CHAPTER I INTRODUCTION

A. Background
Cervical cancer (Cervical Cancer) is a malignant tumor in the cervix . Cervix (lower part of the uterus attached to the top of the vagina. Cervical cancer usually affects women aged 35-55 tahun.90% of cervical cancers are from squamous cells lining the cervix dan10% were derived from cells of the gastrointestinal mucus-producing glands in the cervical yangmenuju uterus. [4] cervical carcinoma usually occurs on zonatransisional located between squamous epithelium and columnar epithelial cells. Until now cervical cancer is the leading cause of death terbanyakakibat cancer in developing countries. Indeed when the disease is dapatdicegah cytology screening programs and health services diperbaiki.Diperkirakan each year about 500,000 new cases found in seluruhdunia and generally occur in developing countries. Disease originated from a viral infection that stimulates epithelial cell perubahanperilaku cervix. In the current research being conducted vaksinasisebagai primary prevention and therapy of this disease in the future. Risk of infection with HPV virus and several other conditions such as perilakuseksual, contraception, or smoke going to promote the occurrence of cervical cancer incidence serviks.Mekanisme cancer is a process which is a variation of up to kompleksdan difficult to dipahami.Insiden and cervical cancer mortality in the world second only to cancer breast. meanwhile, in developing countries still menempatiurutan first as a cause of cancer deaths in the reproductive age. Nearly 80% of cases are in developing countries. Prior to 1930, cervical cancer is the leading cause of death among women and the case was dropped secaradrastik since the introduction of Pap smear screening technique by Papanikolau.Namun, unfortunately until now has not been more popular in the community screening program in negaraberkembang, easy to understand why the high incidence of cervical cancer masihtetap. The most important thing is to face menegakkandiagnosis cervical cancer patients as early as possible and provide effective therapy once prediksprognosisnya. Until now therapeutic options are still limited to surgery, chemotherapy radiasidan, or some combination of these therapeutic modalities. However, this therapy is still a tentusaja symptomatic 'because they still have not touched the basic cause of cancer is a change cell behavior. Lebihmendasar therapies or immunotherapy is still in the stage of this penelitian.Saat treatment options depend on the extent penyebaranpenyakit anatomically and constantly changing along with kemajuanteknologi medicine. Determination of treatment options and prognosis prediction atauuntuk compare the success rate of new therapies should be based on padaperluasan disease. Universally determining the extent agreed penyebaranpenyakit through staging system.

B.

Problem Formulation
Based on the previous background, it can dirumuskanbeberapa problem as follows: 1. What is a uterine cervical cancer and what are kalsifikasidan clinical signs of cervical cancer? 2. What are the factors causing and faktoe risk of cervical cancer? 3.Bagaimanakah picture of the epidemiology of cervical cancer? 4.Bagaimanakah pathology, deployment, and the diagnosis of cervical cancer? 5.Bagaimana way of treatment and prevent cervical cancer?

CHAPTER II DISCUSSION

A. Understanding Cervical Cancer

Cervical cancer (cervical) or carcinoma of the uterine cervix is the number two cancer killer of women in the world after breast cancer. In Indonesia, and even cervical cancer ranks first. Cervical cancer that has entered into an advanced stage often leads to death within a relatively quick period of time. Uterine cervical cancer is the most common malignancy of women ditemukandikalangan. This disease is a process of change from the normal suatuepithelium to be invasive which provide symptomatic Ca danmerupakan process slowly and take many years. Cervix or uterus / cervix is the lower end of the uterus that protrudes into copulation canal (vagina). Cervical cancer develops gradually, but progressively. The process begins with the onset of cancer selyang mutate and evolve into dysplastic cells, so-called terjadikelainan epithelial dysplasia. Starting from mild dysplasia, dysplasia is, severe dysplasia, and eventually became carcinoma in-situ (KIS), then expand again to invasive carcinoma. Degree of dysplasia and KIS is also known as pre-cancerous. From dysplasia to carcinoma in-situdiperlukan 1-7 years time, whereas carcinoma in-situ into karsinomainvasif range 3-20 years. 99.7% of these cancers are caused by human papilloma virus (HPV) oncogenic, which attacks the cervix. Starting occur on the cervix, when it has entered the stage, this cancer can spread to organs throughout the body organlain.

B. Clinical symptoms of Cervical Cancer

Not typical at an early stage. Often just as fluos with a little blood, bleeding or bleeding pervagina pastkoital alleged to be an extended time period. In later stages of new signs of a more typical, either in the form of severe bleeding (mainly in the form eksofitik), fluor albus is odorless and very severe pain. In the precancerous phase, often no symptoms or signs typical. However, sometimes symptoms can be found as follows: 1 Whitish or watery discharge from the vagina. The sap that comes out of the longer vaginaini will stink due to infection and tissue necrosis 2. Bleeding after intercourse (post coital bleeding) and then progress to abnormal bleeding. 3. Incidence of bleeding after the menopause. 4. In the invasive phase of the discharge can be yellowish, berbaudan can be mixed with blood. 5. Symptoms arise when there is bleeding chronic anemia.

6. Pelvic pain (pelvic) or in the lower abdomen when there radangpanggul. When pain occurs in the waist down, the possibility of hydronephrosis. In addition, pain can also occur in other places. 7. In later stages, the body becomes emaciated due to malnutrition, edemakaki, bladder irritation and shaft of the lower intestine (rectum), vesicovaginal or rectovaginal fistula formation, or the symptoms arise due to distant metastases

C.

Causes and Risk Factors for Cervical Cancer

1. Causes HPV (Human Papilloma Virus) is a leading cause additional terbanyak.Sebagai cigarette smokers have been found to cause juga.Wanita smokers contains nicotine and cotinine concentrations in serviksmereka that damage cells. Male smokers also contained material konsetrat inipada genital secretions, and can meet some nutritional selamaintercourse.Defisiensi cervix can also cause servikaldisplasia.National Cancer Institute recommends eating five times that wanitasebaiknya fresh fruits and vegetables setiaphari. If you can not do this, consider konsumsimultivitamin with antioxidants such as vitamin E or beta carotene every day. 2. Risk Factors a. Pattern of sexual relations. Epidemiological studies revealed that the risk of cervical cancer increases with increasing number of pasangan.aktifitas seksualyang begins at an early age, which is less than 20 years, also can dijadkansebagai faktr resko the kanke servks. It is not matannya hubungannyadengan diuga there in vain proficiency level of Regional transformas when serinterekspos. The frequency of sexual hubungna lebitingginya also affect the risk at that age, yeyapitidak lebihtua age group. (Schiffman, 1996). b. parity Cervical cancer is often found in women often give birth melahirkan.Semakin yan often, the big semain terjamgkit risk of cervical cancer. Pemelitian in Latin America shows the relationship between multiparity resikodengan after controlled with HPV infection. c. smoke Some fieldwork menunukan antaramerokok strong relationship with cervical cancer, even after controlling with sex hubungna variabelkonfounding like-pattern. Another discovery of nicotine paa mempekhatkanditemkanna cervical fluid of women smokers is bersifatasebaai kokassnoen materials and co-sma with kasinoge yan pretext adaselanjutnya mendoron toward cancer growth.

d. oral contraceptives The perspective of research conducted by Vessey et al tahun1983 (Schiffman, 1996) found that the increased incidence of cervical cancer is influenced by the duration of use of oral contraceptives. Penelitiantersebut also found that all invasiveterdapat cervical cancer incidence in users of oral contraceptives. Other studies mendapatkanbahwa cancer incidence after 10 years of use 4 times more tinggidaripada not users of oral contraceptives. However, similar studies by peritz yangdilakukan et al concluded that the sexual activity that is closely related merupakanconfounding with tersebut.WHO e. nutritional deficiencies Several studies have shown that deficiency of nutrients beta-carotene and vitamin A tertentuseperti as well as folic acid, berhubungna denganpeningkatan risk of mild and moderate dysplasia .. however sampasaat there is never an indication that the improvement defisensi tersebutakan enurunkan nutritional risk. f. socio-economic Deskrptif and analytical studies showed the strong relationship between the incidence of cervical cancer with a low socioeconomic level. It is also d iperkuat by studies showing that HPV infection was more prevalent in women with low levels of education and income. Factor of nutritional deficiencies, multilaritas and genital hygiene also been linked with the issue. g. sexual partners The role of the sexual partners of patients with cervical cancer mulaimenjadi interesting material for examination. Yangfrekuen condom use was given a low risk of cervical cancer. Poor hygiene associated with circumcision genetalia also a long discussion on the incidence of cancer in addition to his wife serviks.Jumlah doubles partner is also another risk factor.

Womb cancer picture.

D. Treatments for Cervical Cancer

Selection of treatment for cervical cancer depends on the location danukuran tumor, disease stage, age, general state of the patient and rencanapenderita to get pregnant again 1. Surgery In carcinoma in situ (cancer confined to the outer layer servikspaling), all cancers can often be removed with the help of pisaubedah or by LEEP. With treatment, the patient masihbisa have children. Because cancer can recur, it is recommended untukmenjalani reexamination and Pap smears every 3 months for 1 tahunpertama and thereafter every 6 months. If the patient does not have rencanauntuk pregnant again, it is recommended to undergo a hysterectomy. Invasive cancer, a hysterectomy and removal of the structure around it (radical hysterectomy inidisebut procedures) as well as lymph nodes. In young women, the ovaries (ovarian) are still functioning normally and is not removed.

2. radiation therapy Radiation therapy (radiotherapy) is effective for treating invasive cancer is still confined to the pelvic area. Radiotherapy used on high-energy rays to damage cancer cells and stop its growth. There are two kinds of radiotherapy, namely: a. External radiation: berasar rays from a large machine Patients do not need to be hospitalized, irradiation is usually performed 5 days / week for 5-6 weeks. b. Internal radiation: radioactive substances contained in a capsule is inserted directly into the cervix. Capsule is left for 1-3 days during which the patient to be hospitalized. This treatment can be repeated several times for 1-2 weeks. Side effects of radiation therapy are: c. Irritation of the rectum and vagina d. Damage to the bladder and rectum e. Ovaries stop functioning. 3. Chemotherapy If the cancer has spread beyond the pelvis, chemotherapy is sometimes recommended untukmenjalani. In the chemotherapy drugs used untukmembunuh cancer cells. Anti-cancer drugs can be administered through intravenous injection or by mouth. Chemotherapy is given in a cycle, artinyasuatu treatment periods interspersed with periods of recovery, then dilakukanpengobatan, interspersed with recovery of the premises, and so on. 4. biological therapy On biological therapy used substances to improve sistemkekebalan body against disease. Performed on biological therapy of cancer that has spread to other body parts. The most seringdigunakan is interferon, which can be combined with chemotherapy.

E. Cervical Cancer Prevention and Treatment

Kinder to the prevention of cervical control can be divided into three parts, namely prmer prevention, secondary prevention, and public health strategies pencegahantersier in preventing deaths from cervical cancer, among others, is the prevention of primary and secondary pencegaan.

1. Primary prevention Primary prevention is an activity olehsetiap money can be made out of people to avoid factors that may menyebabkantimbulnya cervical cancer. This can be done by healthy hdup menekankanperilaku to reduce or avoid the risk factors sepertikawin young, multiple sexual partners and others. In addition it can be done with the primary jugapencegahan imuisasi HPV in the community 2. secondary prevention Secondary prevention of cervical cancer is done by detection of cervical cancer screening dinidan which aims to find a case-kasuskanker cervical dapatditingkatkan dibni so the chances of healing. Development of cervical cancer requires a invasive lama.Dari prainvasif to take about 10 years or lebih.Pemeriksaan cytology is a simple and sensitive method of pre-invasive untukmwndeteksi karsinoa. If treated properly, prainvasive carcinomas have a cure rate approaching 100%. Kasuspada invasive diagnosis phase has only about 35% resistance level. Programskrining with cytologic examination known as the Pap test and telahdilakukan Mear in developed countries. Prevention of the pap smear terbukimampu reducing deaths from cervical cancer by 50-60% dalamkurun 20 years (WHO, 1986).

In addition, there are also three levels of prevention and treatment of cervical cancer, namely:

1. Prevention of First Instance a. Community Health Promotion for example: 1) public awareness campaign 2) public health education programs 3) Promotion of health b. Special precautions, such as: 1) Intervention source of exposure 2) a chemopreventive 2. Prevention of Second Level a. Early diagnosis, such as screening b. Treatment, for example: 1) Chemotherapy 2) Surgery 3. Third Level Prevention Rehabilitation, such as home care, while most cancer treatment is a multidiscipline approach. Treatment outcomes of radiotherapy and radical surgery about the same, although difficult to compare because most of the operated patients are young and generally good.

CHAPTER III CLOSING

A. Conclusion
1. Uterine cervical cancer is the most common malignancy of women ditemukandikalangan. This disease is a process of change from the normal suatuepithelium to be invasive which provide gejaladan Ca is a process that is slowly and take many years. There are several classifications but the most adherents adalahyang made by IFGO (International Federation of Ginekoloi and Obstetrics), ie Stage 0, 1, 1 a, 1 b, 2, 3, and 4. Clinical symptoms of advanced cervical cancer padastadium new signs of a more typical, well berupaperdarahan great (especially in the form eksofitik), fluor albus yangberbau and the pain is very great. 2. HPV (Human Papilloma Virus) is the most common cause of cervical cancer. In addition to cigarette smokers have been found sebagaipenyebab too. As for risk factors, namely: Patterns of sexual intercourse, parity, smoking, oral contraceptives, nutritional deficiencies, Socio-economic, and sexual partners. 3. From the report FIGO (International Federation Of Gynecology and Obstetrics) in 1988, the age group 30-39 and 60-69 age groups tahunterlihat as much. In general, stage IA more often ditemukanpada age group 30-39 years, whereas for stage IB and II seringditemukan in the age group 40-49 years, stage III and IV seringditemukan in the age group 60-69 years. Rahimterbanyak cancer frequency found in developing countries such as Indonesia, India, Bangladesh, Thailand, Vietnam and the Philippines. In Latin America and AfrikaSelatan frequency of cervical cancer is also a disease keganasanterbanyak of all other existing malignant disease. 4. Treatment of cervical cancer that can be done, yiatu: Surgery, radiation therapy, chemotherapy, and biological therapy. While beberapacara practical to do in everyday life untukmencegah cervical cancer, ie: have a healthy diet, rich in dengansayuran, fruit and cereal to stimulate the immune system, hindarimerokok, avoid sex before marriage or at a very young age ataubelasan year, giving HPV vaccine or vaccination for HPV mencegahterinfeksi, perform an intimate organs or vagina known as a toilet, avoid having sex with many partners, secararutin undergo regular Pap smear tests, and so forth.

C.

Suggestion

Be careful with cervical cancer, it is better to prevent than to cure. It was not easy being a woman, but not that difficult to get through it. Disease can be avoided as long as we are always trying to live a healthy and orderly.

REFERENCES

Alfian Elwin Zai. 2009. Skripsi : Karakteristik Penderita Kanker leher Rahim Yang Dirawat Inap Di Rumah Sakit Umum Pusat Haji Adam Malik Medan Tahun2003-2007 . FKM Universitas Sumatera Utara

Medan.(http://www.researchgate.net/publication/42356226_Karakteristik_Penderita_Kanker_leher_Rahim_Yag _Dirawat_Inap_Di_Rumah_Sakit_Umum_Pusat_Haji_ Adam_Malik_Medan). Diakses Tanggal 5 Februari 2011. Ayu Izza. 2009. Epidemiologi Kanker Serviks.(http://ayuizza.blogspot.com/2009/12/epidemiologi-kanker-serviks.html).Diakses Tanggal 5 Februari 2011.Satyadeng. 2010. Kanker Leher Rahim (Kanker Serviks) .(http://drvegan.wordpress.com/2010/01/10/kanker-leher-rahim-kankerserviks/).Diakses Tanggal 5 Februari 2011.Kumpulan info sehat. 2009. Kanker Serviks Pembunuh Banyak Wanita.(http://kumpulan.info/sehat/artikel-kesehatan/48-artikel-kesehatan/237-kanker-

serviks-leher-rahim-pembunuh-wanita.html). Diakses Tanggal 5 Februari 2011

FOREWORD

The authors gratitude to Allah SWT. Because for all the abundance of mercy, grace and hidayahNya finally able to complete the author of this paper. This paper was prepared to find out how in the face of a patient suffering from Cervical Cancer and Breast Cancer. The authors wish to thank all those who can not mention here who have helped up to the completion of this paper. Hopefully this paper is useful and beneficial for writers and readers, especially in general. The author is fully aware as human beings, not free of shortcomings, as well as this paper is still far from perfect. To that criticism and constructive suggestions of course, is the author expected.

Author Amanda Twentri Febby

FOREWORD

The authors gratitude to Allah SWT. Because for all the abundance of mercy, grace and hidayahNya finally able to complete the author of this paper. This paper was prepared to find out how in the face of a patient suffering from Cervical Cancer and Breast Cancer. The authors wish to thank all those who can not mention here who have helped up to the completion of this paper. Hopefully this paper is useful and beneficial for writers and readers, especially in general. The author is fully aware as human beings, not free of shortcomings, as well as this paper is still far from perfect. To that criticism and constructive suggestions of course, is the author expected.

Author Nola Kartika

TABLE OF CONTENTS
Foreword Table of contents CHAPTER I A. preliminary a) Background b) Formulation of Problem CHAPTER II A. discussion a) Definition b) Symptoms c) Factors d) Treatment e) Prevention CHAPTER III A. cover a) Conclusion b) Suggestions Bibliography