SCREENING TESTS – BASIC (Rs4, 000)
Pap Smear| Cancer Antigen (CA 125)| Full Blood Count (FBC)| Consultation

SCREENING TESTS – EXECUTIVE (Rs 27, 000)
PET Scan| Pap Smear| Cancer Antigen (CA 125)| Full Blood Count (FBC)| Consultation

Positron Emission Tomography (PET) Scan – Cervical Cancer – Advanced

PET scan is a type of test that create 3 dimensional (3D) pictures of the inside of your body.

The PET scan uses a mildly radioactive drug to show up areas of your body where cells are more active than normal. It’s used to help diagnose some conditions including cancer. It can also help to find out where and whether cancer has spread.
It usually takes between 45 and 60 minutes. You will be in the department for at least an hour beforehand. This is because you have an injection of a radioactive liquid (radiotracer) before the scan.

PET scans are often combined with CT scans to produce more detailed images. These are called PET-CT scans.

A PET scan can help to:

⦁ show up a cancer
⦁ find out how big it is and whether it has spread (stage a cancer)
⦁ show whether a lump is cancer or not
⦁ decide the best treatment for your cancer
⦁ show how well a treatment is working

After you have had treatment for cancer, a CT scan may show that there are still some signs of the cancer left. But this may not be active disease. It could be scar tissue left over from cancer killed off by your treatment. A PET scan can show whether this tissue is active cancer or not.

PET scans are sometimes used to look for cancer in the lymph nodes in the centre of the chest.

How to get ready for your PET Scan :

For most PET scans, you need to stop eating for about 4 to 6 hours beforehand. You can usually drink unflavoured water during this time.

You might have instructions not to do any strenuous exercise for between 12 and 24 hours before the scan.

In Specific cases :

Call the number on your appointment letter if not eating is a problem for you, for example if you’re diabetic. You might need to adapt your diet and sugar control and your appointment time could change.

Some people feel claustrophobic when they‘re having a scan. Contact the department staff before your test if you’re likely to feel like this. They can take extra care to make sure you’re comfortable and that you understand what’s going on. Your doctor can arrange to give you medicine to help you relax, if needed.

What Happen at the hospital Before a PET Scan:

• Your radiographer might ask you to change into a hospital gown. You have to remove any jewellery and other metal objects such as hair clips, coins, belts and a wired bra. Metal interferes with the images created by the scanner.
• You have an injection of radiotracer about an hour before the scan. You have the injection through a small plastic tube in your arm (cannula). It’s only a small amount of radiation.
• You need to rest and avoid moving too much during this hour. This allows the radiotracer to spread through your body and into your tissues.

The radiotracer is a radioactive sugar. The one commonly used is called FDG (fluorodeoxyglucose). Cancer cells are very active when they are growing and reproducing in a specific area. They need energy to grow. So, active cancer cells take up the FDG which then shows up brighter on the scan.

In the scanning room during PET Scan

Your radiographer takes you into the scanning room. The PET machine is large and shaped like a doughnut.

You have most scans lying down on the machine couch on your back.
Once you’re in the right position, your radiographer leaves the room. They can see you on a TV screen or through a window from the control room. You can talk to each other through an intercom.

Having the PET scan

1. The couch slowly slides backwards and forwards through the scanner. The machine takes pictures as you move through it.
2. The scan is painless but can be uncomfortable because you have to stay still. Tell your radiographer if you’re getting stiff and need to move.
3. It’s not particularly noisy but you’ll hear a constant background noise. In most places the radiographer will be able to play music for you.
4. When it’s over, your radiographer will come back into the room and lower the couch so you can get up.

This 3-minute video shows you what happens when you have a PET scan or PET-CT scan.

What to expect afterwards?

• Your radiographer removes the cannula from your arm before you go home.
  You can then eat and drink normally.
• The radiation in the radioactive tracer is very small. Drinking plenty of fluids after your scan helps to flush the radiotracer out of your system.
• The radioactive tracer gives off very small levels of radiation that go away very quickly. As a precaution, you should avoid close contact with pregnant women, babies and young children for 6 hours after the scan.

You need someone to take you home and stay overnight if you’ve had medicine to help you relax (sedative).

 For the next 24hours you also shouldn’t:

⦁ drive
⦁ drink alcohol
⦁ operate heavy machinery
⦁ sign any legally binding documents

Most airports have sensitive radiation monitors, which may pick up the trace of radiation following your test. If traveling abroad within a week of your scan, it’s a good idea to take your appointment letter with you.

Possible risks linked to the PET Scan- Cervical Cancer- Advanced

A PET scan is a safe test for most people. But like all medical tests it has some risks. Your doctor and radiographer make sure the benefits of having the test outweigh these risks.

• Pregnancy

Pregnant women should only have the scan in an emergency. There’s a risk that the radiation could harm the developing baby. Contact the department beforehand if you’re or think you might be pregnant.

• Breastfeeding

If you’re breastfeeding, let the department know a few days before your appointment. They will let you know if you need to stop breastfeeding for a length of time after having the radioactive drug. You might need to store enough expressed milk for at least one feed.

• Radiation

Exposure to radiation from the radiotracer during a PET scan slightly increases your risk of developing cancer in the future. Talk to your doctor if this worries you.
Bruising and swelling

You might get a small bruise around the area where they put the needle in.
There’s is a risk that the radioactive tracer will leak outside the vein. This can cause swelling and pain in your arm but it’s rare.

• Allergic reaction

Rarely, people have an allergic reaction to the radioactive tracer. This most often starts with weakness, sweating and difficulty breathing. Tell your radiographer immediately if you feel unwell.

Getting your results for Cervical Cancer – Advanced

Your scan will be looked at by a specialist doctor and you should get your results within 48 hours. You won’t get any results at the time of the scan.

Waiting for results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact them if you haven’t heard anything after 48 hours.

Pap Smear Test

Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. Most guidelines suggest beginning screening for cervical cancer and precancerous changes at age 21.

A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of cervical cancer.

Pap test. During a Pap test, your doctor scrapes and brushes cells from your cervix, which are then examined in a lab for abnormalities.

HPV DNA test. The HPV DNA test involves testing cells collected from the cervix for infection with any of the types of HPV that are most likely to lead to cervical cancer.

Preparing for your appointment

Make an appointment with your doctor if you have any signs or symptoms that worry you.

What you can do

⦁ Be aware of any pre-appointment restrictions, such as not eating solid food on the day before your appointment.
⦁ Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
⦁ Write down your key medical information, including other conditions.
⦁ Write down key personal information, including anything that increases your risk of STIs, such as early sexual activity, multiple partners or unprotected sex.
⦁ Make a list of all your medications, vitamins or supplements.

Cancer antigen 125 (CA125)

Cancer antigen 125 (CA125) is a protein found on most ovarian cancer cells that is secreted into the blood stream and can be measured. CA125 can also be found on other normal and cancerous cells in the body.

A CA125 test may be done:

⦁ if the doctor suspects there may be cancer
⦁ to find out if cancer treatment is working
⦁ to find out if cancer has come back (recurred) after treatment

This test is not recommended as a screening test for ovarian cancer because CA125 can be normal in many women with early stage ovarian cancer and it may be higher than normal in non-cancerous (benign) conditions and other cancers.

How is a CA125 test done?

A CA125 test is a blood test that measures the amount of CA125 protein in the blood. A sample of blood is taken by inserting a needle into the vein in your arm. No special preparation is needed.

What the results mean?

An increased CA125 value can occur in both cancers and non-cancerous conditions.

Cancers

The CA125 blood levels can be increased in ovarian cancer and other cancers including:
⦁ uterine
⦁ fallopian tube
⦁ pancreatic
⦁ breast
⦁ colorectal
⦁ lung
⦁ stomach

A decrease in the CA125 level during treatment usually means that the cancer is responding to treatment.

If the CA125 level stays the same or rises during treatment, it may mean that the cancer is not responding to treatment.

A high CA125 level after treatment is complete may mean that the cancer has come back (recurred).

Non-cancerous conditions

The CA125 blood level may be increased in non-cancerous conditions including:
⦁ menstruation
⦁ pregnancy
⦁ endometriosis
⦁ pelvic inflammatory disease
⦁ non-cancerous ovarian cysts
⦁ uterine fibroids

What happens if the result is abnormal?

The doctor will decide whether further tests, procedures, follow-up care or additional treatment are needed.

Full Blood Count (FBC)

A full blood count (FBC) is a common blood test that your doctor may recommend to:

⦁ Help diagnose some blood cancers, such as leukemia and lymphoma
⦁ Find out if cancer has spread to the bone marrow
⦁ See how a person’s body is handling cancer treatment
⦁ Diagnose other, noncancerous conditions

A FBC measures the amount of 3 types of cells in your blood:

⦁ White blood cell count. A white blood cell count, also called a leukocyte count, measures the total number of white blood cells in a sample of blood. These cells protect the body from infection by attacking invading bacteria, viruses, and other foreign materials in the body. Some white blood cells can also attack cancer cells.

⦁ White blood cell differential. A white blood cell differential measures the number of each type of white blood cell. There are 5 major types of white blood cells, and each type plays a different role in protecting the body. Your doctor can learn valuable information about your health by measuring the levels of these cells:
⦁ Neutrophils
⦁ Lymphocytes
⦁ Monocytes
⦁ Eosinophils
⦁ Basophils

⦁ Red blood cell count. Red blood cells carry oxygen throughout your body. A red blood cell count, also called an erythrocyte count, measures the number of red blood cells in a sample of blood. There are several ways to measure red blood cells.

Two of the most common are:

⦁ Hematocrit (Hct), the percentage of your blood that is made up of red blood cells
⦁ Hemoglobin (Hgb), the amount of the protein in red blood cells that carries oxygen

⦁ Platelet count. A platelet count measures the number of platelets in a sample of blood. Platelets help to stop bleeding by forming blood clots.

The amounts of each of these types of cells have a normal range. Your health care team will note this range on your FBC lab results. A range is used instead of a specific number because a normal amount is different for each person.

How can the services we provide you help?

By the time cervical cancer signs and symptoms develop, the cancer is usually too advanced for curative treatment. Studies show cervical cancer screening reduces the risk of dying of cervical cancer.