deteksi dini kanker serviks (penyuluhan)

of 22 /22
KANKER SERVIKS KANKER SERVIKS SKRINING, DIAGNOSA DAN PENATALAKSANAAN SKRINING, DIAGNOSA DAN PENATALAKSANAAN

Author: faza-kahfi

Post on 14-Dec-2015

17 views

Category:

Documents


5 download

Embed Size (px)

DESCRIPTION

c

TRANSCRIPT

  • KANKER SERVIKSSKRINING, DIAGNOSA DAN PENATALAKSANAAN

  • Apa itu Kanker Serviks ?Kanker Leher Rahim :Adalah kanker yang terjadi pada leher rahim (serviks)Apa itu serviks ?Serviks adalah daerah yang menghubungkan rahim (uterus) dan vagina.

    The Adam Health Illustrated Encyclopedia, A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission

  • Organ Genitalia PerempuanLeher rahim

  • 490,000 perempuan didiagnosa* menderita kanker serviks240,000 di antaranya MENINGGAL Seberapa sering Kanker Serviks ?Menurut WHO TIAP TAHUN, DI SELURUH DUNIA:*80% terjadi di negara berkembang

  • 59,929 29,814Europe78,896 61,670Africa48,328 21,402South America14,670 5796United States/ Canada1,063 330Australia/New Zealand42,538 22,594Southeast Asia61,132 31,314Eastern Asia17,165 8124Central America157,759 86,708Southcentral AsiaBanyaknya Kasus dan Kematian dari Kanker Serviks Prediksi Kasus dan Kematian Kanker Serviks di tahun 2002 1. Ferlay J, Bray F, Pisani P, Parkin DM. Lyon, France: IARC Press; 2004.

  • Bagaimana Terjadinya Kanker Serviks?Kanker serviks dapat berkembang ketika sel yang abnormal dalam serviks mulai membelah diri tanpa terkendali dan berkumpul jadi tumorTUMORJinak tidak berbahaya tetap pada daerah sumbernya, tidak menyebarGanas berbahaya , dapat menjadi kanker akan menyebar ke daerah lainThe Adam Health Illustrated Encyclopedia, A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission

  • Bagaimana terjadinya Kanker Serviks ?Sel Normal Lesi Pra KankerKanker

  • Serviks Normal (Leher Rahim)

  • Lesi Pra Kanker

  • Lesi Pra Kanker

  • Apa penyebab Kanker Serviks?KANKER SERVIKS DISEBABKAN OLEH HUMAN PAPILLOMAVIRUSa,1,2120 Tipe HPV telah diketahui30-40 Tipe HPV menyerang anogenital

    Low risk type ( HPV 6 & 11 )(tidak menyebabkan kanker)Menyebakan anogenital wartsHigh risk type ( HPV 16 & 18)Menyebabkan kanker serviksInfeksi dengan HPV seringkali TIDAK menimbulkan gejala Banyak orang TIDAK tidak tahu mereka terinfeksi HPVBanyak orang dapat menularkan HPV TANPA menyadarinyaAnogenital : area kelamin (termasuk kulit penis, mulut vagina & anus)

  • Cara Penularan

  • Pap Smears sebagai Deteksi DiniPap Smear : pengambilan sel dari serviks, diperiksa dengan mikroskop untuk mengetahui adanya kelainan pada serviksJIKA ANDA SUDAH MENIKAH / MELAKUKAN HUBUNGAN, LAKUKAN PAP SMEAR SECARA TERATUR

  • Penting untuk di-INGAT!Kanker serviks adalah kanker yang banyak menyebabkan kematian pada perempuan Kanker serviks dapat dicegah :Deteksi sedini mungkin dengan PAP SMEAREdukasi mengenai kanker serviksVaksinasi HPV VAKSIN

    KONSULTASIKAN KEPADA DOKTER ANDA TENTANG KANKER SERVIKS & CARA PENCEGAHANNYA

  • Vaksin HPV diberikan kepada siapa ?????Pria usia 9 15 tahunPria usia diatas 15 tahun ??? (On Going Study)Wanita usia 9 26 tahunWanita usia diatas 26 tahun ????

  • Faktor Risiko Kanker ServikPenyebab kanker serviks: infeksi HPV virus

    Faktor risiko yang lain : Mempunyai multipel partner seksual atau berhubungan seks dengan partner yang mempunyai multipel partner seks.

    Sejarah mempunyai sexually transmitted disease (STD)

  • Faktor Risiko Hubungan seksual pertama pada usia muda (sebelum usia 18)

    Pasien atau seksual partner mempunyai penyakit kondiloma genitalia (kutil).

    Tidak menggunakan kondom pada hubungan seksual dengan partner baru.

    Pasangan yang lalu dari partner seks menderita kanker serviks atau sel-sel abnormal.

    Sexual partner menderita kanker penis.

  • Perdarahan per vaginam abnormal (e.g., spotting setelah hubungan seksual, perdarahan diantara periode menstruasi, jumlah darah menstruasi banyak)

    Abnormal (kuning putih, berbau) cairan vaginal Low back pain

    Nyeri saat berhubungan seksual.

    Nyeri saat BAK pada keadaan yang lanjut. Manifestasi Klinik

  • Manifestasi Klinik

    Jika kanker sudah metastasis: Sulit BAK dan mungkin gagal ginjal. Nyeri BAK dan kadang-kadang kencing darah Bengkak di kaki Diarrhea, atau nyeri di daerah anus atau BAB berdarah Mual, lemas, BB turun, nafsu makan turun, dan terasa nyeri Konstipasi Lubang abnormal di leher rahim (fistula) Pembesaran kelenjar limfe di leher atau ketiak Penyebaran lanjut ke tulang , paru, usus atau otak memberikan tanda tanda abnormal

  • Stadium Kanker serviksStage I tumors: sel sel kanker hanya terdapat dan terbatas pada leher rahim.Stage II tumors: sel tumor sudah menyebar di luar bagian dari leher rahim, sepert bagian atas dari vagina atau jaringan di sekitar leher rahim. Stage III tumors: tumor sudah menyebar di organ sekitar seperti bagian bawah dinding vagina, kelenjar getah bening terdekat atau jaringan lemak di sekitar leher rahim sampai mencapai dinding pelvis . Stage IV tumors: tumor menyebar ke organ organ di sekitar organ genitalia ( yaitu kandung kemih atau usus) atau ke organ organ di luar rongga pelvis . Meliputi penyebaran ke paru, hati atau tulang.

  • Stadium Klinis Kanker Leher RahimSource: FIGO Annual Report on The Results of Treatment in Gynaecological Cancer Journal of Epidemiology and Biostatistics, (2001) vol. 6 no. 1, page 14.

    *www.maketheconnection.orgGCF (Gynecologic Cancer Foundation) Presentation

    ***www.maketheconnection.orgwww.cancer.org*www.maketheconnection.orgwww.nccc-online.org*1. Wright TC Jr, Cox JT, Massad LS, et al, for the ASCCP-Sponsored Consensus Congress. JAMA. 2002;287:21202129. 2. Bonnez W. In: Richman DD, Whitley RJ, Hayden FJ, eds. Washington, DC: American Society for Microbiology Press; 2002:557596. 3. Canadian Cancer Society. Cervical Cancer: What you need to know. Available at: http://www.cancer.ca/vgn/images/portal/cit_86751114/63/40/151140772cw_library_wyntk_cervical_en.pdf. Accessed March 13, 2006. 4. Reprinted with permission from Sellors JW, Sankaranarayanan R, eds. Colposcopy and Treatment of Cervical Intraepithelial Neoplasia. A Beginners Manual. Lyon, France: International Agency for Research on Cancer; 2003.

    1/Sellors/Ch. 7/p. 1/ 1; p. 6/ 3, Figure 7.12.1/Sellors/Ch. 7/p. 1/ 1; p. 6/3,4; p. 8/ Figure 7.20; p.9/Figure 7.23.2/Bonnez/p. 576/Figure 12; p. 578/col 1/21/Wright/p.2120/abstract conclusions3/CCS/p 6/24/Sellors/Ch. 7/p.9/Figure 7.23.1/Sellors/Ch. 4/p. 1/ 1; p.5/ 2*1. Wright TC Jr, Cox JT, Massad LS, et al, for the ASCCP-Sponsored Consensus Congress. JAMA. 2002;287:21202129. 2. Bonnez W. In: Richman DD, Whitley RJ, Hayden FJ, eds. Washington, DC: American Society for Microbiology Press; 2002:557596. 3. Canadian Cancer Society. Cervical Cancer: What you need to know. Available at: http://www.cancer.ca/vgn/images/portal/cit_86751114/63/40/151140772cw_library_wyntk_cervical_en.pdf. Accessed March 13, 2006. 4. Reprinted with permission from Sellors JW, Sankaranarayanan R, eds. Colposcopy and Treatment of Cervical Intraepithelial Neoplasia. A Beginners Manual. Lyon, France: International Agency for Research on Cancer; 2003.

    1/Sellors/Ch. 7/p. 1/ 1; p. 6/ 3, Figure 7.12.1/Sellors/Ch. 7/p. 1/ 1; p. 6/3,4; p. 8/ Figure 7.20; p.9/Figure 7.23.2/Bonnez/p. 576/Figure 12; p. 578/col 1/21/Wright/p.2120/abstract conclusions3/CCS/p 6/24/Sellors/Ch. 7/p.9/Figure 7.23.1/Sellors/Ch. 4/p. 1/ 1; p.5/ 2*www.maketheconnection.orgwww.cdc.gov/std/HPV/STDFcat-HPV.htm*1. Hewitt M, Devesa SS, Breen N. Cervical cancer screening among U.S. women: analyses of the 2000 National Health Interview Survey. Prev Med. 2004;39:270-278.2. Crum CP, Rivera MN. Vaccines for cervical cancer. Cancer J. 2003;9:368376.3. Sung HY, Kearney KA, Miller M, Kinney W, Sawaya GF, Hiatt RA. Papanicolaou smear history and diagnosis of invasive cervical carcinoma among members of a large prepaid health plan. Cancer. 2000;88:22832289.4. Schink JC. Strategies for detecting cervical dysplasia: Visual inspection, spectroscopy, and speculoscopy. OBG Manag. 2003;(suppl):58.5. Selvaggi SM. Implications of low diagnostic reproducibility of cervical cytologic and histologic diagnoses. JAMA. 2001;285:15061508.6. Chacho MS, Mattie ME, Schwartz PE. Cytohistologic correlation rates between conventional Papanicolaou smears and ThinPrep cervical cytology: A comparison. Cancer. 2003;99:135140.7. Saslow D, Runowicz CD, Solomon D, et al. American Cancer Society Guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin. 2002;52:342362.8. Uyar DS, Eltabbakh GH, Mount SL. Positive predictive value of liquid-based and conventional cervical Papanicolaou smears reported as malignant. Gynecol Oncol. 2003;89:227232.9. Kulasingam SL, Hughes JP, Kiviat NB, et al. Evaluation of human papillomavirus testing in primary screening for cervical abnormalities: Comparison of sensitivity, specificity, and frequency of referral. JAMA. 2002;288:17491757.5/Selvaggi/ p. 1506/col 1/34/Schink/ p. 5/ col 2/1.5/Selvaggi/ p. 1506/col 1/1, 3.6/Chacho/ p. 137/col 2/58/Uyar/p. 227/abstract7/Saslow/p. 352/col 2/2.8/Uyar/ p. 227/abstract5/Selvaggi/ p. 1506/col 2/1.9/Kulasingam / p.1754/Table 3; p. 1749/abstract3/Sung/p. 2285/col 2/3, 42/Crum/p. 368/col 1/2; col 2/11/Hewitt/p. 270/ col 1/11/Parham/p. S14/Table 1.2/Schink/p. 5/ col 2/2.3/Uyar/p. 227/abstract.4/Kulasingam/p. 1754/Table 3.2/Schink/p. 5/col 2/1.5/Selvaggi/ p. 1506/col 1/1, 3.6/Chacho/p. 137/col 2/5*American Cancer Detailed Guide. American Cancer Society Online Publication. http://www.cancer.org*Stage I is carcinoma strictly confined to the cervix; extension to the uterine corpus should be disregarded. Stage IA: Invasive cancer identified only microscopically. All gross lesions even with superficial invasion are stage Ib cancers. Invasion is limited to measured stromal invasion with a maximum depth of 5 mm* and no wider than 7 mm.[Note: *The depth of invasion should not be more than 5 mm taken from the base of the epithelium, either surface or glandular, from which it originates. Vascular space involvement, either venous or lymphatic, should not alter the staging.]Stage IA1: Measured invasion of the stroma no greater than 3 mm in depth and no wider than 7 mm diameter. Stage IA2: Measured invasion of stroma greater than 3 mm but no greater than 5 mm in depth and no wider than 7 mm in diameter. Stage IB: Clinical lesions confined to the cervix or preclinical lesions greater than stage IA.Stage IB1: Clinical lesions no greater than 4 cm in size. Stage IB2: Clinical lesions greater than 4 cm in size.Stage II is carcinoma that extends beyond the cervix but has not extended onto the pelvic wall. The carcinoma involves the vagina, but not as far as the lower third. Stage IIA: No obvious parametrial involvement. Involvement of up to the upper two thirds of the vagina.Stage IIB: Obvious parametrial involvement, but not onto the pelvic sidewall. Stage III is carcinoma that has extended onto the pelvic sidewall. On rectal examination, there is no cancer-free space between the tumor and the pelvic sidewall. The tumor involves the lower third of the vagina. All cases with a hydronephrosis or nonfunctioning kidney should be included, unless they are known to be due to other causes. Stage IIIA: No extension onto the pelvic sidewall but involvement of the lower third of the vagina. Stage IIIB: Extension onto the pelvic sidewall or hydronephrosis or nonfunctioning kidney.Stage IV is carcinoma that has extended beyond the true pelvis or has clinically involved the mucosa of the bladder and/or rectum. Stage IVA: Spread of the tumor onto adjacent pelvic organs. Stage IVB: Spread to distant organs.