull at the bed linen. The patient may become increasingly confused about time; place, and the identity of familiar people. Reminders as to what day it is, what time it is, and who is in the room will be comforting. The lights should be dim rather than bright, but sufficient for the patient to see faces. Soft music may be calming! Keep the side rails of the bed up for safety.