What does cervical cancer look like after. Uterine cancer: first signs and symptoms, early treatment. Cervical cancer: symptoms

One of the most common cancers is cervical cancer. According to statistics, it appears in about 11 women out of 100 thousand. Most often, the disease is diagnosed in women from 35 to 55 years old. But every year the percentage of young patients (under 30) who show signs of cancer is growing.

Causes of cervical cancer

The most common cause of cancer is papillomavirus. HPV provokes the appearance of a tumor on the cervix. An oncogenic virus is transmitted sexually. However, not every woman infected with HPV develops cancer.

Factors provoking the development of cervical cancer:

• Early onset of sexual activity. At the age of 16 years, epithelial cells on the walls of the neck are still forming. Due to their underdevelopment, they are more susceptible to erosion and can degenerate into cancerous.
• Diseases of the cervix: erosion, dysplasia.
• Weakened immunity.
• Long-term use of contraceptive drugs.
• Abortion.
• Genital herpes.
• HIV infection.
• Weighed down heredity.
• Exposure to radiation.
• Over 45 years old.
• Late or too early onset of menopause.
• Obesity.
• Nicotine addiction.
• Alcohol addiction.
• Stress, prolonged depression.
• Vitamin A and C deficiency.

What does cervical cancer look like?

The uterus is a triangular muscular organ. Its function is to carry the fetus during pregnancy. The length of the organ is approximately 7-8 cm. The base of the uterus is at the top, and the lower, narrowed, part is directed towards the vagina. This narrowing is called the cervix. Outside, the neck is covered with stratified squamous epithelium.

Inside the neck there is a cervical canal lined with a mucous membrane, consisting of a secretory columnar epithelium. The cells in this layer produce thick mucus that prevents pathogens from entering the uterus.

In accordance with the two types of epithelium that covers the cervix from the outside and from the inside, two histological types of cancer of this organ are distinguished: squamous cell carcinoma and adenocarcinoma.

Squamous cell carcinoma

85-90% of cervical cancers are of this type. The neoplasm occurs on the outer, superficial layer of the squamous epithelium. It may refer to an infiltrative ulcerative or tumor form.

The first option looks like a small bleeding ulcer with raised edges (there may be several ulcers), located against the background of reddened, inflamed tissue. Cancer cells are able to multiply very quickly and affect the entire surface of the vagina, spreading to nearby areas of the mucous membrane.

The tumor form has the form of a volumetric tuberous formation, significantly protruding above the surface of the neck. Surrounding tissues are not affected.

Adenocarcinoma (glandular cancer)

This tumor develops from the cells of the columnar epithelium lining the cervical canal. It occurs in about 10-15% of cases. It goes into the vaginal cavity through the external os of the cervix. It can also have 2 forms: endometrioid (endophytic) and papillary (exophytic).

The endophytic form grows into the depths of the uterus and may not be visible during vaginal examination.

The exophytic form grows outward and gradually covers the entire surface of the cervix with a white bloom, consisting of papillary growths. Yellowish patches and bruises stand out against the background of plaque. The visible part of the vaginal walls is not affected.

The first signs of cervical cancer

Most of the malignant neoplasms of the cervix in the early stages are asymptomatic; this is the so-called "dumb" cancer. Only in some patients at the beginning of the development of the disease can there be:

• moderately pronounced vaginal discharge, consisting of lymph (liquid, transparent or slightly yellowish, odorless);
• discharge from a mixture of blood and lymph (look like "meat slops");
• contact bloody discharge not associated with menstruation (after intercourse, physical exertion, gynecological examination, etc.);
• changes in the nature of the menstrual cycle. The discharge becomes more abundant and prolonged, accompanied by pain.

Symptoms of the further development of oncology in the cervix:

1. Bleeding occurs in the middle of the cycle, which appears quickly and ends just as quickly.
2. Bloody vaginal discharge during menopause.
3. Back and lower abdominal pain.
4. General weakness, drowsiness, fatigue.
5. In some cases, swelling of the legs is possible.

Since the development of the disease can be very slow and imperceptible, it is recommended that all women undergo a preventive gynecological examination annually.

Stages of cervical cancer

The stage of cervical cancer is determined by the prevalence of the tumor, the involvement of regional lymph nodes and the presence of metastases. There are 4 of them. Each stage has several more substages:

• Stage 0. This stage is treatable. Cancer cells affect only a small part of the surface of the cervix, without penetrating deep into the mucous membranes. There are no clinical symptoms. This degree is called cancer in situ (precancerous).
• Stage 1. The tumor is local in nature: it affects only the cervix, not spreading to the body of the organ. The lymph nodes are not enlarged. This stage is almost 100% curable.
• Stage 2. It is characterized by an increase in the tumor up to 4-6 cm in diameter. The body of the uterus is affected, then the upper and middle third of the vagina. The lower third and the walls of the pelvis are not affected. The lymph nodes are not enlarged. Stage 2 cervical cancer can be cured in 90% of cases.
• Stage 3. The tumor of the cervix becomes large, affects the lower third of the vagina, and then grows into the walls of the pelvis, or causes kidney damage. Regional lymph nodes are enlarged. There are no metastases. With stage 3 cervical cancer, the chances of being cured are about 30%, and it is necessary.
• Stage 4. The tumor at this stage reaches its largest size, spreading to adjacent organs or growing outside the pelvis. It is accompanied by the formation of distant metastases. In this case, it is almost impossible to cure the patient. Therefore, therapy is aimed at prolonging life and reducing pain.

Prevention

Prevention of cervical cancer includes the following measures:

1. Quitting bad habits - smoking and alcohol abuse.
2. Every 6 months, a mandatory visit to a gynecologist.
3. Timely treatment of genital infections (chlamydia, thrush).
4. Responsible attitude to sex life - refusal from frequent change of partners and early onset of sexual relations (previously 16-18 years old).
5. Barrier contraception during intercourse.
6. Compliance with the rules of hygiene - take a shower before and after sexual intercourse, use clean linen, monitor the cleanliness of clothes.
7. Annual colposcopy. This procedure aims to thoroughly examine the cervix.
8. Annual delivery of a smear for oncocytology.
9. Refusal of self-medication. This includes abortions and oral contraceptive pills.

Oncology is a problem faced by medicine after the invention of vaccinations and antibiotics. Life expectancy has increased significantly thanks to modern science. In our time, heart disease and malignant tumors have come to the fore. The latter are one of the main causes of disability and disability. A tumor can arise from any organ. However, from year to year, specialized institutions record statistics: in men, malignant neoplasms of the lung, stomach and prostate are more common. In women, the mammary gland and reproductive organs are affected. Now the formidable oncological pathology has ceased to be a sentence. Medical science has made great strides in the treatment of malignant tumors, including cervical cancer common in women.

Cervical cancer: basic prerequisites

Nature has arranged the organism very ingeniously. Each cell is tuned for a specific type of work. The internal structure of all organisms is extremely similar. However, the need to give birth to offspring leaves its mark. The female genital area is designed specifically for conceiving, carrying and giving birth to a child. It includes several interconnected organs.

The female reproductive system consists of several organs

The ovary is used for the production of eggs and female sex hormones. Fertilization takes place in the fallopian tube. In addition, this small organ allows the fertilized egg to enter the uterus, where the fetus will spend forty weeks before birth. The uterus of a non-pregnant woman is small and round. It transforms into an elongated cylindrical neck. Most of it is located in the lower abdomen. The cervix ends inside the upper part of the vagina.

The cervix is \u200b\u200bdivided into two parts (abdominal, vaginal), not only because of the peculiarities of its location at the junction of two anatomical regions. The inner layer of the abdominal and vaginal portion of the cervix is \u200b\u200bfundamentally different. The abdominal part is covered with one row of densely packed cells - the columnar epithelium. The vaginal part contains stratified squamous epithelium. It is in the junction zone of the two types of epithelium that a tumor most often begins to develop.

The cervix is \u200b\u200bcovered with two types of epithelium - stratified squamous and cylindrical

Cervical cancer is a malignant neoplasm that has arisen from the cylindrical or stratified epithelium. In Russia, 12 thousand new cases of the disease are recorded during the year. Young women (30 years old) and survivors of menopause (60 years old) are at risk. The number of cases increases annually by 2%.

Cervical cancer - video

Cancer varieties

There are several types of malignant neoplasms of the cervix:

Causes and factors of development

Modern medical science has established the role of the human papillomavirus in the development of the disease. This microorganism causes growths on the skin in the form of warts and genital warts. Infection with the virus can occur through sexual contact. The papillomavirus penetrates into cells and becomes a host in it, controlling all processes. The cell becomes a plant for making copies of the virus.

In most cases, papillomavirus infection ends with the victory of its own immunity and the final disposal of the body from the pathogenic agent. In five percent of cases, the virus settles inside the cell for a long time. He is able to change the genes inherent in every cell from the moment of its birth. In fact, it creates the first cell from which a tumor will grow later.

Papilloma virus promotes malignant degeneration of cervical cells

Malignant cells are fundamentally different from healthy ones. First, they do not perceive any regulatory signals from the body. They are immune to the effects of immunity. Secondly, malignant cells are determined to spend nutrients captured from the blood exclusively for the production of their own kind. Over time, new vessels grow into the tumor, supplying it with food. The body consistently receives less building material and energy, therefore, in the late stages of the development of cancerous tumors, weight and muscle mass loss is observed.

Much more dangerous than the tumor itself is its secondary foci - metastases. There are two ways in which malignant cells can spread - lymphatic and blood vessels. In the first case, they settle in the lymph nodes, in the second - in distant organs. A full-fledged secondary tumor focus is formed from one cell that has entered a new territory. Cancer cells first appear in the cervical and vaginal lymph nodes, then in the uterine, inguinal. Through blood vessels, the tumor spreads to the liver, lungs, bones and kidneys.

Cancer cells spread through the blood and lymph vessels

The spread of cancer to adjacent structures - table

Stage of the disease	The likelihood of metastasis cancer in the nearest lymph nodes	The likelihood of metastasis cancer to distant organs
Stage 0 (cancer in situ)	Absent	Absent
Stage 1 (the depth of tumor penetration is not more than 3 mm)	0,3%	Absent
Stage 1 (depth of tumor penetration from 3 to 5 mm)	13%	Absent
Stage 1 (depth of tumor penetration more than 5 mm)	15–18%	2,5%
Stage 2	25–30%	10,8%
Stage 3	50–60%	High
Stage 4	High	High

Cervical cancer rarely occurs against a background of complete well-being. The virus changes the appearance of cells and fundamentally disrupts their usual work. Dysplasia of the epithelium is formed. Cervical cancer is often associated with other epithelial diseases (eg, erosion). An epithelium appears on the cervix, which should normally be absent.

Diseases of the cervix - photo gallery

Erosion is a defect of stratified squamous epithelium Ectropion - a combination of erosion and deformation of the cervix
Leukoplakia - areas of keratinization of stratified squamous epithelium Polyp refers to background diseases of the cervix

The risk of developing striatum cell carcinoma or cervical adenocarcinoma increases with the use of nicotine. In addition, the situation is influenced by pregnancy and childbirth in adolescence, as well as sexually transmitted diseases (gonorrhea, syphilis, trichomoniasis, chlamydia,).

Signs of the disease

A malignant tumor at the initial stage of its development (cancer in situ, stage 1) is most often asymptomatic. That is why the process is often diagnosed in a neglected form. In the later stages, cancer invades neighboring organs and a set of signs appears that characterize the launched oncological process:

• bloody discharge;
• bleeding during different periods of the monthly cycle;
• unpleasant odor of discharge;
• painful sensations in the sacrum area;
• aching pains in the lower abdomen;
• painful sensations when emptying the bladder and intestines;
• pallor of the skin and shortness of breath;
• unmotivated weight loss;
• fever.

Ways to identify cancer

Recognizing cervical cancer is a challenge for an experienced gynecologist. Suspicion of a tumor is a reason to undergo a comprehensive examination:

• gynecological examination is the primary diagnostic measure. The cervix can be viewed with the naked eye. A suspicion of a malignant process is caused by the presence of growths resembling cauliflower, areas with a discolored or uneven surface, tortuous pathological vessels, and minor hemorrhages. The treatment of a suspicious area of \u200b\u200bthe cervix with iodine helps to determine the visible borders of the tumor. Normal and abnormal epithelium will differ significantly in color intensity;
  Gynecological examination is a mandatory stage in the diagnosis of cervical cancer
• rectal examination. Feeling of the rectum and vagina allows you to determine the mobility and suspect their involvement in the oncological process. The lumpy surface of the vagina and rectum indicate an advanced stage of cancer;
• an objective examination reveals an increase in lymph nodes. Lumpy contours, immobility in relation to the surrounding tissues are a sign of the involvement of lymph nodes in the malignant process;
• a blood test allows a specialist to identify signs of anemia - a deficiency of red cells of erythrocytes and hemoglobin;
• ultrasound is a painless and safe way to look inside the body and assess the structure of the uterus, cervix, tumor size and get other important information about the disease;
  Ultrasound is one of the main methods for diagnosing cervical cancer
• colposcopy allows you to see the cervix and cervical canal at high magnification. The main assistant is a miniature video camera;
• histological examination under a microscope. The study of the prepared and stained tissue section allows you to identify cancer cells and determine their type;
• the search for metastases using ultrasound in the liver and other abdominal organs is one of the main diagnostic stages;
• chest x-ray is a way to identify metastases in the lungs;
• tomography (computed or magnetic resonance imaging) is a study that allows a specialist to study the internal organs in detail. Layered images of the breast and abdomen contain maximum information about the tumor itself and about its secondary foci;
  Tomography allows you to study the location and size of the tumor, as well as identify metastases
• obtaining epithelial fragments from the cervical canal using the curettage method;
• if there is a suspicion of involvement of the bladder and rectum in the process, the picture of these organs from the inside can be studied by a specialist using cystoscopy and sigmoidoscopy, respectively. These two methods involve inspection using a miniature video camera attached to a special tool;
• to diagnose a disintegrating tumor, it is sometimes enough to take a smear from it and examine individual cancer cells under a microscope (cytology);
• in some cases, the prevalence of cancer helps to establish angiography - a study of blood vessels using X-ray and a special contrast agent.

Treatment: modern technology

Treatment of cervical cancer is carried out by a gynecologist in conjunction with an oncologist. There are three main methods for treating malignant neoplasms: surgical excision of the lesion, exposure to chemotherapy and X-ray radiation. Most often, a combination of two or three treatments is used.

Surgery

Surgical treatment is often used for cervical cancer. The possibility of removing the tumor focus exists only in the first two stages of the disease. The scope of the operation is determined by the doctor individually. The following types of surgical interventions are used to treat cervical cancer:

Radiation treatment

X-ray radiation is often used for advanced stage II and III cervical cancer. Treatment is under the supervision of a radiologist. The radiation dose is selected individually. Impact on a cancer tumor and its metastases can be carried out in two ways: remotely using a gamma device or by bringing special applicators containing a radiation source directly to the tumor. X-rays are detrimental not only to the cells of the neoplasm. This method has side effects - digestive upset, changes in blood composition.

For cervical cancer, intracavitary radiation is used

Chemotherapy

Chemotherapy is used as a component of comprehensive treatment for advanced cervical cancer. For this purpose, experts prescribe antineoplastic drugs that have a detrimental effect on malignant cells:

Achievements of modern medicine are drugs that block the germination of new vessels into a cancer (targeted therapy). These medicines include:

Unfortunately, chemotherapy, as well as X-ray radiation, has serious side effects: changes in blood composition, decreased immunity, and gastrointestinal upset.

Complications and prognosis

The prognosis of cervical cancer treatment is determined by the specific type of tumor, the stage of its spread and the methods of therapy used. The best results are achieved by specialists in the treatment of cancer in the first two stages of development.

Survival statistics - table

One of the most dangerous complications of cervical cancer is relapse.The probability of activation of the oncological process is about 30%. Lymph nodes are more often affected (70% of cases). The onset of tumor growth in other organs is noted in 6-12% of cases. The probability of an unfavorable prognosis in case of a relapse of the disease increases many times over. The five-year survival rate in such a situation does not exceed 27%. Adverse signs of disease activation are dull aching pains, weakness, lethargy, loss of appetite.

Cervical cancer and pregnancy

Cervical cancer and pregnancy are not uncommon. The symptoms and signs of the disease in this case are similar to those described above. However, this situation imposes many restrictions on the conduct of operations, chemotherapy and X-ray radiation. In each case, the doctor makes a decision individually. The survival rate is significantly reduced (by about 30%). It is possible to become pregnant after surgical treatment of cervical cancer, provided that the organ is preserved (zero and first stages). In other cases, it is possible to preserve the eggs before the intervention and use the technologies of surrogate motherhood.

Prevention

Dispensary examination, timely treatment of venereal and other diseases of the female genital area are effective methods of cancer prevention. However, at present, new technologies are actively entering the business - a vaccine against papillomavirus. This drug contains only the outer shell of the agent, therefore, it is impossible to contract the disease at the time of vaccination. In response to it, the body's immune system produces antibody proteins that will protect a woman from the virus and related diseases, including cervical cancer. In Russia, imported drugs Cervarix and Gardasil are approved for use. Vaccination is a must for adolescent girls and young girls. In other cases, the doctor makes the decision individually. Depending on the age, the drug is administered twice or three times within six months. Immunity against the virus lasts for over 15 years. It is undesirable to vaccinate a woman during pregnancy.

Cervarix - human papillomavirus vaccine

Cervical cancer is currently a disease with a favorable prognosis. Early detection of a tumor and adequate complex therapy allows a woman to lead a full life and have children. This is certainly facilitated by regular dispensary examinations. The modern method of preventing cervical cancer is vaccination.

This is a malignant tumor that develops from the mucous lining of the cervix in the zone of transition of the cervical epithelium to the vaginal epithelium. Cervical cancer is one of the most common malignant tumors in women, and the second most common cancer after breast cancer. More than 500 thousand new cases of cancer are detected annually. In a significant part of the patients, the tumor is detected at a late stage, this is due to the insufficient diagnostic coverage of the female population, as well as the very rapid growth rates of the tumor.

Causes of cervical cancer

A combination of several factors is common. More often, the tumor occurs in women aged 40-55 years from low-income social strata, living in rural areas and having more than 6 children.

The following factors influence the development of cervical cancer:

Earlier onset of sexual activity - from 14 to 18 years old, at this age the cervical epithelium is immature and is especially susceptible to damaging factors.
- frequent change of sexual partners (equal to or more than 5 increases the risk of developing cancer by 10 times) both for the woman herself and her husband;
- smoking more than 5 cigarettes a day;
- taking hormonal contraceptives and, as a result, refusal from barrier contraception (condoms and caps), while there is a risk of contracting sexually transmitted infections;
- non-observance of sexual hygiene; sexual partners who have not been circumcised (since cervical cancer can provoke smegma);
- immunodeficiency, nutritional deficiency of vitamins A and C;
- infection with genital herpes viruses and cytomegalovirus;
- Infection with the human papillomavirus (HPV).

Currently, through international studies, the direct carcinogenic role of HPV in the development of cervical cancer has been proven. It was revealed that from 80 to 100% of cervical cancer cells contain human papillomavirus. Once in the cell, the virus integrates into the DNA chains of the cell nucleus, forcing it to "work for itself", creating new viral particles, which, leaving the cell through its destruction, are introduced into new cells. HPV infection is sexually transmitted. The virus can have a productive (formation of genital warts, papillomas on the genitals) and a transforming effect on cells (causing degeneration and cancer).

There are several forms of HPV infection in the body:

Asymptomatic - despite the fact that the virus goes through a full life cycle in the patient's cells, during examination it is practically not detected and, after a few months, subject to good immunity, it can be excreted from the body spontaneously;

Subclinical form - when viewed with the naked eye, the pathology of the cervix is \u200b\u200bnot determined, but with colposcopy, small multiple condylomas of the cervical epithelium are revealed;

Clinically pronounced forms of infection: genital warts are clearly defined in the area of \u200b\u200bthe external genitalia, anus, less often on the cervix.

More than 80 types (varieties) of the virus are known, about 20 of them are capable of infecting the mucous membranes of the genital organs. All of them have a different effect on the development of cervical cancer: viruses of "high risk": 16, 18, 31, 33, 35,39, 45, 50, 51, 52, 56, 58, 59, 64, 68, 70 types ; "low risk" viruses: types 3, 6, 11, 13, 32, 42, 43, 44, 72, 73.

It has been established that types 16 and 18 are most often found in cervical cancer, 6 and 11 in benign tumors and only rarely in cancer. At the same time, type 16 is found in squamous cell carcinoma of the cervix, and type 18 in adenocarcinoma and poorly differentiated cancer.

Precancerous diseases (dangerous due to frequent transformation into cancer): cervical dysplasia (changes in the structure of the epithelium that do not exist normally), erosion of the cervix, leukoplakia. They require compulsory treatment, most often, laser evaporation of the affected area.

1- Polyp of the cervical canal; 2- erosion of the cervix.

Cervical cancer symptoms

Cervical cancer symptoms are divided into general and specific.

General symptoms: weakness, weight loss, loss of appetite, sweating, unreasonable rises in body temperature, dizziness, pallor and dryness of the skin.

Specific symptoms of cervical cancer may include the following:

1. Bloody discharge from the genital tract, not associated with menstruation, can be insignificant, smearing, or profuse, in rare cases, bleeding is observed. Often, spotting occurs after sexual intercourse - "contact discharge". Possible manifestations in the form of acyclic secretions or against the background of menopause. In the later stages, the discharge can acquire an unpleasant odor associated with the destruction of the tumor.

2. Pain in the lower abdomen: may accompany bloody discharge, or occur with advanced forms of cancer as a result of infection or tumor growth of other pelvic organs or structures (nerve plexuses, pelvic walls).

3. Swelling of the extremities, external genital organs occurs with the progression of the disease in advanced and advanced cases, occur as a result of metastasis in the nearby pelvic lymph nodes and blocking of large vessels that drain blood from the lower extremities.

4. Dysfunction of the intestines and urinary bladder occurs when a tumor grows into these organs - the formation of fistulas (holes between organs that do not exist normally).

5. Urinary retention associated with mechanical compression of the ureters by metastatic lymph nodes with the subsequent shutdown of the kidney from work, the formation of hydronephrosis, resulting in the poisoning of the body with waste products (uremia) in the complete absence of urine - anuria.

In addition, the described changes lead to the penetration of purulent infection through the urinary tract and death of patients from severe infectious complications. Possible hematuria (blood in the urine).

6. Edema of the lower extremity on the one hand - can occur in the later stages, in the presence of metastases in the lymph nodes of the pelvis and their compression of the large vessels of the extremity.

Screening for suspected cervical cancer includes:

1.examination in mirrors and bimanual (manual) examination - a standard examination by a gynecologist, visual examination allows to identify or suspect a tumor pathology by the appearance of the cervical mucosa (proliferation, ulceration);

View of the cervix in the mirrors

2. staining with a solution of Lugol (iodine) and acetic acid: allows you to identify indirect signs of both initial and advanced cervical cancer - vascular tortuosity, staining of pathological foci less intense than normal areas, and others;

The area of \u200b\u200baltered epithelium (dark area, shown by an arrow)

3. colposcopy - examination of the cervix with a magnification of 7.5 to 40 times, allows you to examine the cervix in more detail, identify precancerous processes (dysplasia, leukoplakia) and the initial form of cancer;

4. taking smears for cytological examination from the cervix and cervical canal - should be performed annually for every woman to detect microscopic, initial forms of cancer;

5. a biopsy of the cervix and curettage of the cervical canal - taking a piece of the cervix for examination under a microscope, required if cancer is suspected, can be performed with a scalpel or an electric knife.

6. ultrasound examination of the pelvic organs - allows you to assess the prevalence of the tumor process in the small pelvis (stage), it is necessary to plan the scope of the operation;

7. computed tomography of the small pelvis - in unclear cases, with suspicion of tumor germination of adjacent organs;

8. intravenous urography - performed to determine the function of the kidneys, since in cervical cancer, compression of the ureters by a tumor is often found, followed by impaired renal function and turning it off;

9. cystoscopy and rectoscopy (or irrigoscopy - X-ray contrast examination of the intestine) - examination of the bladder and rectum in order to identify their tumor invasion;

10. chest x-ray and abdominal ultrasound - performed to exclude distant metastases.

Cervical cancer stages:

Stage 0 - the initial stage - "cancer in place", the survival rate of patients, after treatment is 98-100%;
Stage 1 (A, A1, A2-1B, B1, B2) - is divided into subgroups, stage A - the tumor grows into the cervical tissue no more than 5 mm, Stage B - tumor up to 4 cm;
Stage 2 (A and B) - the tumor has spread to the uterus, but without involving the walls of the pelvis or the upper third of the vagina;
Stage 3 - the tumor invades the upper third of the vagina, the pelvic wall, or causes hydronephrosis on one side (it blocks the ureter, the kidney is out of work);
Stage 4 - invasion into the bladder, rectum or pelvic bones (sacrum), as well as the presence of distant metastases.

Metastases are screenings from the main tumor that have its structure and are able to grow, disrupting the function of those organs where they develop. The appearance of metastases is associated with the regular growth of the tumor: the tissue grows rapidly, there is not enough nutrition for all its elements, some of the cells lose their connection with the rest, break away from the tumor and enter the blood vessels, spread throughout the body and enter organs with a small and well-developed vascular network (liver , lungs, brain, bones), settle in them from the bloodstream and begin to grow, forming metastatic colonies. In some cases, metastases can reach enormous sizes (more than 10 cm) and lead to the death of patients from poisoning with the waste products of the tumor and disruption of the organ. Cervical cancer most often metastases to nearby lymph nodes - adipose tissue of the small pelvis, along the large vascular bundles (iliac); from distant organs: to the lungs and pleura (integumentary lining of the lungs), to the liver and other organs. If metastases are isolated, their removal is possible - this gives a better chance of cure. If they are multiple - only supportive chemotherapy. Pleurisy is a big problem for patients - a metastatic lesion of the lining of the lungs, which leads to a violation of its permeability and the accumulation of fluid in the chest cavity, leading to compression of organs - lungs, heart, and causing shortness of breath, heaviness in the chest and exhaustion of patients.

A favorable prognosis is possible only under the condition of adequate treatment (surgery or radiation therapy or their combination) at the initial, 1-2 stages. Unfortunately, at stages 3-4, the survival rate is extremely low, does not exceed 40%.

Cervical cancer treatment

The best treatment results have been obtained with initial cervical cancer (“cancer in place”) that does not grow into the surrounding tissue. In young patients of childbearing age planning childbirth, there are several options for organ-preserving treatment: excision of the affected area with a scalpel within healthy tissues or laser evaporation, cryodestruction (liquid nitrogen), ultrasonic removal of the cervix.

In microinvasive cancer - tumor ingrowth into the underlying tissues of no more than 3 mm, as well as for all other stages of the tumor, an operation is required - extirpation of the uterus without appendages in women of childbearing age and removal with appendages in women in the postmenapausal period. At the same time, starting from stage 1b, the removal of nearby lymph nodes is added to the treatment.

In addition, the operation can be supplemented with radiation therapy.

In stages 1-2, independent radiation therapy is possible, without surgery: intracavitary (through the vagina) and remote (outside).

The choice of treatment method depends on the age, general well-being, and the patient's wishes.

When the tumor grows into the surrounding organs, a combined operation is possible (removal of the uterus with a part of these organs).

For large, inoperable tumors, radiation therapy is an option for treatment, provided that the tumor is reduced in size, the next step is surgery.

At large stages of the tumor process, palliative operations are possible (relief of symptoms): removal of the colostomy on the stomach, the formation of a bypass anastomosis.

The treatment option may be chemotherapy - surgery or chemotherapy-radiation treatment without surgery.

In the presence of metastases in distant organs, only chemotherapy.

Full recovery of the patient is possible as a result of the use of surgical or combined effects.

After treatment, dynamic observation is mandatory: a visit to the gynecologist to perform colposcopy and take smears every 3 months.

In no case should you self-medicate, since the favorable period for treatment will be missed during this time.

Complications of cervical cancer:

compression of the ureters, urinary retention, hydronephrosis, purulent urinary tract infection, bleeding from the tumor and genital tract up to profuse (fatal), the formation of fistulas (messages between the bladder or intestines and the vagina).

Doctor's consultation on cervical cancer:

Question: how often do women get cervical cancer?
Answer: This tumor occurs quite often, occupies the 2nd place in frequency after breast cancer in Europe. In Russia - 6th place among malignant tumors and 3rd among the organs of the reproductive system. Women of all ages are ill, but more often 50-55 years old.

Question: Is it possible to have children after cervical cancer treatment?
Answer: Yes, perhaps, subject to early stages of cancer and performing organ-preserving surgeries.

Question: What alternative to surgical treatment of cervical cancer is there?
Answer: There can be many treatment options, it all depends on the patient's desire and the capabilities of the medical institution: excision with a scalpel (knife amputation) within healthy tissues or laser evaporation, cryodestruction (liquid nitrogen), ultrasonic removal of the cervix and others.

Doctor-oncologist Barinova Natalya Yurievna

This is an oncological disease in which a malignant degeneration of the mucous membrane of the cervix is \u200b\u200bdiagnosed. In terms of the frequency of clinically diagnosed cases, cervical cancer is superior only to breast and endometrial cancer.

The main risk areas for cervical cancer are women between the ages of 40 and 55. But, recently, the disease is dramatically younger. Increasingly, cervical cancer (cervical cancer) is detected in patients under 30 years of age. There is one more problem - untimely diagnosis. Although the disease is fairly easy to detect, in more than half of cases, cervical cancer is found at an advanced stage. If you suspect a disease, you should urgently consult a gynecologist.

Types of cervical cancer

The main classification of cervical cancer arises from the type of tissue affected by the tumor. The uppermost and protective layer is squamous epithelium. In this case, we can talk about the following forms:

• Dysplasia (it can have 3 degrees) is a precancerous condition;
• Cancer in situ. This is the name of the degree of the tumor with minimal invasion into other layers;
• Squamous cell carcinoma of the uterus.

Directly in squamous cell carcinoma of the cervix, the following types can appear:

• Papillary;
• Warty;
• Keratinizing;
• Non-keratinizing;
• Lymphoepithelioma-like;
• Basaloid;
• Squamous transitional.

Tumors that invade the secreting epithelium are called adenocarcinomas. They can be:

• Endometrioid;
• Serous;
• Clear-celled;
• Mesonephral;
• Mucinous.

Often, the process is accompanied by the formation of concomitant tumors of other etiologies:

• Neuroendocrine and large cell carcinomas;
• Carcinoids;
• Sarcomas;
• Small cell cancer of the cervix.

Classification of forms of cancer

Distinguish cancer by location (vaginal part of the cervix and the inside). In addition, there are several forms of growth:

• Pre-invasive. In this case, stage zero is assigned. The malignant process develops strictly within the epithelium;
• Microinvasive. The depth of the lesion does not exceed 0.5 cm, without metastases;
• Non-invasive (stage 1). Cervical cancer cells are not widespread, progresses very slowly;
• Exophytic. The most common type in which the tumor grows in the lumen of the vagina. Externally resembles cauliflower forks. This is stage 3 (with damage to the tissues of the vagina). At stage 4, metastases to various organs can be observed;
• Endophytic. The tumor grows secretly in the cervical canal. It becomes noticeable only in the late stages of tumor decay, leading to looseness and unevenness of the cervix. Outwardly defined as a bleeding ulcer that grows deep into the tissues of the uterus;
• Mixed. This is a rather rare option, since it involves the presence of several tumors of various types at once.

Causes

The main threat of cervical cancer in women is viruses that lead to mutations and degeneration of healthy tissue cells into malignant tumors. Risk factor # 1 is human papillomavirus (HPV). But this virus has more than 100 varieties with varying degrees of risk of developing oncology. It is because of this feature that over 90% of cases of cervical cancer develop. After entering the body, the HPV virus can proceed in 3 forms:

• Asymptomatic form;
• Subclinical form;
• Clinical form. There are multiple or single growths (condylomas and papillomas) in the genital area.

The most dangerous and with a high level of oncogenic risk are HPV strains carrying markers 16, 18, 45 and 46. The average level of risk of developing cervical cancer is type 31, 33, 51, 52 and 58 strains.

Other causes of cervical cancer include:

• Predisposition. If women among relatives had cases of cervical cancer, then you should be extremely careful about your health and be regularly examined;
• Viruses - genital herpes, HIV, chlamydia, cytomegalovirus;
• Untreated or untreated genital infections;
• Diseases of the cervix, accompanied by changes in tissues (erosion, dysplasia, leukoplakia);
• The presence of benign tumors (fibroids, fibroids), which under long-term adverse conditions can degenerate into malignant, other neoplasms;
• Strong weakening of immunity;
• Uncontrolled human exposure to radiation, chemical toxins;
• Frequent abortion or curettage, as well as complications associated with these and other surgical procedures;
• Frequent pregnancy and childbirth;
• Microtrauma of the cervix or the uterus itself, as well as the cervical canal;
• Early onset of sexual activity;
• Change of partners more often 2 - 3 times a year;
• Long term stress;
• Uncontrolled use of oral combined contraceptives;
• Long-term smoking or alcohol addiction;
• The presence of chronic inflammation in the pelvic area without proper treatment. Other chronic diseases associated with inflammation.

Symptoms

The main and most alarming symptoms are:

• Unforeseen and frequent bleeding (after a visit to the gynecologist, after intercourse, between normal periods, during menopause);
• Menstrual bleeding lasts more than a week in duration;
• Discharge with blood, they can have an unpleasant odor and signal the onset of tumor decay;
• Purulent discharge with a pungent and unpleasant odor;
• Prolonged cuts (lower abdomen and uterine region);
• Pain that is spasmodic. In this case, part of the pain can be given to the lower back;
• Excessive vaginal dryness and pain during intercourse;
• Sudden weight loss (10 to 15 kg in a few weeks). This symptom is unconditional and requires a quick visit to a doctor;
• Persistent constipation and pain during bowel movements. Other diseases associated with the intestines;
• A sharp increase in frequency, or vice versa, severe delay in urination. This is due to the growth of the tumor, which compresses the bladder. Blood may be present in the urine;
• Constant severe weakness;
• Excessively fast fatigability;
• Sweating too much for no apparent reason;
• A slight increase in temperature without signs of a cold (from 37 ° C to 37.8 ° C);
• Constant swelling of the limbs. This is especially true for the legs and feet;

The symptoms listed above are not a prerequisite, but their presence may indicate other serious diseases, including gynecological or sexually transmitted diseases. Therefore, do not postpone a visit to a gynecologist.

Diagnostics

Diagnosis of cervical cancer consists of several stages:

• Examination by a gynecologist to detect oncology. It is necessary to pass it 2 times a year;
• Scraping from the surface of the cervix for cytological examination (Pap smear);
• Colposcopy. Examination using a special device that helps to enlarge and bring closer the image of the cervical tissue;
• Biopsy - with the help of this microinvasive method, a biomaterial is taken for histological examination;
• The procedure for curettage of the cervical canal. It is necessary and carried out only when cytology shows oncology or dysplasia, and colposcopy does not reveal anything;
• Schiller test samples (with vinegar or iodine);
• Examination of the pelvic organs using ultrasound. Allows you to fairly accurately identify the presence or absence of tumor formations. If ultrasound is not enough to determine the exact location and quality of the tumor, then pelvic MRI may be prescribed.

If there are several symptoms at once and serious suspicions of cervical cancer, the gynecologist may also prescribe related examinations related to other organs for the detection of metastases:

• Ultrasound of the liver and kidneys;
• Ultrasound examination of the bladder;
• Radiography of the lungs. This is how distant metastases to the chest are revealed;
• X-ray of the colon (irrigoscopy);
• Appointment of cystoscopy and rectoscopy. Examination data of the bladder and rectum make it possible to find out the presence of metastases or tumors that have penetrated into their walls;
• Intravenous urography. Cervical cancer is often accompanied by squeezing of the ureters and leads to serious kidney problems. Up to the development of atrophy of the renal tissues or ureters. This method allows you to identify such violations.

Which doctors to contact

The main physician conducting examinations and prescribing treatment is a gynecologist. If cancer is found in the process, then an oncologist will additionally need to be observed. Doctors of another profile (therapist, endocrinologist) are visited as needed or in cases of detection or development of other diseases.

Treatment

Treatment methods largely depend on the degree of development of the disease. Here you need to remember that, although there are only 5 stages of cancer (including zero), each of them has 2-3 degrees of difficulty (categories A or B). The designation depends on the size and location of the tumor:

• Stage 1A1. (invasive stage). The tumor is detected only by microscopic examination. Only the area of \u200b\u200bthe cervix is \u200b\u200baffected (without metastases). The dimensions do not exceed 7 mm in volume and 3 mm of the lesion in the depth of the epithelium. Treatment is conization (excision of diseased tissue) in young women or traditional hysterectomy (removal) of the uterus in postmenopausal women. With concomitant damage to the lymph nodes or blood vessels, lymphadenectomy is prescribed (lymph nodes are removed) of the pelvic region. After the operation, radiation therapy is prescribed (it can be with or without chemotherapy);
• Stage 1A2 (invasive stage with complications). The tumor also cannot be detected visually, but upon detection it turns out that its dimensions exceed 7 mm in width of the lesion and 3 mm in depth. The treatment for patients of childbearing age is the excision of the cervix or its conization, and for the elderly, a hysterectomy is prescribed. Pelvic lymphadenectomy is mandatory. If metastases are detected, chemotherapy and radiation therapy are performed;
• Stage 1B The tumor is visible visually, and its size does not exceed 4 cm. There can be 2 methods of treatment: surgery with external radiation. In the first case, a radical hysterectomy is performed (removal of the uterus completely with appendages and tubes) and bilateral oophorectomy. Pelvic lymphadenectomy is prescribed and performed. In especially favorable cases, surgical treatment is carried out with the preservation of all organs. In the second case, the problem is solved by a radiosurgical method. First, brachytherapy is performed, and after 1.5 - 2 months - the operation itself;
• Stages 1B2 - 5A. the tumor is detected visually, and its dimensions are equal to or slightly exceed 4 cm. In such a situation, tumor lesions of the vagina, rectum with the bladder are possible. The most optimal treatments are radiation therapy and chemotherapy. ;
• Stage 5B. The area of \u200b\u200bthe lesion and the overall size of the tumor can be any. Distant metastases are also present at this stage. At this stage, palliative treatment is performed.

Follow-up after treatment

All patients who have been diagnosed with cervical cancer and have received appropriate treatment should regularly visit a gynecologist and undergo the necessary instrumental and laboratory diagnostics.

Within 2 years after treatment, a cytogram analysis should be performed every 3 months. For another 3 years after that, a smear is taken every six months. Throughout his subsequent life, the cytogram is handed over annually. This is necessary in order to avoid relapses of the disease.

To control the appearance or development of metastases, as well as for their early detection, MRI, CT and PET of the abdominal and pelvic organs are used.

Prevention

The most effective prevention is recognized as vaccination against the papilloma virus (HPV), as the main primary source of cancer. It can be done from 9 to 11 years old, since the drugs are most effective if the vaccine is given before the onset of sexual activity. This means before infection with a sexually transmitted virus. It also makes sense to vaccinate against this virus for all women under 45 years old.

The most studied and effective means of immunization is the Gardasil vaccine (Gardasil). The drug effectively protects against the virus 4 years after vaccination. Then the procedure must be repeated.

Cervical cancer - a malignant tumor that develops in the cervical region. This form of cancer is one of the first among oncological diseases of the genital organs. Cervical cancer most often occurs between the ages of 35 and 55. It is much less common in young women.

About half a million women fall ill every year in the world. Moreover, the risk of developing the disease largely depends on race. For example, Hispanics get sick 2 times more often than Europeans.

This cancer of the female genital organs can be successfully treated in its early stages. Often it is preceded by precancerous conditions (erosion, dysplasia), getting rid of which, it is possible to prevent the appearance of cancer.

It is important to know that the diagnosis of cervical cancer is not a sentence. If a woman started treatment on time, then she has excellent chances of recovery. More than 90% of early stage tumors are curable. Modern methods allow the uterus and ovaries to be preserved. Thus, patients who successfully cope with the disease retain their sexuality and can successfully become pregnant.

Human papillomavirus (HPV) from the Papovaviridae family plays an important role in the development of cervical cancer. Moreover, the virus is transmitted from partner to partner, even if the couple used a condom. Due to the small size of the pathogen, it easily penetrates the pores in the latex. In addition, the virus can be transmitted from any infected part of the body (lips, skin).

This virus introduces its genes into the DNA of epithelial cells. Over time, this leads to cell degeneration. They stop maturing, lose the ability to perform their functions, and can only actively share. This leads to the fact that in place of one mutated cell a cancerous tumor appears. Gradually, it grows into the nearest organs and lets out metastases to distant parts of the body, which leads to serious consequences for the body.

In addition to the virus, there are a number of factors that can cause the appearance of a malignant neoplasm in the cervix.

1. Early onset of sexual activity in girls.
2. Having a large number of sexual partners.
3. Smoking.
4. Sexually transmitted infections.
5. Excessive obsession with diets.

Uterus anatomy

Uterus - This is the muscular organ in which the fetus is carried during pregnancy. Basically, the uterus consists of smooth muscles. It is located in the small basin. The upper part includes the fallopian tubes, through which the egg enters the uterus from the ovaries.

In front of the uterus is the bladder, and behind it is the rectum. Elastic ligaments protect the uterus from displacement. They are attached to the walls of the pelvis or woven into the fiber.

The uterus resembles a triangle. Its base is turned upward, and the lower narrowed part, the cervix, opens into the vagina. On average, the uterus has a length of 7-8 cm, a width of 3-4 cm and a thickness of 2-3 cm, a uterine cavity of 4-5 cm3. In women before pregnancy, the uterus weighs 40 g, and in those who have given birth, 80 g.

The uterus has three layers:

• Parameter or peri-uterine fiber. It is the serous membrane that covers the outside of the organ.


• Myometrium or the middle muscle layer, consisting of intertwined bundles of smooth muscle. It has three layers: outer and inner - longitudinal and middle - circular, in which blood vessels lie. The purpose of the myometrium is to protect the fetus during pregnancy and uterine contraction during childbirth.


• Endometrium or mucous layer. This is the inner mucous membrane, which is densely penetrated by blood capillaries. Its main function is to ensure the attachment of the embryo. Consists of integumentary and glandular epithelium, as well as groups of ciliated cylindrical cells. On the surface of this layer, the ducts of simple tubular glands open. The endometrium consists of two layers: the superficial functional exfoliates during menstruation, the deep basal layer is responsible for the restoration of the superficial.

Parts of the uterus

• Fundus of the uterus - upper convex part.


• Body of the uterus - the middle part has the shape of a cone.


• Cervix - the lower, narrowest part.

Cervix

The lower narrowed part of the uterus looks like a cylinder through which the cervical canal passes. The cervix consists mainly of dense elastic tissue rich in collagen and a small number of smooth muscle fibers. The cervix is \u200b\u200bconventionally divided into two sections.

• Supravaginal partlocated above the vagina


• Vaginal partenters the vaginal cavity. It has thick edges (lips) that limit the external opening of the cervical canal. It leads from the vagina into the uterine cavity.

The walls of the cervical canal are covered with cells of the columnar epithelium, and tubular glands are also located there. They produce thick mucus that prevents microorganisms from entering the uterus from the vagina. Also, ridges and folds on the inner surface of the canal perform this function.

The cervix in the lower vaginal part is covered with squamous non-keratinizing epithelium. Its cells also enter the cervical canal. Above, the canal is lined with columnar epithelium. This picture is observed in women after 21-22 years. In young girls, the columnar epithelium descends below and covers the vaginal part of the cervix.

Here are the answers to the questions women are most concerned about about cervical cancer.

What are the stages of cervical cancer?

Stages of cervical cancer

Stage 0
Cancer cells are found only on the surface of the cervical canal, do not form a tumor and do not penetrate deep into the tissues. This condition is called cervical intraepithelial neoplasia.

Stage I
Cancer cells grow and form a tumor, which penetrates deep into the tissues of the cervix. The neoplasm does not go beyond the organ, does not spread to the lymph nodes.

Substage IА. The diameter of the neoplasm is 3-5 mm, the depth is up to 7 mm.

Substage IB. The swelling can be seen with the naked eye. Penetrates into the connective tissues of the cervix by 5 mm. Diameter ranges from 7 mm to 4 cm.

It is diagnosed only by microscopic examination of a cytological smear from the cervical canal. If atypical (irregular) cells of squamous epithelium are found in this analysis for oncocytology, then it is recommended to conduct an examination with a coloscope. This is a device that allows you to conduct a detailed inspection, displaying an image on the screen. And also carefully examine the cervix and do tests for cancer.

Stage II
The tumor grows into the body of the uterus and goes beyond it. It does not extend to the walls of the small pelvis and the lower parts of the vagina.

Sub-stage IIA... The tumor is about 4-6 cm in diameter, visible on examination. The neoplasm affects the cervix and upper vagina. Does not spread to the lymph nodes, does not form metastases in distant organs.

Substage IIB... The neoplasm spreads to the peri-uterine space, but does not affect the surrounding organs and lymph nodes.

For diagnostics, a study is prescribed with the help of a coloscope, ultrasound of the pelvic organs. A biopsy may also be required. This is taking a tissue sample from the cervix. This procedure is carried out during coloscopy or independently. With the help of a curette, a part of the epithelium is scraped from the cervical canal. Another method is wedge biopsy.

It is performed using an electric surgical loop or scalpel. Allows to take tissue from deep layers for analysis.

Stage III
The malignant tumor has spread to the walls of the small pelvis and the lower part of the vagina. It can affect nearby lymph nodes and interfere with the flow of urine. Does not affect distant organs. The tumor can be large.

Sub-stage IIIA

The neoplasm has grown into the lower third of the vagina, but the walls of the small pelvis are not affected.

Substage IIIB... The tumor causes blockage of the ureters, can affect the lymph nodes in the small pelvis and be found on its walls.

Colposcopy, biopsy, computed tomography are used for diagnosis. The latter method is based on X-ray irradiation. With their help, the scanner takes many pictures, which are compared in the computer and give a complete picture of the changes. Magnetic resonance imaging is also informative. The operation of the tomograph is based on the action of radio waves, which absorb and release different types of tissues to varying degrees.

Stage IV
The tumor has reached a considerable size and has spread widely around the cervix. Near and distant organs and lymph nodes are affected.

Substage IVA... Metastases have spread to the rectum and bladder. Lymph nodes and distant organs are not affected.

Substage IVB... Distant organs and lymph nodes are affected.

For diagnosis, visual examination, intestinal endoscopy, computed tomography or magnetic resonance imaging are used to determine the size of the neoplasm. In order to identify distant metastases, positron emission tomography is prescribed. Glucose with a radioactive atom is introduced into the body. It concentrates in tumor cells and metastases. Such clusters are then detected using a special camera.

What are the signs of cervical cancer?

In the early stages of cervical cancer, there are no specific symptoms. The woman does not notice any changes or discomfort. The first signs appear when the tumor reaches a significant size and affects adjacent organs. Therefore, it is so important to undergo a preventive examination by a gynecologist annually in order to detect cancer at an early stage, when it can be overcome.

Cervical cancer symptoms

1. Vaginal bleeding.
   • After the onset of menopause
   • Between periods
   • After gynecological examination
   • After intercourse
   • After douching


2. Changes in the nature of menstruation.
   • Prolongation of the bleeding period
   • Change in the nature of the discharge


3. Change in vaginal discharge.
   • With traces of blood
   • An increase in the amount of leucorrhoea
   • In the later stages of tumor decay, the discharge becomes fetid and looks like meat slops.


4. Pain during intercourse.
5. Pain in the back and lower abdomen.
6. Swelling of the feet
7. Violation of urination and bowel movement.
8. Decreased performance, weakness.

It should be noted that these signs are not specific to a cervical tumor. They can occur with other diseases of the genital organs. However, if you find such symptoms, this is a reason to urgently consult a gynecologist.

Consultation with an oncologist on the treatment of cervical cancer

Diagnosis of cervical cancer

What awaits you at the doctor's appointment?

Taking anamnesis. The doctor collects data on health complaints, the course of menstruation, etc.

Visual inspection... Examination of the vagina and lower cervix using gynecological mirrors. At this stage, the doctor takes smears of the vaginal contents for the microflora and for the presence of cancer cells (oncocytology).

If there is a need for a more thorough examination, a colposcopy is prescribed. It is performed using an instrument equipped with magnifying lenses and a lighting element. The procedure is painless and allows special tests to detect cancer cells and take a tissue sample for analysis. During the examination, the doctor may notice an area of \u200b\u200bthe mucous membrane that is different in color from the surrounding tissues or rises above them.

If the tumor develops in the thickness of the walls of the uterus (endophytic), then the organ increases in size and has a barrel-shaped shape. In the case when the growth of the tumor is directed outward (exophytic), then during examination the doctor sees growths similar to cauliflower. These are rounded formations of gray-pink color that begin to bleed when touched. Also, the tumor may look like a fungus on a pedicle or look like an ulcer.

What is the test for cervical cancer?

Today, the globally recognized test for the early diagnosis of cervical cancer is the PAP test or test Pappanicolaou.

The analysis is taken with a spatula or a Wallach brush from the mucous membrane of the cervix. Then the material is sent to the laboratory in a special container. There, the sample is applied to a glass slide and a study of cell characteristics (cytological) is carried out. The result will be ready in 7 days.

The analysis is taken no earlier than the fifth day from the start of the cycle and no later than 5 days before the start of menstruation. The day before visiting a gynecologist, you need to refrain from sexual intercourse and douching.

There are several other tests available to diagnose cervical cancer.

1. Cytology for atypical cells. This is taking a sample of the contents of the cervical canal. Under a microscope, the presence of cancer cells is determined.
2. Thin Prep-Method or Liquid Cytology. It consists in the preparation of special thin-layer cytological preparations.
3. HPV test "double gene trap". It allows you to diagnose not the tumor itself, but the degree of infection with the human papillomavirus and the degree of risk of developing cancer.

In conclusion, we emphasize once again how important it is to visit a gynecologist in a timely manner. A preventive visit to the doctor once every six months will reliably protect you from the development of a cancerous tumor and help maintain health.

What is cervical squamous cell carcinoma?

Two types of epithelium cover the cervix. Depending on which cells become the basis of the tumor, 2 types of cancer are distinguished:
Squamous cell carcinoma of the cervix is \u200b\u200ba malignant tumor that develops from squamous epithelial cells that cover the vaginal part of the cervical canal. It accounts for 80-90% of all cases. This type of disease is much more common than glandular cancer (adenocarcinoma).

This form of cancer is caused by a mutation in squamous epithelial cells. Infection with human papillomavirus, the presence of polyps and erosion of the cervix can lead to the transformation of normal cells into cancerous ones. Also, the cause can be inflammation and the spiral, which is used as a means of contraception.

The action of these factors leads to trauma and inflammation of squamous epithelial cells. This causes a breakdown in the DNA structure, which is responsible for the transfer of genetic information to daughter cells. As a result, during division, not a typical squamous epithelial cell, which can perform its functions, is formed, but an immature cancerous one. She can only share and produce like herself.

Squamous cell carcinoma has three stages:

• poorly differentiated squamous cell carcinoma - an immature form, the tumor is soft, fleshy, actively growing.
• squamous cell non-keratinizing cancer - an intermediate form, characterized by a wide variety of manifestations.
• squamous cell carcinoma - a mature form with a firm, dense consistency, the beginning of tumor formation.

Squamous epithelium cancer can take many forms. So cancer cells form a tumor in the form of small rounded formations - cancer pearls. They can take the form of a fungus or warts covered with papillary epithelium. Sometimes the tumor looks like small ulcers on the lining of the cervix.

If cancer can be detected in the early stages, then it responds well to treatment. An operation is performed to remove the tumor and a course of chemotherapy to prevent the formation of new foci of the disease. In this case, it is possible to preserve the uterus and in the future a woman can carry and give birth to a child.

If the moment is missed, and the tumor has grown in the tissue of the uterus, then it will be necessary to remove it and, possibly, the appendages. To consolidate the results of treatment, chemotherapy and radiation therapy are prescribed. A serious danger to life and health arises in patients with the fourth stage of cancer, when secondary foci of a cancerous tumor appear in near and distant organs.

What is the prevention of cervical cancer?

Prevention of cervical cancer is largely based on a woman's conscious attitude to her health.

Regular visits to the gynecologist are important.

• It is necessary to visit a doctor 2 times a year. The gynecologist will take swabs for flora from the vagina.
• once a year, it is advisable to undergo a colposcopy for a thorough examination of the state of the cervix.
• A cytological study for atypical cells is carried out once every 3-4 years. This PAP test allows you to determine the precancerous state of the mucous membrane or the presence of cancer cells
• Your doctor will order a biopsy if necessary. Taking a small piece of mucous for a thorough examination.

It is especially important to undergo these examinations for women who are most at risk of developing cervical cancer.

Main risk factors:

1. Early onset of sexual activity and early pregnancy. The risk group includes those who often had sexual intercourse before the age of 16. This is due to the fact that at a young age, the epithelium of the cervix contains immature cells that are easily reborn.


2. A large number of sexual partners throughout life. American studies have shown that a woman who has had more than 10 partners in her life has a 2-fold increase in the risk of developing a tumor.


3. Sexually transmitted diseases, and especially the human papillomavirus. Viral and bacterial venereal diseases cause cell mutations.


4. Long-term use of oral contraceptives causes hormonal disruption in the body. And imbalance is bad for the condition of the genitals.


5. Smoking. Tobacco smoke contains carcinogens - substances that help healthy cells turn into cancerous ones.


6. Long-term diets and poor nutrition. Lack of antioxidants and vitamins in food increases the likelihood of mutation. In this case, the cells suffer from free radical attacks, which are believed to be one of the causes of cancer.

Prevention methods

1. The presence of a permanent sexual partner and regular sexual activity significantly reduce the likelihood of tumors and other diseases of the genital area.


2. Also very important is the use of condoms to prevent infection with the human papillomavirus (HPV). While these products do not provide an absolute guarantee, they reduce the risk of infection by 70%. In addition, condom use protects against sexually transmitted diseases. According to statistics, after the transferred venereal diseases, mutations in the cells of the genital organs occur much more often.


3. If there is an unprotected sexual contact with a condom, it is recommended to use Epigen-Intim for the hygiene of the internal and external genital organs. It has antiviral effect and can prevent infection.


4. Compliance with the rules of personal hygiene plays an important role. To preserve the normal microflora of the genital organs and maintain local immunity, it is advisable to use intimate gels with lactic acid. This is important for girls after puberty. Choose products that contain the least amount of flavor.


5. Quitting smoking is an important part of prevention. Smoking causes vasoconstriction and interferes with blood circulation in the genitals. In addition, tobacco smoke contains carcinogens - substances that contribute to the transformation of healthy cells into cancerous ones.


6. Refusal of oral contraceptives. Long-term intake contraceptivefunds can cause hormonal imbalance in women. Therefore, it is unacceptable to independently determine which pills to take to prevent pregnancy. This should be done by the doctor after the examination. Hormonal disorders caused by other factors can also cause swelling. Therefore, you need to consult a doctor if you notice a malfunction of the menstrual cycle, increased hair growth, after 30 you have acne, or you began to gain weight.


7. Several studies have identified a link between cervical cancer and injuries that have resulted from gynecological manipulations. This includes abortions, childbirth injuries, and spiral placement. Sometimes, as a result of such injuries, a scar can form, and its tissue is prone to degeneration and can cause a tumor. Therefore, it is important to trust your health only to qualified specialists, and not to private doctors, whose reputation you doubt.


8. Treating precancerous conditions, such as dysplasia and cervical erosion, can prevent tumor development.
9. Proper nutrition. It is necessary to eat a sufficient amount of fresh vegetables and fruits, more cereals containing complex carbohydrates. It is recommended to avoid foods that contain a lot of food additives (E).

As a specific prophylaxis, a vaccine has been developed against the virus that causes cervical cancer.

Is the cervical cancer vaccine effective?

The vaccine against cervical cancer is given with Gardasil. It is a quadruple vaccine against the most dangerous types of human papillomavirus (HPV), the leading cause of cervical cancer. It was registered in Russia in 2006.

The drug contains virus-like particles (proteins) that cause the production of antibodies in the human body. The vaccine contains no viruses that could multiply and cause illness. The drug is not used to treat cervical cancer or papillomas on the genitals, and should not be administered to infected women.

Gardasil is designed to protect the body from the human papillomavirus. It has been scientifically proven that its varieties 6, 11, 16, 18 cause the appearance of papillomas (warts) on the genitals, as well as cervical and vaginal cancer.

Vaccination against cervical cancer guarantees immunity for three years. It is recommended for girls aged 9-17. This is due to the fact that, according to statistics, women in whom a cancerous tumor was found after 35 years, contracted HPV at the age of 15-20 years. And from 15 to 35 years old, the virus was in the body, gradually causing the transformation of healthy cells into cancerous ones.

Vaccination is done in three stages:

1. On the appointed day
2. 2 months after the first dose
3. 6 months after the first injection

To acquire long-term persistent immunity, it is necessary to repeat the introduction of the vaccine at 25-27 years.

The drug is produced by the oldest German pharmaceutical corporation Merck KGaA . And to date, more than 50 million doses have already been used. In 20 countries, this vaccine is included in the national vaccination schedule, which indicates its recognition in the world.

There is still debate about the safety of this drug and the feasibility of its introduction to adolescents. Severe side effects (anaphylactic shock, thromboembolism) and even death have been described. The ratio is one death per million vaccinations given. At a time when more than 100,000 women die from cervical cancer every year. On this basis, those who have not been vaccinated are at much greater risk.

The manufacturers conducted an investigation, during which it was proved that the percentage of complications from vaccination against cervical cancer does not exceed the corresponding figure in other vaccines. The developers say that many deaths were not caused by the drug itself, but occurred in the period after its introduction and are associated with other factors.

Opponents of vaccination against cervical cancer argue that it makes no sense to vaccinate girls at such an early age. It is difficult to disagree with this argument. At 9-13 years old, girls usually do not have an active sex life, and immunity lasts only 3 years. Therefore, it makes sense to postpone vaccination at a later date.

The information that Gardasil has a bad effect on the reproductive system and is "part of a conspiracy theory for the sterilization of the Slavs" is an invention of sensationalists. This has been shown by many years of experience in using the drug in the USA, the Netherlands and Australia. Women who were vaccinated with Gardasil did not experience fertility problems more often than their peers.

The significant cost of the vaccine (about $ 450 per course) severely limits the number of women who can get the vaccine for their money. It is hard to argue that the manufacturing corporation makes huge profits. But a drug that can actually protect against cancer is worth the money.

Summing up, we note that Gardasil is an effective means of preventing the appearance of cervical cancer. And the percentage of complications is no more than that of influenza or diphtheria vaccines. Based on this, it can be recommended to vaccinate those young women who are at risk. This should be done at the age of 16-25, when the likelihood of contracting HPV increases. Vaccinations can be carried out after a thorough medical examination if no serious illness is found during the examination.