Uterine oncology is common in gynecological practice quite often. One of the most common lesions is considered to be cervical cancer, cervical carcinoma or cervical cancer.
Uterine carcinoma - what is it?
Most often carcinoma of the cervix is found among patients 35-50 years of age, as well as in women prone to frequent changes in sexual partners.
The photo shows the appearance of cervical cancer in colposcopy
Even before the development of cancer cells, the structures of the uterine neck are undergoing strong changes, epithelial dysplasia develops. If treatment is not carried out, the changes progress further, gradually shifting first to non-invasive, and then to invasive cancer.
All changes can be traced during histological studies.
Statistics in Russia
Non-invasive forms of cervical cancer occur among patients four times more often than invasive species. Cancer of the uterine neck began to show up more often, and the tendency to frequent cases of such cancer continues to grow.
Due to screening tests in recent years, the number of patients with uterine cervical cancer has been detected in the early stages of development. Such a factor led to the fact that female deaths from such oncological diseases significantly decreased.
The average cervical cancer is found in 11 out of 100 thousand women. Unfortunately, the cancer of the uterine neck has become more common in young women, which specialists associate with the early onset of permanent sexual relations.
In general, mortality from pathology has decreased threefold, however, with too late detection, the survival rate remains at a rather low level.
The disease most often affects Russian women 35-50 years of age, however, about 5-6% of cases of this oncology occur in relatively young patients( about 20-30 years), and 20% are 65 years old women and older.
Risk Factors and Causes of
The underlying pivotal factor in the onset of cervical carcinoma is human papillomavirus.
Almost all patients with cervical cancer detect traces of this virus in the body. The most oncogenes of HPV types are 8 and 16, it is these varieties that most often provoke malignant tumor processes in the cervical tissues.
This virus is transmitted during sexual contact, and often even barrier contraception can not prevent it.
In addition to HPV, the causes of the appearance of a cancerous tumor in the cervix can be:
- Frequent change of sexual partners or their multiplicity;
- Early onset of "adult" life with regular sexual relations;
- Erosive lesions of the cervical tissues;
- Weak immune status;
- Presence of infectious pathologies transmitted through sexual intercourse;
- The presence of nicotine dependence;
- Permanent contact with carcinogenic substances;
- Long-term use of oral contraceptives;
- Heredity. Women with relatives with similar oncopathology significantly increase the risk of developing cervical carcinoma.
How does cervical cancer appear in women?
In the initial stages of cervical cancer proceeds secretly, without manifesting itself. This fact is very unfavorable, because it is precisely the malignant tumor of the cervical tissues that was detected at the early stages that has all the chances for a final cure.
Early warning signs of
Some patients may already have early symptoms of cervical cancer such as:
- Sputum extracts, minor bleeding between menstruation;
- Negligible hyperthermia( 37-37, 7 ° C);
- Unusual and uncharacteristic discharge after sexual intimacy, representing a bloody substance from a dirty brown to a pinkish hue;
- Menstrual cycle disorders;
- Soreness in the lower abdomen.
Pain symptomatology can occur from time to time, especially often such a sign appears after sexual intimacy.
Symptoms of carcinoma in later stages of
In the later stages of development, the above symptomatology is supplemented by more vivid manifestations such as:
- Bloody impurities in the urine;
- Chronic urination;Rectal bleeding of painless nature;
- Hyperactivity;
- Intestinal disorders;
- Swelling of the feet;
- Abundant uterine bleeding not associated with menstruation;
- At the terminal stage of cervical cancer, hydronephrosis may occur( kidney damage caused by disorders of the urinary flow and manifested by atrophy of the kidney parenchyma).
Classification of
According to the type of epithelium from which the tumor process takes place, oncogynecologists distinguish:
- Squamous cell carcinoma of the cervix( 84-96%);
- Adenocarcinoma( 4-16%).
Depending on the intensity and direction of growth, as well as on the nature of the development of the tumor process, cervical cancer is distinguished:
- The pre-invasive is a 0 grade oncology that is of an intraepithelial nature;
- Non-invasive - this form of oncology is considered to be the first stage of development when cancer is characterized by a slow growth of the oncocellular structures that do not extend beyond the boundaries of the mucosal cervical tissues;
- Microinvasive - such a cancer is superficial, does not germinate in the underlying tissues deeper than 5 mm. The probability of metastasis with such a tumor is minimal;
- Exophytic - the tumor grows in the form of cauliflower, is considered the most common form and is best diagnosed at an early stage, it grows into the vaginal lumen;
- Endophytic - this tumor forms inside the cervical canal and outwardly resembles an ulcer that bleeds at the slightest touch. The tumor grows into the uterine body.
How quickly does a cancer develop?
Cervical cancer can develop for decades. Even before the formation of a true cancer, dysplastic changes begin on the surface of the mucous cervical tissues, which last for years.
The picture shows the development of cervical cancer
If you do not begin to treat dysplasia on time, then it progresses and at the third stage develops to the initial stages of intraepithelial cancer, the treatment of which should already take place on the oncological line.
Zero
At the zero stage of cervical cancer, abnormal cellular structures are located on the surface of the mucous membranes of the cervical canal. During this period, processes occur that precede abnormal mutations of normal cells in the cancer cells.
At this stage, 100% cure and survival are observed.
Initial
At the first stage of the process, the oncochamber is localized in the superficial epithelial mucous layers of the cervical tissues. Abnormal cells do not spread to closely located organs, and the tumor is severely limited.
Prognosis for this stage of cancer is very positive, the survival rate reaches 98-100%.A professionally performed surgery gives the woman the opportunity to have a baby in the future.
Second
In the 2 stages of the oncology process in the cervical tissues, the tumor becomes larger, however, adjacent and underlying tissues do not affect the tumor. Education can grow into lymph nodes of regional importance or into the uterine walls.
Usually, this stage is characterized by the appearance of the first signs of oncology in the uterine neck.
At this stage, the tumor often grows into the body of the uterus and is localized inside the organ. The prognostic data deteriorates noticeably, the survival rates are also decreasing.
Third
In 3 stages of the cancerous process in the cervix, patients experience a deterioration in overall well-being. Oncology is continuously progressing, inhibiting the activity of the kidney, ureter and urinary system.
Cancer metastasizes into the uterine walls, spreads through the pelvic area, penetrating into the organs located there. Even if the therapeutic tactics are chosen as correctly as possible, the forecasts are extremely unfavorable, the mortality rate of patients is about 70%.
Fourth
The fourth stage of cervical cancer is considered a terminal stage, when the question is no longer about curing, but about the maximum possible prolongation of a patient's life.
Because treatment is ineffective, palliative therapy is used to relieve the patient's life.
The tumor at this stage already penetrates into the urinary, intestinal, bone tissues. The disease in this case is incurable, so the forecasts are unfavorable.
The five-year lifespan for cervical cancer rarely reaches 10%.
Metastasis
Cervical carcinoma can metastasize to the uterine body, the parameter, the vagina.
Metastasis occurs predominantly in a lymphogenous way through the lymph node structures located near the uterine body, the neck, through the hypogastric and iliac, precritical, etc.
There is a likelihood of hematogenous metastasis when the tumor processes reach a wide spread and penetrate the blood into the bone, liver or pulmonary system.
Similar spread of cancer cells usually occurs in the 3-4 stages of oncology.
The role of HPV
It has been scientifically proven that certain types of papillomavirus play a significant role in the formation of cervical carcinoma.
If the immune status of a woman is strong enough and can withstand papillomavirus, then the development of cancer will not occur.
cervical cancer and pregnancy
Sometimes such clinical situations occur when cervical cancer is combined with pregnancy( 1 case for 2500 pregnancies).
It is possible to become pregnant with cervical malignant oncology with a probability of 30%.The average age of oncological and pregnant patients is about 27-29 years.
Treatment activities are planned in accordance with the period of pregnancy, the stage of development of cervical cancer, the nature of tumor formation, etc.
At 0 stages, pregnancy is usually preserved, and the operation is performed after childbirth. If invasive cervical cancer is found in the 1-2 trimester, then surgery is performed through extensive extirpation.
If the tumor process is at the stage of neglect, the fetal egg is removed, and then the course of radiation therapy is conducted.
When an invasive cervical cancer is detected against a viable fetal background, the patient undergoes a cesarean section, and then an expanded extirpation is performed.
If after the treatment of cervical carcinoma the uterine body has been fully preserved, then with a favorable reaction to restorative therapy, a woman can quite hope for pregnancy and childbirth.
What is the danger of the disease?
The risk of cancer of the uterine neck is its very difficult consequences:
- Risk of removal of the uterus, cervix, vagina, intestines, and bladder. In this case, a woman is provided with a disability, and the main task of doctors is to preserve and maximally extend her life;
- If only the reproductive organs are affected, removal only threatens the uterus, the cervix and the vagina. In this case, a woman can never give birth to a child;
- Can only remove the uterus, leaving the appendages. Then the hormonal disorders will not be so obvious as when removing the ovaries;
- It is believed that the outcome of treatment is successful, if the removal affected only the cervical canal;
- If a woman has been removed from the vagina, then she will have to forget about sex;
- If the uterus is removed, and the ovaries are left, then of course the woman will not be able to give birth, but her sexual desire and sex life are preserved to the full.
Diagnostics
The diagnostic process is divided into several stages.
- At the first stage the patient undergoes a gynecological examination on the armchair with the use of mirrors.
- The gynecologist then assigns laboratory tests such as a general and biochemical blood test, a Pap test, a HPV test, a vaginal bacterial and bacterioscopic vaginal test.
- Diagnostic studies of instrumental nature, which include such procedures as colposcopy, x-ray, biopsy of uterine neck tissues, renal urography, ultrasound examination of low-tidal organs, MRI or CT, etc.
Treatment of
Treatment is the most effective at the initial stages of cervical carcinoma. Various methods are used, but the most effective is surgical intervention.
In general, the treatment can be carried out:
- Operational;
- Chemotherapeutic;
- Laser;
- Radiotherapy;
- Hyperthermic method.
Often to increase the effectiveness of complex therapy using several methods.
Surgical treatment can be carried out in several ways, such as laser therapy, ultrasound, cryodestruction, hyperthermia.
Radiotherapy can be performed in-vivo or remotely. A similar technique involves the destruction of cancer cell structures through irradiation.
When chemotherapy is used, antineoplastic drugs are administered intravenously.
Similar therapy is usually performed for patients of postmenopausal age, because the drugs used have a disastrous effect not only on the oncocells, but also on healthy cellular structures, which adversely affects the condition of the whole organism.
Survival prognosis
If the oncology process was identified at zero or the first stage, then the predictions are almost always favorable in all cases. To avoid the neglect of such a disease, it is recommended to undergo a gynecological examination at least once every six months.
Video on the causes and methods of cervical cancer prevention: