Treatment of cancer of female organs. The main signs of oncology in women

24.10.2018

Cancers of the genital organs in women can be divided into two types: benign and malignant.

Considering the first signs of cancer, these include neoplasms that do not spread tumor cells throughout the body, but which need to be paid attention to prevent their degeneration.

Benign tumors

Benign tumors grow in width, but are unable to spread to other organs. But they are also oncological tumors, and if they are not treated in time, complications are likely. There are such types of these neoplasms:

fibroma;
myoma;
fibroids;
cystoma;
polyp.

Fibroids typically appear on parts such as the ovaries, labia, or inside the cervix. Formed from fibrous connective tissue. Cancer manifests itself in female signs of pain in the pelvis and difficulty during bowel movements.

Fibroids are characterized by heavy bleeding during menstruation and pain in the lower abdomen. With complications, the pain becomes stronger, chills and fever appear. It represents the formation of nodules and compactions.

Fibroids form in the uterus and can reach significant sizes. As the tumor develops, pressure occurs in the pelvis, and the amount of discharge during menstruation increases.

Cystoma. Formed from a cyst. The first signs are irregularities in the menstrual cycle, discomfort and bloating. Sometimes the appearance of pain, spasms and discomfort during intimacy is characteristic.

Polyps are soft, red-pink growths. Arranged in clusters. With them, bleeding appears after sexual intercourse and discharge increases during menstruation.

General symptoms

Often, cancer of the female genital organs does not have specific symptoms and is similar to other diseases or disorders and abnormalities in work. There are a number of general signs that you should pay attention to and if you find yourself experiencing symptoms, you should immediately consult a doctor in order to prevent the development and exacerbation of oncology in advance:

Bloating.

This symptom is very common in ovarian cancer, and most often it is neglected. This is one of the main symptoms, so if you cannot fasten your skirt or pants, pay attention to this.

Stomach ache.

Pressure and constant aching pain in the area below the navel, not associated with menstruation, often indicate the development of cancer in the female genital organs.

Lower back pain.

You can even get used to monotonous pain of a constant nature and not pay attention to it, but this is a symptom of oncology.

Fever.

If you have a high temperature all day for a long period, you should visit a doctor. This is a dangerous sign not only of ovarian cancer, but also of disorders in the body or diseases.

Heavy bleeding.

Unnatural bleeding from the genitals is a common sign of the development of cancer. Excessive bleeding during menstruation, unnatural bleeding in the stages between them and during sexual intercourse are symptoms of cancer development in women.

Stomach upsets.

Diarrhea, constipation, flatulence and irregular stool, sometimes with the presence of blood, are reasons to consult a doctor. These are signs not only of genital cancer, but such manifestations indicate possible rectal cancer.

Changes in the genital organs.

Changes uncharacteristic of the vulva or vagina (skin color, discharge, blisters, wounds) can serve as a signal of the development of cancer, so a visit to the doctor is required. Regular examination by a gynecologist is the basis for preventing cancer.

Weight loss

Losing more than five kilograms per month without stress and effort is unnatural. Weight fluctuations are possible, but rapid weight loss is not a positive fact.

Fatigue

Chronic lethargy is one of the main signs of cancer in any part of the body. Exhaustion and fatigue even from light loads are characteristic of the last stages, but sometimes appear at the initial stage.

Breast changes

Any lumps, wounds, swelling or redness found on the mammary glands during examination are not a good sign, so you should immediately consult a doctor.

Before talking about cancer, you should know that it has four stages of development, and in the first stage the symptoms are almost imperceptible.

Uterine cancer and its causes

The causes of cancer in women may include promiscuity, early onset of sexual activity, viral diseases and cervical injuries. Cancer often develops due to herpes (papillomas), so it is recommended to get tested in order to detect pathology in time.

At the second and third stages of uterine cancer, specific signs are bloody discharge, the presence of blood in the urine, pain in the back and legs. It should be added that the first stage often has no symptoms, and the pathology can be diagnosed during an examination by a gynecologist.

With cancer of the uterine body, polypous growths form. A malignant tumor, when germinating, affects the appendages and abdominal cavity, which is why an unpleasant-smelling discharge is formed, consisting of a mixture of pus and blood.

Ovarian cancer

Ovarian cancer is slightly less common than uterine cancer, but it is common, especially in older women who have not known the joys of motherhood. Sometimes this is influenced by genetic inheritance.

Characteristic signs for this pathology are nausea, vomiting, bloating and constipation. The early stages are asymptomatic, which is why they are dangerous, and the tumor itself changes the functioning of the intestines, causing fluid accumulation.

Vaginal cancer

The first sign can be purulent-bloody leucorrhoea. In this case, dense ulcers form on the walls of the vagina, which subsequently cause pain and lead to compression of the internal cavity. In this case, intoxication of the body occurs, and difficulties arise when urinating. It is observed more often in women during menopause and menopause.

Labia cancer

This type develops during menopause and consists of ulcerative nodules with dense edges. As the tumor grows, it penetrates deeper, affecting the lymph nodes. Initial signs are burning, itching and pain. During exacerbation, purulent-bloody discharge occurs.

Treatment methods

Malignant tumors of the female genital organs are removed using combined treatment methods or individual types of procedures.

This is determined by the doctor and depends on the location of the tumor, its type and stage.

Treatment includes surgery, radiation therapy, and in case of complications, the use of systemic drugs (chemotherapy) and hormone therapy. A special method is symptomatic treatment used at the last stage.

Modern medicine has achieved unprecedented success in the treatment of cancer. Many patients get the opportunity to forget about the disease forever and return to normal life. However, cancer can only be cured if it is diagnosed early enough. That’s why it’s so important to know the first signs of cancer as a woman. This knowledge can save the life of you and your loved ones!

Benign tumors in women

Tumors are divided into two categories: benign and malignant. In turn, malignant tumors are divided into cancer (tumors originating from epithelial tissue) and sarcomas (derived from connective tissue).

Benign tumors have the following properties:

tumor cells do not differ from the tissue cells from which they arise;
do not give metastases;
They almost never relapse after therapy.

Benign tumors include:

fibroids. The leading symptom is abdominal pain and constipation;
fibroids lead to heavy bleeding and pain. Sometimes patients experience fever and chills;
. It grows in the uterus and can reach very impressive sizes;
cystoma. The origin of this tumor is a cyst. The leading signs of cystoma are abdominal pain, flatulence, menstrual cycle irregularities and pain during sexual intercourse;
polyps are benign neoplasms, the presence of which is indicated by pain during sex, as well as an increase in the volume of menstruation.

You should not think that benign tumors can be left untreated or their treatment can be delayed indefinitely. The main danger of such neoplasms is that they can degenerate into malignant ones. Therefore, the sooner the diagnosis is made and therapy is started, the lower the risk of malignant degeneration.

Early signs and general symptoms

The first signs of cancer in women

Early diagnosis of oncology in women is complicated by the fact that the first symptoms are nonspecific. This means that the initial symptoms are often mild and resemble symptoms of other diseases or are even attributed to overwork.

The initial signs of oncology include:

increased fatigue, weakness and irritability;
long;
abdominal pain that is not associated with the menstrual cycle;
pain in the lumbar region;
low-grade fever. Many oncological diseases are accompanied by low-grade fever (37.2-37.5). The temperature usually rises in the evening;
bleeding from the genitals. Both heavy menstruation and bleeding after sex or even physical activity may occur;
bowel disorder (diarrhea, constipation);
weight loss without diet and increased physical activity;
lumps in the mammary glands, the appearance of discharge from the nipple, as well as swelling of the lymph nodes in the armpits may indicate.

Cervical and uterine cancer

The main reasons leading to oncology in women include:

viral diseases;
genital injuries;
frequent change of sexual partners;
smoking.

It has been proven that the development of uterine cancer is provoked by infection with the human papilloma virus and the herpes virus. Therefore, it is important to undergo tests to detect these viruses at least once a year.

There are several stages of the disease, and in the first stages any noticeable symptoms are either absent altogether or are attributed to a deterioration in the general condition of the body or the consequences of overwork. Only at the third stage do more specific symptoms appear:

blood in urine;
bleeding in women who have experienced menopause;
back pain radiating to the legs.

In later stages, leucorrhoea appears with inclusions of pus. The tumor grows into the abdominal organs, causing symptoms of digestive disorders.

Cancer of the ovaries, vagina, labia

Dangerous diseases of the female organs

It can appear in any woman, but there are factors that increase the likelihood of developing cancer in women. These include:

heredity. If a woman's relatives had ovarian cancer, it is possible that she inherited a predisposition to this disease;
too early onset of menstruation;
absence of pregnancy;
excess weight;
uncontrolled use of hormonal drugs;
diseases of the appendages;
bad habits;
living in an area with unfavorable environmental conditions.

Initial symptoms of ovarian cancer include:

pain in the lower abdomen;
discomfort during sexual intercourse;
bloating;
bleeding between periods;
low-grade fever;
if the ovary is affected on only one side, the pain is localized on one side of the abdomen;
tumors of the appendages can be manifested by cessation of the menstrual cycle, as well as breast reduction and deepening of the voice;
digestive disorders.

The symptoms of cancer in women described above often resemble symptoms of indigestion. Therefore, women often self-medicate, wasting precious time that could be spent on treating ovarian cancer.

Vaginal cancer is manifested by the appearance of purulent-bloody discharge. In this case, you can feel dense ulcers on the walls of the vagina, which cause noticeable discomfort. At the same time, problems with urination are observed.

Labia cancer has the following symptoms:

the appearance of ulcers with hard, easily palpable edges;
and itching, as well as pain in the labia area;
symptoms of general intoxication: low-grade fever, fatigue, drowsiness.

Treatment options

Treatment of pelvic cancer in women

Treatment of oncology in the female half of humanity is selected depending on the stage of the disease and the location of the tumor. The most commonly used methods are:

surgical intervention. During surgery, the surgeon can remove either just the tumor or the entire affected organ. At the initial stages, minimally invasive (gentle) operations are used;
radiation therapy (radiotherapy). Exposure to targeted radiation stops tumor growth. Radiation therapy is often given before surgery;
chemotherapy. During treatment, cytotoxic drugs are used that suppress the proliferation of malignant tumor cells. Unfortunately, the drugs do not have a targeted effect on malignant cells: the entire body suffers, so chemotherapy is usually quite difficult for patients to tolerate. However, you should not refuse it: modern treatment regimens allow you to achieve excellent results and long-term relapse or complete cure;
hormone therapy. Hormonal drugs are used only in case of development of hormone-dependent tumors.

At the last stage of the disease, symptomatic (palliative) treatment is used. In this case, we are not talking about healing, but about alleviating the symptoms of cancer, for example, relieving pain.

Diagnostics

Diagnosis of oncology in women includes:

gynecological examination;
anamnesis collection. Often, in order to make a diagnosis or suspect the presence of a malignant process, the doctor needs to find out whether the patient’s relatives have had cancer;
histological analysis. Modern methods make it possible to identify even a small number of cells that have undergone malignant degeneration;
ultrasonography;
MRI and CT;

Prevention

Prevention of stress and depression

There are no reliable measures to prevent cancer. However, there are ways to reduce its development to a minimum:

regular gynecological examinations. It is necessary to visit a gynecologist at least once a year. If a woman has a history of cancer in her family, it is advisable to increase the frequency of visits to at least once every six months;
consult a doctor at the first signs of cancer;
to refuse from bad habits;
do not have unprotected sex with an unverified partner;
take hormonal medications and contraceptives only after consultation with a specialist;
wash yourself regularly, use special intimate hygiene products;
avoid hypothermia;
try to avoid stress: a connection between chronic stress and the development of cancer has been proven.

Unfortunately, anyone can get sick. In modern conditions, this diagnosis is not a death sentence. However, the sooner treatment is started, the better the result will be. The main guarantee of health and long life is regular medical examinations and unquestioning adherence to medical recommendations!

In the video, experts explain whether there is life after removal of the uterus and ovaries:

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fibroma;
myoma;
fibroids;
cystoma;
polyp.

Fibroids form in the uterus and can reach significant sizes. As the tumor develops, pressure occurs in the pelvis, and the amount of discharge during menstruation increases.

Polyps are soft, red-pink growths. Arranged in clusters. With them, bleeding appears after sexual intercourse and discharge increases during menstruation.

General symptoms

Bloating.

This symptom is very common in ovarian cancer, and most often it is neglected. This is one of the main symptoms, so if you cannot fasten your skirt or pants, pay attention to this.

Stomach ache.

Pressure and constant aching pain in the area below the navel, not associated with menstruation, often indicate the development of cancer in the female genital organs.

Lower back pain.

You can even get used to monotonous pain of a constant nature and not pay attention to it, but this is a symptom of oncology.

Fever.

If you have a high temperature all day for a long period, you should visit a doctor. This is a dangerous sign not only of ovarian cancer, but also of disorders in the body or diseases.

Heavy bleeding.

Stomach upsets.

Changes in the genital organs.

Weight loss

Losing more than five kilograms per month without stress and effort is unnatural. Weight fluctuations are possible, but rapid weight loss is not a positive fact.

Fatigue

Breast changes

Any lumps, wounds, swelling or redness found on the mammary glands during examination are not a good sign, so you should immediately consult a doctor.

Before talking about cancer, you should know that it has four stages of development, and in the first stage the symptoms are almost imperceptible.

Uterine cancer and its causes

With cancer of the uterine body, polypous growths form. A malignant tumor, when germinating, affects the appendages and abdominal cavity, which is why an unpleasant-smelling discharge is formed, consisting of a mixture of pus and blood.

Ovarian cancer

Ovarian cancer is slightly less common than uterine cancer, but it is common, especially in older women who have not known the joys of motherhood. Sometimes this is influenced by genetic inheritance.

Vaginal cancer

Labia cancer

Prevention of labia cancer

Regular gynecological examinations help prevent the development of labia cancer, which not everyone can avoid. It is also advisable to follow the recommendations of oncologists to reduce the risk of getting sick. Increased immune status protects well from cancer, for which it is recommended to lead a healthy lifestyle, which includes:

moderate physical activity, hardening;
absence of bad habits (alcohol consumption, smoking, drug addiction should be excluded);
diet and proper diet with foods rich in vitamins, microelements, and plant fiber;
proper sleep and rest (it is better to avoid stressful situations and overwork, which, according to psychosomatics, provoke cancer);
genital hygiene;
maintaining normal weight;
absence of promiscuity.

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Diagnosis of cancer of the external genitalia in women

Due to the similarity of the early symptoms and clinical picture of cancer and precancerous lesions, the onset of cancer often goes unnoticed. Recognition of cancer can be helped by a cytological examination of a fingerprint smear from the surface of an ulceration or a smear prepared from a scraping from a suspicious area of the mucosa. The final diagnosis of cancer of the external genitalia in women is made using a biopsy. To diagnose metastases in superficial lymph nodes, they are punctured to obtain punctate for cytological examination.

Cancer of the external genitalia in women should be differentiated from the following diseases. Papilloma is a single lobular formation of a round shape, soft consistency, has a thin stalk, and does not infiltrate the underlying tissue.

Genital condylomas have the appearance of multiple soft thin papillae. They are found in young women and are located at the entrance to the vagina and on its mucous membrane around the anus.

A chronic ulcer is small in size, located in the area of the anterior and posterior commissures, and is characterized by severe pain and inflammatory infiltration of surrounding tissues.

A tuberculous ulcer has the character of a superficial ulceration with a granular, greasy bottom and undermined edges.

Complications

With the development of labia cancer, there is a high probability of metastases spreading not only to nearby but also to distant organs. Chemotherapy treatment is often accompanied by side effects such as swelling of the lower extremities, inflammation, rupture of sutures, which leads to the accumulation of fluid in the wound.

The role of tumor markers in the diagnosis of ovarian cancer

In addition, after chemotherapy there may be the following consequences:

decline immune systems;
volume reduction vagina;
apathetic state;
discomfort during urination;
general weakness;
feeling anxiety;
increased nervous state.

After taking painkillers, patients experience nausea, dizziness, decreased blood pressure, and dry mouth.

Diagnosis

Due to the localization of the pathology on the skin, there are no problems with diagnosis. This type of cancer is easier to diagnose than any other. First you need to contact a gynecologist.

The specialist will collect anamnesis, identify complaints, and then conduct an examination using mirrors.

During the examination, the patient will find a node or ulcer on the labia, and the diameter of the growth or tissue lesion will be recorded. To accurately examine the ulceration, use a magnifying glass or use a colposcope. Using palpation, the density and consistency of the tumor, the extent of the oncological process, the adhesion of the tumor to other tissues and mobility are determined.

The patient undergoes a biopsy: the skin area is sent for histological examination. This helps to perform differential diagnosis with other pathological conditions.

The following manipulations are also indicated for diagnosis:

vulvoscopy;
fluorescence microscopy of the vulva;
radiological examinations using radioisotopes of phosphorus;
cytology of smears from the surface of the tumor;
lymphography is an important study for assessing the condition of the lymph nodes;
sigmoidoscopy - for visual assessment of the rectum;
cystoscopy - if there is a suspicion of tumor formations in the bladder or urethra.

Women suspected of having this type of cancer also undergo a chest x-ray, since metastases affect lung tissue. The condition of the small pelvis is also examined, because these organs are located closest to the lesion.

Endometriosis:

Endometriosis- this is the growth of tissue similar to the mucous membrane of the uterus in its muscular layer in the area of the cervix, vagina, fallopian tubes, ovaries, etc. The tissue retains hormonal dependence and undergoes transformations according to the menstrual cycle. The disease most often occurs in women of working age, has a long-term course, and is prone to relapses. The disease is characterized by severe pain in the premenstrual period and during menstruation, heavy prolonged menstruation, intermenstrual bleeding, and frequent disturbances of reproductive function.
In some cases, pain may occur during sexual intercourse. Treatment of the disease is long-term, medicinal and surgical. Endometriosis can be caused by uterine fibroids, fibrocystic mastopathy, cholecystitis, and gastritis.
Normal pregnancy and childbirth and breastfeeding the child slow down the growth of the tumor and can contribute to its disappearance.

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Vulvar cancer stage IV

Therapy

After diagnosis, the woman is referred to an oncologist. He will develop competent treatment tactics. Most often, treatment begins with surgery.

The operation is performed without general anesthesia. Local anesthesia is well tolerated by the body even in old age.

After surgery, a course of radiation therapy is indicated. The method is prescribed to prevent relapses.

If, according to indications, surgery cannot be performed, they are treated only with radiation therapy, but a larger dosage of drugs is prescribed. This technique is not as effective as the surgical one.

At the initial stage, cancer can be removed using vulvectomy: the patient’s labia majora, labia minora, and clitoris are excised.

The extent of surgical intervention depends on the stage of the pathology:

The first is radical vulvectomy, removal of regional lymph nodes.
The second is that surgery is combined with radiation therapy and fast electrons are used.
The third is, in addition to the previous methods, the elimination of inguinal lymph nodes and blood vessels.
Fourth, therapy is symptomatic in nature, since other methods will not bring the desired result. The patient is prescribed painkillers, anti-inflammatory nonsteroids, and narcotic analgesics. Sometimes blood transfusions, anti-itch ointments, and antihistamines are recommended.

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Forecast

When diagnosing the disease at stages 1-2, the outcome is favorable. Life expectancy without recurrence for three years is observed in 50-70 percent of patients.

With metastasis, the prognosis will not be so good, since the likelihood of death increases significantly. Success in treatment can only be achieved in 7-10 percent.

Clinical signs and symptoms

Symptoms of vulvar cancer at the onset of the disease are scanty (burning, itching, leucorrhoea, dysuria are possible).
Later, pain, bloody, purulent discharge, and difficulty urinating appear. A tumor of the vulva is most often localized on the labia majora, less often on the labia minora, in the clitoral area and on the posterior commissure of the lips; macroscopically it can be exophytic (nodular or papillary) or endophytic (ulcerative or infiltrative).

Complications and side effects of treatment

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The use of fluorouracil can cause side effects such as stomatitis, diarrhea, leukopenia, thrombocytopenia, and anemia.

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Classification

Experts identify several of the most common areas of cancer localization.

Uterus

In most cases, the pathological process is called endometrial carcinoma. This is explained by the fact that the initial formation of the tumor occurs in the mucous membrane of the uterine body. This condition is considered one of the most frequently diagnosed among all malignant processes of the female reproductive system.

The onset of pathology occurs in the postmenopausal period and occurs in the female half of the population aged 50-60 years. Tumor cells have a predisposition to metastasize not only to nearby, but also to distant organs and systems.

Fallopian tubes, lymph nodes and blood vessels may be affected. After entering the blood system, metastases spread throughout the body.

Cervix of the uterine body

This is the lower part of the uterus, which passes into the vagina. In medicine, the disease is also called carvical carcinoma.

The disease ranks second among the total number of malignant neoplasms affecting the female genital organs. A tumor can form in any woman, regardless of age. Most often, however, it is diagnosed between the ages of 35 and 55 years.

In most cases, the onset of the disease is preceded by infection with the human papillomavirus, the route of transmission of which is unprotected sexual contact.

About 85 percent of cases are squamous cell carcinoma of the cervix, when the tumor is formed from squamous epithelial cells, which are similar in structure to skin cells.

The first symptoms of cervical canal cancer

Other types of cancer are formed from columnar glandular epithelium (adenocarcinoma). Also, both types of cells can participate in tumor development.

Pathological cells can also give metastases to both nearby and distant systems and organs.

Ovaries

The development of ovarian carcinoma occurs between the ages of 50-70 years. According to statistics, it occurs in one woman out of seventy. This type of genital cancer is the third most common.

It is also worth noting that ovarian cancer is considered the most dangerous disease. It accounts for more deaths than any other malignant tumor of the reproductive system.

Since the structure of the ovaries is made up of various tissues, a neoplasm can form from one of them or several at the same time.

Cancer cells can spread to nearby tissues as well as to other organs through the lymphatic system. In addition, pathogenic cells enter the circulatory system.

As a result, metastasis will be diagnosed in distant organs. As a rule, the lungs and liver are affected.

Vagina

In this area, the formation of approximately one percent of all malignant processes is noted. The disease is more often diagnosed in women when they reach 45-65 years of age. In approximately 95% of cases, the cancer has a squamous cell form and is morphologically similar to cancer of the vulva or cervix.

The cause of the development of squamous cell type neoplasms is papillomavirus.

Experts also identify diethylstilbesterol-dependent vaginal carcinoma, which is a relatively rare disease. It is detected in women whose mothers consumed diethylstilbesterol during pregnancy.

Vulva

It is a system of external female genital organs. Vulvar carcinoma accounts for about four percent of all female genital cancers. In most cases it develops after menopause.

Usually the disease is characterized by tissue damage near the entrance to the vagina. Cancer is formed from the same cells as a malignant skin tumor.

90 percent are squamous cell carcinoma, about 4% are basal cell carcinoma. The remaining six percent account for melanoma, Bartholin gland tumor, Paget's disease and others.

The development of the oncological process begins on the surface. Then it spreads to nearby tissues without affecting other organs. Despite the aggressiveness of some types of ovarian malignancies, their peculiarity lies in their rather slow progression.

If left untreated for a long time, the cells begin to spread to the vagina, anus, or urethra. They can also penetrate the lymph nodes of the reproductive system.

Preinvasive vulvar carcinoma

Until recently, it was generally accepted that the use of chemotherapy in patients with vulvar cancer was inappropriate due to the low sensitivity of squamous cell carcinoma cells to their effects. However, clinical practice indicates the possibility of using chemotherapy to treat this pathology.
Thus, for pre-invasive vulvar carcinoma, the use of fluorouracil ointment can lead to a cure: Fluorouracil, 5% ointment, apply 5 g to the affected area at night, 5 days, repeated courses every 6-12 weeks.

Differential diagnosis

It is necessary to carry out a differential diagnosis of vulvar cancer with papillomas (exophytic form), ulcers with chancroid, tuberculosis and syphilis (endophytic form).

Diagnosis of vulvar cancer is based on data from:■ gynecological examination;■ vulvoscopy using a colposcope;■ cytological examination of fingerprint smears or scrapings from the surface of a suspicious area;■ histological examination of a biopsy specimen.
To determine the condition of the inguinal and femoral lymph nodes, palpation, ultrasound and puncture biopsy are used. According to their structure, they are found:■ predominantly squamous cell forms of cancer (keratinizing and non-keratinizing);■ less often - glandular;■ extremely rarely - basal cell.

Etiology and pathogenesis

The etiology and pathogenesis of vulvar cancer have not been sufficiently studied.
The mechanism of development of various parts of vulvar cancer is often induced by hormonal changes that occur during menopause and postmenopause. This, to a certain extent, determines the fact that vulvar cancer occurs in relatively elderly women.
There are background and precancerous diseases of the vulva.
Background processes are characterized by a large number of clinical and pathomorphological manifestations, which are caused by dystrophic changes in the vulva. Their occurrence is associated with metabolic and neuroendocrine disorders during the aging process and, to a large extent, with viral infection. According to clinical manifestations, kraurosis (lichen sclerosus), leukoplakia (squamous hyperplasia) and vulvar condylomas are distinguished.

Possible complications

This cancer can lead to metastases. During treatment, including chemotherapy and radiation, side effects may occur: swelling of the legs, inflammatory processes, suture dehiscence. Liquid may accumulate in the seam area.

There is a risk of consequences after surgery if the nerve is damaged. The woman experiences tingling and numbness. The seam does not heal well - it must be lubricated with products prescribed by the doctor.

Complications of chemotherapy:

Taking painkillers can lead to the following effects:

clouding of consciousness;
feeling of nausea;
dizziness;
decreased blood pressure;
feeling of dry mouth;
constant desire to quench thirst.

Cervical cancer

The tumor itself grows from the epithelial cells of the soft tissues of the inner walls of the cervix and body of the uterus. The tumor is moderately aggressive and grows quite slowly compared to other tumors. Cervical cancer and uterine oncology are one of the most common diseases in women, and they rank second after breast tumors.

Causes

The main reason is that a change occurs at the chromosomal level, and cells begin to randomly divide, multiply and lose the ability to self-destruct or die.

Papillomavirus.
Herpis.
Viral diseases that damage the soft tissue of the uterus.
Often appears in older women.
The risk group includes nulliparous women.
Rare sexual relations.
Diabetes.
Alcohol and cigarettes.
Excess weight.
Genetics.
Hormonal changes in the female body, drugs that affect them.

Stages

Stage 1- the tumor is small in size and spreads only within one tissue.
Stage 2- the cancer process affects nearby tissues. Back pain and fever may already appear.
Stage 3- is large in size and begins to swell. The cancer affects and damages nearby lymph nodes.
Stage 4- metastases go to the nearest organs: intestines, bladder, kidneys and liver. Headaches and pain in bones and muscles appear against the background of general intoxication of the body.

The most important thing to remember is that cancer in the early stages of development has a high survival rate, since metastases do not affect organs. At stage 3, the lymph nodes are already damaged, which is why surgeons at this stage usually remove the uterus along with the nearest lymphatic system.

NOTE! First of all, the patient needs to pay attention to pain, temperature and bleeding from the vagina and immediately contact a gynecologist for an examination.

Surgical, combined and radiation treatment methods are generally accepted. Chemotherapy is not used often.
For systemic chemotherapy of vulvar cancer, all recommendations for mono- and polychemotherapy for cervical cancer can be used.
In the treatment of patients with vulvar cancer, the leading treatment method is surgery.
The combined method is used in 2 options:■ surgery followed by radiation therapy;■ preoperative radiation followed by surgery.
For patients in whom vulvectomy is not possible due to comorbidities or tumor spread, radiation therapy may be the only treatment that improves survival.

Recurrence of vulvar cancer

When vulvar cancer recurs, a combined treatment is also sometimes used, including chemotherapy (Scheme 3), radiation, and surgery, although the effectiveness of treatment is insignificant.

Precancerous diseases of the vulva

represented by epithelial dysplasias. Depending on the degree of damage to the epithelial layer, mild, moderate and severe epithelial dysplasia are distinguished. The diagnosis is made on the basis of histological examination of biopsy specimens.
Currently, the accepted classification of premalignant changes in the vulva is in the form of vulvar intraepithelial neoplasia (VIN). VIN I corresponds to mild dysplasia, VIN II to moderate dysplasia, VIN III to severe dysplasia and preinvasive carcinoma.
If we take into account the average age of patients with non-tumor dystrophic diseases (56 years), it is clear that in order to identify early forms of vulvar tumors, special attention should be paid to the age group of 60 years and older.
The anatomical and topographical features of the external genitalia, abundant blood supply and extremely developed lymphatic network contribute to the rapid spread of vulvar cancer and metastasis.
The predominant route of metastasis for vulvar cancer is lymphogenous; hematogenous spread is very rare. Regional lymph nodes of the first order are superficial and deep inguinal-femoral lymph nodes, and second order are deep pelvic ones. A retrograde route of metastasis is possible.

Vulvar cancer stage III

The following combinations of drugs are used as neoadjuvant chemotherapy for stage III vulvar cancer. Regimen 1: Bleomycin IM 10 mg/m2 2 times/week, 2-3 weeks + Methotrexate orally 10 mg/m2 2 times/week, 2-3 weeks. The courses are repeated after 3 weeks, 4 courses are carried out.
Scheme 2: Mitomycin IV drip 10 mg/m2 on the 1st day + Fluorouracil IV as a 24-hour infusion, 30 minutes after the administration of mitomycin, 1 g/m2, 3 days.
Systemic chemotherapy with platinum derivatives or fluorouracil improves treatment outcomes for patients with stage III vulvar cancer in combination with surgery and radiation.
Scheme 3: Cisplatin IV drip 100 mg/m2 on the 1st day + Fluorouracil IV as a 24-hour infusion of 1 g/m2, 5 days.
The course is repeated after 3 weeks. The number of courses depends on the effectiveness of the therapy.
This combination chemotherapy causes complete tumor regression in 53-89% of initially inoperable patients.

Oncological pathologies of the female reproductive system are quite common. One of the common diseases of this kind is uterine cancer.

This disease is called differently - endometrial cancer, cancer of the uterine body, cancer of the uterine mucosa, etc. All these oncological processes are uterine cancer.

Disease concept and statistics

Uterine cancer is a malignant tumor process that develops from the inner epithelial layer - the endometrium.

On average, this disease is found in 2-3% of the female population. Endometrial cancer can occur in every woman, however, women over 45 are most susceptible to this type of cancer.

Classification

Oncologists classify uterine cancer into two types: autonomic and hormonal.

Autonomous cancer accounts for 1/3 of all cases of uterine oncology. This form of the disease occurs suddenly without any prerequisites or reasons.

Experts believe that such oncology is of hereditary etiology or occurs under the influence of traumatic injuries.

The picture shows a uterine cancer cell under a microscope

The hormonal type of uterine cancer develops due to hormonal changes in the female body. This type of cancer accounts for 2/3 of all cases of endometrial cancer. It is characterized by pronounced disturbances of endocrine-metabolic origin.

According to histological data, cancer of the uterine body can be:

Leiomyosarkinoma;
Glandular squamous cell oncology, etc.

Depending on the degree of differentiation of cellular structures, cancer can be highly differentiated, poorly differentiated or moderately differentiated.

Causes

As mentioned above, endometrial cancer can be hormone-dependent or autonomous in nature. Based on this, we can identify several characteristic causes of uterine body cancer:

Increased stimulation of the epithelial uterine layer by estrogen hormones;
Metabolic disorders such as obesity, diabetes, hypertension;
Hormone-producing ovarian tumors;
Adenoma of the adrenal cortex;
Treatment with hormone-containing drugs;
The presence of severe liver pathologies accompanied by disturbances in metabolic sex-hormonal processes (hepatitis, etc.);
Negative heredity, such as the presence in blood relatives of oncological formations in the intestines, mammary gland, ovaries or in the body of the uterus;
Late onset of menopause;
Lack of pregnancies with natural births;
Long-term use of oral contraceptives like Dimethisterone;
Irradiation of pelvic organs, etc.

Symptoms of uterine cancer in women

Signs of oncological formations of the uterine body are very diverse, however, in the early stages of the development of the cancer process, any symptoms are usually absent.

First signs

Among the first alarming symptoms of uterine cancer, uterine bleeding not associated with menstruation stands out.

A similar sign, according to oncologists, is observed in almost 7-9 out of ten patients.

Such bleeding may vary in nature:

Abundant;
Scarce;
Multiple;
Breakthrough;
One-time;
Intermittent, etc.

Contact bleeding that occurs as a result of sexual intercourse, gynecological examination, lifting heavy objects, douching, etc. is very typical for uterine cancer.

In addition to discharge, when uterine cancer reaches advanced stages of development, it can be recognized by the following symptoms:

Hyperthermia with low-grade fever;
Nagging pain in the lumbar area, perineum, abdomen;
A noticeable reduction in performance, excessive and rapid fatigue, even to the point of exhaustion;
Sexual intercourse is accompanied by pain, which can also appear after it;
Refusal to eat;
Problems with bowel movements such as constipation or diarrhea;
Severe weight loss.

How to identify uterine cancer by symptoms before menopause?

In women who are premenopausal, it is considered quite normal to have uterine bleeding, which gradually becomes scarce and bothers you less and less.

If an oncological process begins to develop in the uterine body, then the typical reduction in symptoms does not occur, and it often happens that uterine discharge, on the contrary, becomes more abundant and frequent.

What manifestations can be observed in postmenopause?

During menopause, women usually do not have menstruation. Therefore, if sudden vaginal discharge occurs, you should always suspect the presence of a uterine cancer process.

Moreover, the frequency of such bleeding, its duration, intensity and abundance at this age no longer matter.

Stages and their lifespan

Oncologists distinguish several sequential degrees of uterine cancer:

At the first stage Oncological formation is located directly in the uterine body. The probability of recovery is about 80-90%;
At the second stage During the oncological process, the tumor formation penetrates beyond the boundaries of the uterine body and affects the cervical canal (cervix), however, nearby organs are not affected. Recovery occurs in approximately ¾ of cases;
On third stage of cancer, the oncological process spreads to the appendages and vagina. Survival rate is about 40% of patients;
On fourth stage of cancer of the uterine body, tumor processes spread beyond the pelvic region, the formation grows into the intestinal and bladder tissues. Survival rate – no more than 15%.

Consequences

Cancer of the uterine body is a very dangerous pathological condition. If there is no adequate therapy, then uterine cancer will certainly lead to the death of the patient.

Often, cancer of the uterus requires its removal along with the appendages, part of the vagina and the cervix. However, this factor usually does not play a significant role, because cancer is found mainly in women aged 45-60 years with adult children.

Pathways of metastasis

In case of cancer in the body of the uterus, the main routes of metastasis are vessels and nodes, and at the terminal stage the circulatory system also participates in the spread.

First, the lesion spreads to the lymph node structures in the iliac region and hypogastric zone. Much less often, the lesion affects other groups of pelvic lymph nodes.

Metastasis extends to the cervical canal and beyond the uterine body. In a hematogenous manner, metastases penetrate from the upper uterine region into the appendages; in addition, the vagina, and sometimes even the kidney or liver or bone tissues are affected.

Diagnostics

The diagnostic process for uterine cancer begins with a gynecological examination using speculum. The patient is then sent for an ultrasound examination, which reveals the true size and structure of the uterus, as well as the structure and thickness of the endometrium.

The photo shows what uterine cancer looks like on ultrasound diagnostics

The resulting biomaterial is often scraped. This procedure is performed using general anesthesia in a hospital setting.

When analyzing for the detection of tumor markers for uterine cancer, the following markers are used:

Carcinoembryonic antigen;
HCG or human chorionic gonadotropin.

Thanks to its introduction into gynecological oncology practice, it was possible to save the lives of many patients.

How quickly does the disease develop?

The rate of development of the oncological process in the uterine body is determined by the histological type of formation, concomitant pathologies, the strength and intensity of the body's anticancer resistance, the adequacy of therapy, the age of the patient and other similar factors.

Therefore, it is impossible to say for sure how long it will take for the final development of the cancer process in the uterine body.

The difference between pathology and fibroids

They call the process of hyperplastic enlargement of uterine tissue that occurs as a result of traumatic factors, frequent abortions, curettage, a large number of sexual partners, genitourinary inflammation, lack of orgasms in women, etc.

Cancer of the uterine body and fibroids have absolutely nothing to do with each other. These are completely different pathologies, so fibroids never degenerate into cancer.

Benign uterine hyperplasia is formed in the muscular layer of the organ, and oncology - in the epithelial layer. When fibroids are detected, observation tactics are usually chosen to determine whether the fibroids are growing or not.

For this purpose, the patient undergoes a gynecological examination every six months. As for direct scientific evidence of the relationship between cancer and fibroids, there is no evidence.

Treatment and prevention

In general, it depends on individual prognostic results:

The basis of treatment is surgery, which involves removing the uterine body along with the ovaries.
Sometimes radio irradiation is performed before and after surgery to reduce the risk of cancer recurrence, but such treatment has absolutely no effect on survival rates;
In addition to surgery, chemotherapy is used. Such an approach to treatment is justified when the tumor process is widespread, as well as when the tumor is autonomous, has active metastasis, and relapses. Platinum drugs such as Cisplatin, Carboplatin, Adriamycin, as well as Doxorubicin, Taxol, Epirubicin, etc. are used. For hormonal-dependent oncology of the uterine body, chemotherapy treatment is ineffective;
Hormone therapy provides good therapeutic results. For such treatment, progestagen drugs are usually used: Megeys, Depostat, Provera, 17-OPK, Farlugal, Depo-Provera, etc. These drugs can be combined with Tamoxifen or prescribed without it. If active metastasis occurs and treatment with progestogens is ineffective, Zoladec is prescribed. Sometimes I combine hormonal treatment with chemotherapy.

When determining the appropriate therapeutic method, the oncologist takes into account several decisive factors such as the physiological state of the patient, the presence of endocrine disorders, histological parameters, tumor size and extent, etc.

Preventive measures are the most effective anti-cancer measure. Primary preventive actions involve avoiding factors that provoke such cancer, such as obesity, diabetes and infertility.

In other words, you need to strictly control weight, treat fertility and diabetes.

There are also secondary preventive measures that involve timely detection and treatment of inflammatory pathologies and precancerous conditions.

Women over 40 are recommended to undergo annual screening examination using transvaginal ultrasound. This procedure makes it possible to detect cancer of the uterine body in its infancy, which significantly increases the chances of recovery and long life.

If a precancerous disease is discovered in the patient, then it must be treated.

Patient survival prognosis

Every year the number of cancer patients with cancer of the uterine body increases; every year this pathology is detected in half a million patients. But timely diagnosis and an adequate approach to the treatment process make it possible to achieve a high and favorable survival prognosis.

In general, the prognosis for the survival of cancer patients is determined by the stage of initiation of therapy, the degree of cell differentiation, etc.

For example, with a highly differentiated formation with the first degree of development, the survival rate will be 96%, and with a low degree of cell differentiation and 4 degrees of development, the survival rate does not exceed 18%.

The following video will tell you how to recognize and treat uterine cancer:

Malignant tumors can occur in any organ of the female reproductive system - the vulva (external genitalia), vagina, cervix, uterus, fallopian tubes or ovaries.

Uterine cancer

Although this malignant tumor is commonly called uterine cancer, its more accurate name is endometrial carcinoma because the tumor initially arises in the lining of the uterus (endometrium). In women, it is the fourth most common cancer and the most common malignant tumor of the female genital organs. Uterine cancer usually develops after menopause, usually in women between 50 and 60 years of age. Tumor cells can spread (metastasize) both to adjacent tissues and to many other organs - down to the cervix, from the uterus to the fallopian tubes and ovaries, to the tissues surrounding the uterus, to the lymphatic vessels that transport lymph to all organs, lymphatic nodes, into the blood, then through the bloodstream to distant organs.

Symptoms and diagnosis

Abnormal bleeding from the uterus is the most common early symptom of uterine cancer. Bleeding may occur after menopause and may be repeated, irregular, or heavy in women who continue to menstruate. One out of every three women with uterine bleeding after menopause is diagnosed with this form of cancer. If you experience abnormal uterine bleeding after menopause, you should immediately consult a doctor, as it may be caused by a malignant tumor.

To diagnose this malignant tumor, several methods are used. The Pap test can detect cervical cancer cells, but it does not detect tumor cells in about one third of cases. Therefore, the doctor also performs an endometrial biopsy or fractional curettage (separate curettage of the cervical canal and the uterine cavity), in which tissue from the lining of the uterus is removed for examination under a microscope.

If the results of a biopsy or fractional curettage confirm the presence of a cancer in the lining of the uterus, further tests must be done to determine whether the cancer has spread outside the uterus. Ultrasound (ultrasound), computed tomography (CT), cystoscopy (fiber optic examination of the bladder), barium sulfate x-ray of the intestine, chest x-ray, intravenous urography (examination of the kidneys and ureters), bone scan and liver, sigmoidoscopy (examination of the rectum using a flexible fiber-optic instrument) and lymphangiography (x-ray examination of the lymphatic system) provide the necessary information and help prescribe optimal treatment. In each case, only some of the studies listed above are carried out for specific indications.

Treatment

Extirpation, that is, surgical removal of the uterus, is the basis of treatment for this type of malignant tumor. If the cancer has not metastasized beyond the uterus, then hysterectomy almost always leads to a cure. During the operation, the surgeon usually also removes the fallopian tubes, ovaries (that is, performs a salpingo-oophorectomy) and nearby (regional) lymph nodes. They are examined by a morphologist to determine the stage of cancer development and determine the need for postoperative radiation therapy.

Even when the cancer has not metastasized, your doctor may prescribe postoperative drug therapy (chemotherapy) if some cancer cells remain undetected. Usually hormones are used that suppress the growth of a malignant tumor. Progestins (progesterone is a female hormone that blocks the effects of estrogen) and similar hormonal medications are often effective.

If the cancer has spread beyond the uterus, higher doses of progestins are usually prescribed. In 40% of women with metastases of a malignant tumor, it decreases in size and its growth is suppressed under the influence of progestins for 2-3 years. If treatment is effective, it may continue indefinitely. Side effects of progestins include weight gain due to water retention and, in some cases, depression.

If the cancer has spread widely or if hormone therapy does not have a beneficial effect, other chemotherapy agents such as cyclophosphamide, doxorubicin and cisplatin may be added. These medications are much more toxic than progestins and cause many side effects. Before starting treatment, you must carefully weigh the risks and expected benefits of chemotherapy.

Overall, nearly two-thirds of women diagnosed with this type of cancer remain alive without relapse (recurrence) of the cancer within 5 years of diagnosis, less than a third die from the disease, and nearly 10% survive without cancer. cured If this malignancy is detected early, almost 90% of women live at least 5 years and usually recover. The chances are better for younger women, women whose cancer has not spread beyond the uterus, and women who have a slow-growing type of cancer.

Factors that increase the likelihood of uterine cancer

Exposure to high doses of estrogens (the main female hormones) from hormone-producing tumors or from medications containing high doses of estrogens, including estrogen replacement therapy without progesterone after menopause
Menopause after 52 years
Menstrual irregularities (such as excessive bleeding, bleeding between periods, or long intervals between periods)
Obesity
Absence of childbirth
High blood pressure
Diabetes
Tamoxifen therapy

Cervical cancer

The cervix is the lower part of the uterus that extends into the vagina. Among malignant tumors of the female genital organs, cervical cancer (cervical carcinoma) is the second most common tumor among women of all ages and most common among younger women. Cervical cancer is usually found in women between 35 and 55 years of age. The development of this malignant tumor may be associated with a virus (human papillomavirus), which can be transmitted during sexual intercourse.

The younger a woman is at the time of her first sexual intercourse, and the more sexual partners she has in the future, the greater the risk of cervical cancer.

About 85% of cervical cancers are squamous cell cancer, which means they develop from stratified squamous epithelial cells, similar to skin cells, that cover the outside of the cervix. Most other types of cervical cancer develop from columnar epithelial cells of the glands in the cervical canal (adenocarcinoma) or both types of cells.

Cervical cancer cells can penetrate deep into the lining of the uterus, enter the vast network of small blood and lymphatic vessels found in the deeper layers of the cervix, and then invade other organs. In this way, a malignant tumor metastasizes both to distant organs and to tissues located near the cervix.

Symptoms and diagnosis

Symptoms include bleeding between periods or after sexual intercourse. A woman may not experience pain or other symptoms until the later stages of the disease, but routine Papanicolaou tests (Pap smears) can detect cervical cancer early enough. This disease begins with slow changes in normal cells and often takes several years to develop. Changes are usually detected by examining the cells of the cervical mucosa under a microscope, which are taken for a Pap smear. Physicians have described these changes as stages ranging from normal (no pathology) to invasive cancer.

The Pap test is inexpensive and can accurately detect cervical cancer in 90% of cases, even before symptoms appear. As a result, with the introduction of this research method into practice, the number of deaths from cervical cancer decreased by more than 50%. Doctors generally recommend performing the first Pap test when a woman becomes sexually active or reaches the age of 18, and then annually thereafter. If normal results have been obtained for 3 consecutive years, such a woman can then have a Pap smear only every 2 or 3 years until her lifestyle changes. If this cytological examination were carried out regularly in all women, the mortality rate from cervical cancer could be reduced to zero. However, almost 40% of patients do not undergo regular screening.

If, during a gynecological examination, a tumor, ulcer or other suspicious area is detected on the cervix, as well as suspicious changes in relation to a malignant tumor are detected on the Pap smear, the doctor performs a biopsy (takes tissue from the cervix for examination under a microscope). The tissue sample for this test is usually obtained during a colposcopy, in which the doctor uses a fiber-optic system with a magnifying lens (colposcope) to carefully examine the cervix and select the most suspicious area for biopsy. Two types of biopsy are used - targeted biopsy, in which a small piece of cervical tissue is taken under the control of a colposcope, and endocervical curettage, in which the mucous membrane of the cervical canal is scraped without visual control. Both types of biopsies involve some pain and some bleeding. Both methods usually provide enough tissue for a pathologist to make a diagnosis. If the diagnosis is unclear, the doctor performs a cone biopsy, which removes more tissue. Typically this type of biopsy is performed using loop electrosurgical excision (excision) techniques on an outpatient basis.

If cervical cancer is detected, the next step is to determine the exact size and location of the tumor; this process is called determining the stage of development of a malignant tumor. Determining the stage begins with a general examination of the pelvic organs and several special types of studies (cystoscopy, chest x-ray, intravenous urography, sigmoidoscopy) to determine the extent of spread of the cervical tumor to adjacent tissues or more distant organs. If necessary, additional tests such as computed tomography, barium sulfate X-ray of the intestines, liver and bone scans may be carried out.

Treatment

Treatment depends on the stage of development of cervical cancer. If the malignant tumor is limited to its superficial layers (carcinoma in situ), the doctor can remove such a tumor completely - part of the cervix is removed surgically or using loop electrosurgical excision (excision). After such treatment, the ability to have children is preserved. However, the doctor recommends that the woman come for examinations and Pap smears every 3 months during the first year and every 6 months thereafter, since the malignant tumor may recur. If a woman is diagnosed with carcinoma in situ and she does not plan to have children, then she is recommended to have her uterus removed (extirpation).

If the cancer has reached a more advanced stage of development, hysterectomy in combination with removal of surrounding tissue (radical hysterectomy) and lymph nodes is necessary. However, normally functioning ovaries in young women are not removed.

Radiation therapy is also highly effective for treating advanced cervical cancer if the tumor has not spread beyond the pelvic organs. Although radiation therapy does not usually cause early side effects, it sometimes causes inflammation of the rectum and vagina; later, damage to the bladder and rectum may develop, and ovarian function usually ceases.

If the cancer has spread beyond the pelvic area, chemotherapy is sometimes recommended. However, only 25-30% of patients receiving it can expect a positive effect, and this effect is usually temporary.

Pap test results: stages of cervical cancer

No pathological changes
Minimal cervical dysplasia (early changes that are not yet cancerous)
Severe dysplasia (late changes that are not yet malignant)
Carcinoma in situ(malignant tumor limited to the most superficial layer of the cervical mucosa)
Invasive cancer

Like other malignant skin tumors, vulvar cancer begins on the surface and first spreads to nearby tissues without spreading to other organs. Although some tumors can be aggressive, most types of vulvar cancer grow relatively slowly. If treatment is not carried out, they gradually penetrate into the vagina, urethra or anus, and penetrate into the lymph nodes of this area.

Symptoms and diagnosis

The development of vulvar cancer can be easily detected - unusual nodes or ulcers appear near the entrance to the vagina. Sometimes there are areas of peeling or discoloration of the skin. The surrounding tissue may have a wrinkled appearance. The discomfort is usually not severe, but itching in the vagina is disturbing. Subsequently, bleeding or watery discharge often develops. The appearance of these symptoms requires immediate medical attention.

To make a diagnosis, the doctor performs a biopsy. After numbing the suspicious area with an anesthetic, a small area of discolored skin is removed. A biopsy is needed to determine whether skin changes are cancerous or due to infectious inflammation or irritation. A biopsy also makes it possible to recognize the type of malignant tumor when it is detected and determine a treatment strategy.

Treatment

A vulvectomy is a surgery that removes a large area of vulvar tissue near the vaginal opening. Vulvectomy is necessary for all types of vulvar cancer except preinvasive carcinoma to remove squamous cell malignant tumors of the vulva. This extensive removal is done because this type of vulvar cancer can quickly spread to nearby tissue and lymph nodes. Because a vulvectomy may also remove the clitoris, the doctor discusses treatment with the woman diagnosed with vulvar cancer to develop a treatment plan that is best suited for her based on comorbidities, age, and aspects of her sex life. Sexual intercourse after a vulvectomy is usually possible. To treat cancer in very advanced stages, in which complete cure is unlikely, radiation therapy may be given after surgery. If a malignant tumor is detected and removed early, then in 75% of cases there are no signs of its reappearance over the next 5 years; if the cancer has spread to the lymph nodes, less than 50% of women survive.

Since basal cell carcinoma of the vulva does not tend to metastasize to distant organs, surgical removal is usually sufficient. If the malignant tumor is small, then removal of the entire vulva is not necessary.

Vaginal cancer

Only about 1% of all malignant tumors that arise in the female genital organs develop in the vagina. Vaginal cancer (carcinoma) usually appears in women between 45 and 65 years of age. In more than 95% of cases, vaginal cancer is squamous cell and is morphologically similar to cervical and vulvar cancer. Squamous cell carcinoma of the vagina can be caused by human papillomavirus, the same virus that causes genital warts and cervical cancer. Diethylstilbesterol-dependent carcinoma is a rare type of vaginal cancer that occurs almost exclusively in women whose mothers took the drug diethylstilbesterol during pregnancy.

Symptoms and diagnosis

Vaginal cancer grows into the vaginal mucosa and is accompanied by the formation of ulcers that can bleed and become infected. Watery discharge or bleeding and pain during intercourse appear. If the cancer becomes large enough, it may also affect the functioning of the bladder and rectum, causing frequent urination and pain when urinating.

When vaginal cancer is suspected, the doctor will scrape the vaginal lining to examine under a microscope and perform a biopsy of lumps, ulcers, and other suspicious areas noticed during a pelvic exam. A biopsy is usually performed during a colposcopy.

Treatment

Treatment for vaginal cancer depends on the location and size of the tumor. However, all types of vaginal cancer can be treated with radiation therapy.

If the tumor is localized in the upper third of the vagina, the uterus and pelvic lymph nodes and upper part of the vagina are removed (extirpation), or radiation therapy is used. For cancer in the middle third of the vagina, radiation therapy is prescribed, and for cancer in the lower third, surgery or radiation therapy is prescribed.

After treatment for vaginal cancer, sexual intercourse may be difficult or impossible, although sometimes a new vagina is created using a skin graft or part of the intestine. Survival at 5 years is observed in approximately 30% of women.

Fallopian tube cancer

A malignant tumor can also develop in the fallopian tubes. This is the rarest location of a malignant tumor of the female genital organs. Symptoms include vague abdominal discomfort and sometimes watery or bloody vaginal discharge. Usually a nodular formation is detected in the pelvis, but the diagnosis is made only after removal and cytological examination of the tumor. Removal (extirpation) of the uterus, fallopian tubes, ovaries and omentum, followed by chemotherapy, is almost always necessary. The prognosis is approximately the same as for ovarian cancer.

Trophoblastic disease

Trophoblastic disease is a tumor-like growth of trophoblast tissue (a tissue element of the fetal egg); This definition refers to trophoblast pathology, which clinically manifests itself in the form of hydatidiform mole and choriocarcinoma.

Trophoblastic disease can develop from epithelial cells of chorionic villi remaining after spontaneous abortion or full-term pregnancy, but, as a rule, it arises from a fertilized egg as an independent pathological process of transformation of chorionic villi into grape-shaped formations (hydatidiform mole). In rare cases, the placenta is affected in a normal fetus. In more than 80% of cases, trophoblastic disease is non-malignant, that is, it is a hydatidiform mole; however, in 20% of cases, a malignant tumor is observed - choriocarcinoma. There are non-metastatic (invasive) forms of trophoblastic disease and metastatic ones, in which the tumor spreads beyond the uterus throughout the body (liver, lungs, brain).

The likelihood of developing trophoblastic disease is highest during pregnancy between 35 and 45 years of age. This tumor occurs in approximately 1 in every 2,000 pregnant women in the United States, and for unknown reasons it is nearly 10 times more common among women in Far Eastern countries. In Russia, the incidence of hydatidiform mole is 1 in 820-3000 births, and the incidence of choriocarcinoma is 1 in 5000 births.

Symptoms and diagnosis

Hydatidiform mole often appears soon after pregnancy. A woman feels pregnant, but her belly grows much faster than it does during a normal pregnancy, because the size of the uterus increases very quickly due to the growth of the tumor. This is accompanied by severe nausea and vomiting, and uterine bleeding may occur; such symptoms indicate the need to immediately seek medical help. With hydatidiform mole, dangerous complications develop such as infectious inflammation, bleeding and toxicosis of pregnancy (preeclampsia), usually occurring in the second trimester of pregnancy.

A woman with a hydatidiform mole does not feel fetal movements and its heartbeats cannot be heard. When bleeding occurs, the release of many bubbles with transparent contents resembling clusters is observed. Examination of this material under a microscope allows you to confirm the diagnosis.

Your doctor may order an ultrasound to check for a hydatidiform mole and the absence of a fetus or amniotic sac (the membranes that contain the fetus and the fluid surrounding it). Blood tests are performed to determine the level of human chorionic gonadotropin (a hormone normally produced as pregnancy progresses). With hydatidiform mole, the concentration of gonadotropin is sharply increased, since the tumor produces a significant amount of this hormone. This analysis is less convincing in early pregnancy, when gonadotropin levels are also high.

Treatment

The hydatidiform mole must be completely removed. Usually it is removed by dilatation (expansion) of the cervix and vacuum aspiration by curettage of the uterus. Only in rare cases is removal (extirpation) of the uterus required.

After surgery, regular monitoring of the level of human chorionic gonadotropin in the blood is carried out to exclude the occurrence of choriocarcinoma. With complete removal of the hydatidiform mole, the hormone content returns to normal, usually within 8 weeks and remains so in the future. If a woman becomes pregnant after removal of a hydatidiform mole, then explaining the increase in the concentration of human chorionic gonadotropin becomes difficult, since it may be associated with both pregnancy and the unremoved part of the tumor. Therefore, after removal of a hydatidiform mole, women are advised to protect themselves from pregnancy for a year using oral (taken orally) contraceptives.

In the benign form of trophoblastic disease, chemotherapy is not required, but in its malignant form (that is, when choriocarcinoma occurs), chemotherapy is always prescribed. Medicines used for treatment include methotrexate, dactylonomycin, or a combination of these drugs.

The probability of cure reaches almost 100% in women with hydatidiform mole and non-metastatic form of trophoblastic disease and approximately 85% in women with late detection of the disease. As a rule, a woman can have children after removal of a hydatidiform mole. After a course of chemotherapy, pregnancy occurs in 50% of women interested in it.