The first signs of cervical cancer at an early stage of development in women. Cervical cancer

Health

Cervical cancer- malignant tumor of the female genital organs. This common disease ranks 4th among cancer problems in women. In most cases, the disease is asymptomatic and is accidentally discovered during an examination by a gynecologist. A woman may notice a slight discharge of blood after lifting weights, douching, or sexual intercourse.

11 out of 100 thousand women are diagnosed with this disease. This amounts to about 600 thousand cases per year. For some reason, the disease occurs 2 times more often in Latin women. There are two periods in a woman’s life when the risk of developing the disease is especially high: 35-40 and 60-65 years. And girls under 25 years of age practically do not get cervical cancer.

Since the 70s of the last century, mortality from cervical cancer has decreased by 70%. This is due to the fact that doctors massively examine patients for the presence of altered cells. Thanks to this approach, in most cases it is possible to recognize the disease in the early stages, when it can be completely cured.

Cervical cancer develops from the mucous membrane that lines the cervical canal. A tumor cannot grow from healthy cells. Therefore, the disease is always preceded by precancerous conditions. For example, this is cervical dysplasia. By starting treatment on time, you can protect yourself from cancer. The tumor can develop from condylomas and scars that formed after childbirth. It takes 2 to 15 years for these precancerous conditions to develop into tumors.

Cervical cancer is one of the few cancers that can be prevented. Regular visits to the gynecologist and a special vaccination will help protect you. PAP smear and other modern methods make it possible to detect the disease in the early stages.

Cervical cancer is caused by infection with the human papilloma virus. Increase the risk of a malignant tumor: early pregnancy, a large number of sexual partners, sexually transmitted diseases, inflammatory processes of the genital organs, smoking and long-term use of hormonal contraceptives.

Anatomy of the uterus

The uterus is a hollow organ consisting of smooth muscle. It is located in the lower abdomen between the bladder and rectum. The uterus is suspended by ligaments that are attached to the walls of the abdomen and hold it in place.

The main function of the uterus is to ensure the attachment of a fertilized egg and create the best conditions for the growth of the fetus. During childbirth, the uterus contracts, pushing the baby out. The uterus is an organ that allows a woman to perform her main function - to give birth to a child.

The size of the uterus is small. Approximately 8cm high, 4cm wide and 2cm thick. It has the appearance of a flattened pear. Its wide part faces upward - this is the fundus of the uterus. In this area, it includes the fallopian tubes leading to the ovaries. The middle part is the body of the uterus. At the bottom it narrows, passing into the cervix, which descends into the vagina.

The uterus consists of three layers:

1. Perimetry- outer serous membrane. This is a layer of peritoneum that covers the organs in the abdominal cavity.

2. Myometrium- middle muscle layer. It consists of three layers of smooth muscles, which are arranged longitudinally or in rings surrounding the uterus. Has a small amount of connective and elastic fibers.

3. Endometrium- inner mucous layer. It, in turn, consists of two layers: basal and functional. The basal one is adjacent to the myometrium. It is responsible for the restoration of the mucous membrane after menstruation. Inside the cavity there is a functional layer. It consists of epithelial cells and glands.

Let's take a closer look structure of the cervix, which interests us most today.

The cervix is mainly composed of smooth muscle, collagen and elastic tissue. Due to this structure, it is denser than the uterus. Its main task is to block the access of microbes to the uterus and not to release the child from it prematurely.

The length of the cervix is 3-4 cm. Inside it there is a cervical canal or canal of the cervix. It connects the interior of the uterus to the vagina. There are folds on the inner surface of the channel. They are needed to prevent vaginal contents from entering the uterus. The canal is usually clogged with thick mucus, which prevents germs and sperm from entering the uterus. But in the middle of the menstrual cycle, the mucus becomes more liquid. This is necessary so that sperm can enter the uterus and fertilize the egg.

The inside of the cervical canal is covered columnar epithelium, which has a lot tubular glands. Inside the cervical canal there is a border where the squamous epithelium becomes cylindrical. The part of the cervix that enters the vagina (lips) is covered flat non-keratinizing epithelium.

What are the stages of uterine cancer?

In order to choose the right treatment, it is necessary to know the characteristics of the tumor and the degree of its development. For this purpose, neoplasms are classified.

Cervical cancer develops from glandular and epithelial cells. Based on this, tumors are divided according to morphological characteristics:

· Adenocarcinoma- arises from gland cells that are located in the cervix.

· Squamous cell carcinoma- arises from mutated squamous epithelial cells. This form is the most common.

Depending on the size of the tumor, its spread, the presence of metastases and the condition of the lymph nodes, the doctor determines stage of cervical cancer. Each stage has several substages, which are designated by Roman numerals and letters.

Stage 0

Cancer cells were detected only on the surface of the cervical canal. They do not penetrate into deep layers. This condition is also called cervical intraepithelial neoplasia.

A smear for oncocytology (PAP test) and a biopsy help to make a diagnosis and begin treatment. To perform a biopsy, a small piece of mucous membrane is taken from the changed area and examined in the laboratory.

Stage I

Cancer cells grow deep into the tissues of the cervix, but the tumor does not extend beyond the organ.

· I.A.- small tumor from 0.5 to 7 mm. Does not apply to lymph nodes and other organs.

· I.B.- the tumor can be seen with the naked eye. It has a diameter of 7 mm to 4 cm and penetrates deep into the cervix by more than 5 mm. Does not apply to lymph nodes and neighboring organs.

If a smear for oncocytology shows that a woman has altered (atypical) glandular epithelial cells on the mucous membrane of the cervix, then a diagnostic examination is prescribed. For diagnosis use: colcoscopy with biopsy. A colcoscope is a device that allows you to examine the vagina and cervix under multiple magnification. At the same time, the doctor takes a sample of cells (a tiny section of mucous membrane) for analysis under a microscope. This is a very accurate method that accurately determines the presence of cancer.

Stage II

The tumor extends beyond the boundaries of the cervix and body of the uterus, but is not yet detected in the lower parts of the vagina and on the walls of the pelvis.

· IIA- the tumor is about 4 cm in diameter, but does not extend into the periuterine space. It can affect the upper parts of the vagina. There are no cancer cells in nearby lymph nodes or distant organs.

· IIВ - the tumor affects the tissues of the periuterine space (parametrium). Lymph nodes and neighboring organs are not infected.

For diagnosis, a colcoscope is used and a sample of mucosal cells is taken for a biopsy. Using biopsy forceps, the doctor removes 0.5 cm of tissue from the vaginal part of the cervix. To examine the mucous membrane deep in the cervical canal, diagnostic curettage is performed using a curette. The doctor also palpates all nearby lymph nodes and determines whether they are enlarged. This may indicate the presence of tumor metastases.

Stage III

The tumor affects the lower part of the vagina and is found on the walls of the pelvis. It can reach any size. The tumor compresses the ureters and interferes with the removal of urine from the kidneys to the bladder. Distant lymph nodes and organs are not affected by cancer cells.

· IIIA- the tumor has affected the lower third of the vagina, but the walls of the small pelvis are clean.

· IIIB- the tumor is found on the walls of the pelvis and impairs the patency of the ureters. Lymph nodes and distant organs are not affected by cancer. This substage also includes cases where there are metastases in the nearest lymph nodes.

Diagnosis at this stage consists of colcoscopy and wedge biopsy. This procedure takes a sample of cells from the deep layers of the cervix. Additionally, an examination using an endoscope of the bladder and rectum is prescribed. It helps determine whether there are metastases there. X-rays and computed tomography (CT) are used to examine distant organs.

Stage IV

The tumor spreads far beyond the cervix. Metastases are found in any organs and lymph nodes.

· IVA- The tumor has spread to the rectum and bladder, which surround the uterus. It does not affect the nearest lymph nodes or organs located far from the cervix.

· IVB- the tumor is found in distant organs: liver, lungs.

In order to diagnose what type of tumor the tumor is, a biopsy is performed. Magnetic resonance imaging (MRI) is used to detect metastases in distant organs.

What are the signs of uterine cancer?

What does a woman experience with cervical cancer?

In the initial stages, the disease does not manifest itself in any way and the woman does not feel anything unusual. But then the tumor grows into the deeper layers of the uterus. This causes the following symptoms:

Menstruation becomes longer, heavier, or more painful
Heavy intermenstrual bleeding or spotting appears in the middle of the cycle
Bloody vaginal discharge after douching, physical activity and visiting a gynecologist
Copious mucous discharge, sometimes mixed with blood
Pain during intercourse
Aching pain in the lower abdomen
Women during menopause may experience bleeding from the vagina.

Although these symptoms can appear with other gynecological diseases, they should alert a woman. This is a reason to see a doctor.

What a gynecologist can detect for cervical cancer

The first thing the doctor does is collect anamnesis. This means that the gynecologist asks about signs of illness that worry the woman. Finds out whether there were cases of genital cancer among her relatives.

After this, the doctor performs diagnostic procedures:

1. vaginal examination using gynecological speculum. At the same time, he assesses the condition of the cervix, fornix and vaginal walls. In about 95% of affected women, signs of cancer can be detected during a routine examination. A lumpy tumor covered with folds is visible on the neck, which bleeds. It often has ulcers and a coating of dead cells. Sometimes these changes extend to the vaginal vaults. If the tumor is located deep in the canal or does not grow outward, but into the thickness of the uterine wall, then the signs may be less noticeable.

2. Bimanual gynecological examination. One hand of the doctor probes the uterus through the vagina, and the other through the anterior wall of the abdomen. With cancer, the uterus is enlarged, painful and denser. If metastases occur, it does not move well to the sides.

3. Oncocytology smear (Papanicolaou test, Pap test). This is a smear of the glandular epithelium (surface cells). If the mucosal cells have mutated, then when examined under a microscope this will be noticeable. In such cells, the structure of the cytoplasm changes and the nuclei enlarge. A positive test result does not prove the presence of cancer, but serves as a reason for a more thorough examination. If atypical cells are detected, the doctor advises doing an analysis to detect the DNA of the human papillomavirus.

4. Colposcopy is carried out if the test results are not very good (there are atypical cells or signs of human papillomavirus). A colcoscope is a device that resembles binoculars. It allows you to greatly enlarge the image of the vaginal mucosa and cervix. To make the changes more noticeable, the mucous membrane is treated with a solution of acetic acid. During the examination, the doctor can notice even the most minor changes and the slightest tumor. Ulcers, areas that rise above the rest of the mucous membrane, and warts can alert you.

5. Biopsy - This is the removal of a tissue sample for careful examination under a microscope. The material is taken using special forceps, a curette, a scalpel or an electric loop from those places where there are signs of disease. To make the procedure painless, this area is treated with painkillers.

6. Palpation of lymph nodes. The doctor checks the lymph nodes by touch, determines their size and density. This is done to identify metastases.

7. Additional Research. The doctor may prescribe an ultrasound of the pelvic organs, x-rays, computed tomography and magnetic resonance imaging. If the tumor is confirmed, then to clarify its size and search for metastases, the following methods are used: cystoscopy, excretory urography, radioisotope renography, sigmoidoscopy.

What is squamous cell carcinoma of the cervix?

Squamous cell carcinoma of the cervix is a malignant tumor that arises from mutated cells of the squamous epithelium that covers the lower vaginal part of the cervix.

How does this form of cancer appear?

Before the tumor appeared, for some reason changes appeared in the squamous epithelial cells. Most often this is due to infection with the human papillomavirus, which is transmitted through sexual contact. Other reasons can lead to mutations:

· bad ecology;

· sexually transmitted diseases;

· early onset of sexual activity;

· early pregnancy before 16 years of age;

· smoking.

They cause changes in chromosomes. At the same time, cell division accelerates and the natural mechanisms of cell death are disrupted. As a result, cells change, cease to perform their functions, and divide very actively. This is associated with tumor growth.

How does squamous cell carcinoma of the cervix manifest?

In the first stages, a cancerous tumor causes slight bleeding from the vagina. This is due to the fact that the blood vessels that feed it are easily injured. This can happen during sex, sports, or douching.

When the tumor reaches a large size, other symptoms appear:

· pain in the lower abdomen and lower back;

· swelling of the legs;

· weight loss;

· weakness and fatigue;

· slight rise in temperature.

How is squamous cell carcinoma of the cervix treated?

There are several treatment methods. The choice depends on the stage of the disease, the woman’s health status, and her age.

1. Operation - if the disease is detected in the early stages, then it is enough to remove a section of the cervix. If the tumor has reached a large size, the uterus and ovaries are removed.

2. Radiation therapy - destruction of cancer cells using high-energy radiation: x-rays, neutrons, beta and gamma rays.

3. Chemotherapy- treatment with toxins that destroy cancer cells. Effectively combined with radiation therapy.

4. Immunotherapy- treatment with interferons helps in the initial stages. These are drugs that contain proteins similar to those that produce human immunity to fight cancer cells.

How life-threatening is squamous cell carcinoma of the cervix?

It all depends on the stage at which the disease was detected. If the changes are microscopic or shallow (grade I), then removing part of the cervix will be sufficient. It is not life threatening. With proper treatment, the disease will no longer bother the woman. If after 2 years there are no complications, then she can carry and give birth to a child.

At stages II and III, the uterus will need to be removed. In this case, you will not be able to get pregnant. But the chances of life and recovery are quite high - about 70%. When there are metastases to other organs (stage IV), the woman faces a difficult fight against the disease.

What is the prevention of cervical cancer?

Prevention of cervical cancer includes many points. There is a special vaccine that is designed to protect against the human papillomavirus (HPV), the main cause of the disease. It's called Gardasil. Used to vaccinate only women not infected with the virus.

Other methods are aimed at eliminating risk factors for developing cancer..

1. Treatment of precancerous conditions. First of all, this is cervical dysplasia, as well as erosion, papillomas and warts in this area. Such defects can become the basis for a tumor, since their cells can degenerate into cancerous ones.

2. Prevention of infection with human papillomavirus and genital herpes. These infections are transmitted sexually. Condoms help protect against them - they are also an effective remedy against other sexually transmitted diseases that increase the risk of developing cancer.

3. Refusal of promiscuous sex life. Studies have shown that if a woman has had more than 10 sexual partners in her life, the risk of developing cervical cancer increases 3 times.

4. If you have sex unprotected with a condom, the antiviral drug Epigen-intim will help reduce the risk of infection. This spray must be used to treat the internal and external genitalia.

5. It is necessary to tell girls about the dangers of early sexual activity and early first pregnancy (before 16 years of age). At this age, the mucous membrane of the genital organs has not yet fully formed, and its cells are actively growing and dividing. If they are injured, there is a high probability that they will begin to mutate.

6. If there is a need for gynecological manipulations: abortion, curettage, insertion of a spiral, then contact a qualified gynecologist. Poor performance of these procedures leads to the appearance of scars. And they can serve as the basis for a tumor.

7. When choosing hormonal birth control pills, you need to consult a gynecologist. Self-administration of these drugs can cause hormonal imbalances, which lead to the appearance of hormone-dependent tumors. Failure of hormone production can occur for another reason. Therefore, if you notice that your periods have become irregular, tell your doctor. He will prescribe the necessary tests and then prescribe treatment.

8. Quitting smoking helps reduce the number of carcinogens that affect the female body. These compounds cause cell mutation and the appearance of tumors.

9. Regular visits to the gynecologist help prevent the development of cancer or detect it in the early stages. Therefore, at least once a year, come for a preventive examination to the doctor, even if nothing worries you.

What test is there for cervical cancer?

To detect cervical cancer in the early stages, women undergo en masse smear for oncocytology. It is also called Pap test or Pap test named after the scientist who invented it. To do this, a smear is taken from the cervical canal with a special brush. Then it is passed over a glass slide and an imprint is obtained. He is sent to the laboratory. There, the structure of cells is examined under a microscope. If deviations are detected in the structure of their nuclei or cytoplasm, then a suspicion arises that the woman may develop a tumor. In this case, additional research is required.

PCR swab (polymerase chain reaction) - another test that shows whether you are at risk of developing cervical cancer. It determines whether a woman is infected human papillomavirus. Samples of mucus and cells are taken with a special probe and transferred to a test tube, which is sent to the laboratory. But it must be borne in mind that infection does not always cause illness. Papillomas, and especially cancer, may not develop if the immune system copes with the viruses.

Liquid cytology - the third option, the most informative and accurate, but expensive. It allows you to determine whether the virus is present, how much there is and whether there are changes in the cells. The brush used to make a smear from the cervical canal is immersed in a special container with liquid. This solution of cells is then applied to a glass slide and examined under a microscope.

How is surgery performed for cervical cancer?

There are many options for surgical treatment of cervical cancer. The choice of method depends on the stage of the disease. Let us introduce you to the basic techniques.

Laser surgery and cryosurgery

Prescribed for stage 0. In this way, cancer cells that lie on the surface can be removed. This is done only if the tumor has not grown deep into the tissue. Laser surgery burns or vaporizes cancer cells using a beam of laser beams. Cryosurgery uses liquid nitrogen, which freezes the diseased area and causes the death of cancer cells.

Conization

This small operation allows you to get rid of a tumor that has grown 1 mm in depth - stage I. During the procedure, a cone-shaped area is removed from the cervix. It is subsequently examined in the laboratory. If no changed cells are detected at the edges of the cone, then the treatment ends.

The procedure can be performed with a scalpel or a wire loop through which a weak electric current passes. After such a gentle operation, a woman can become pregnant and give birth to a child in the future.

Trachelectomy (amputation of the cervix)

Indicated for the treatment of stage I cervical cancer for women who want to have a child in the future. The operation is performed through an incision in the abdominal wall. The cervix and upper part of the vagina are removed. In addition, the doctor may remove nearby lymph nodes. After such an operation, the risk of recurrence of the disease is low. A woman can give birth to a child in 5-6 years. Childbirth is carried out through caesarean section.

Hysterectomy

This is an operation to remove the cervix and body of the uterus in stages I and II of cancer. In this case, the doctor tries to preserve the ovaries, lymph nodes and uterine ligaments. There are several options for uterine amputation.

· Open hysterectomy - the operation is performed through the anterior wall of the abdomen. After this, the woman spends a week in the hospital, and recovery will take about 6 weeks.

· Vaginal hysterectomy - removal of the uterus through the vagina. It is easier to tolerate than open surgery, there are fewer complications and there are no stitches left. The woman spends 2-3 days in the hospital. The recovery period lasts up to 3 weeks.

· Laparoscopic hysterectomy - removal of a diseased organ through small incisions (1-2 cm) using special equipment - a laparoscope. Such an anemic and high-precision operation allows you to avoid complications and fully recover in 2-3 weeks.

Radical hysterectomy

This is a treatment for stage II cancer. It involves removing the cervix and uterus, as well as the upper part of the vagina, fallopian tubes and ligaments, ovaries and lymph nodes.

· Removal of organs through an incision in the lower abdomen. The woman spends 5-7 days in the hospital; recovery takes about a month and a half.

· Removal of the uterus through the vagina. Lymph nodes and ligaments are removed using a laparoscope. A camera and surgical instrument are attached to the end of a special tube. The laproscope is inserted into the abdominal cavity through small holes in the abdomen. With this type of operation, there is less blood loss and healing is easier.

When choosing an operation, the surgeon sets himself 2 tasks: to preserve healthy organs as much as possible and to remove all cancer cells so that the tumor does not reoccur.

Exenteration of the pelvic organs

The most extensive operation performed for stages III and IV cervical cancer. In this case, all pelvic organs affected by the tumor are removed. This is the uterus, part of the colon, bladder, lymph nodes. After this, a bladder and a path for excreting feces are created from other parts of the intestine. Recovery after such an operation may take from 6 months to a year.

Contraindications serious illness may occur before undergoing surgery to remove the uterus. These include: severe diseases of the cardiovascular system and kidneys, lungs and liver, diabetes mellitus in the later stages, inflammation of the uterine appendages and pelvic tissue. With them, any surgical treatment is life-threatening. In this case, other treatment methods are prescribed: radiation and chemotherapy, interferon drugs.

Despite the statistics, stage and doctors’ forecasts, there is always a chance for recovery and a normal life. Remember this! The most important condition is your optimism and faith in a cure.

When is radiation therapy indicated for uterine cancer?

Radiation therapy, or radiotherapy, destroys cancer cells using radiation. For this purpose, X-rays, beta, gamma and neutron radiation are used. There are two treatment options:

· external - the source of radiation is not in the patient’s body;

· internal - a cylinder with a radioactive substance is inserted into the woman’s vagina.

Treatment is carried out in several sessions. The woman is laid on the couch. Radiation sources are directed to the sore spot, and healthy areas of the body are covered with a special protective cloth. The irradiation lasts a few minutes, and then the woman can return home.

Radiation therapy is carried out over a course of 6-7 weeks. To enhance the therapeutic effect of radiotherapy, low doses of the chemotherapy drug Cisplatin are additionally administered. This treatment is called chemoradiotherapy.

Indications

Cervical cancer responds well to radiation therapy. Therefore, this method is used for all stages of the tumor. The doctor individually selects the procedure method and dose.

Contraindications

There are diseases for which radiotherapy cannot be used:

· diseases accompanied by elevated temperature;

· tuberculosis;

· severe forms of diabetes;

· heart attack, heart and kidney failure;

· blood diseases;

· tumor disintegration, which is accompanied by bleeding.

Side effects of radiation therapy

During a course of radiotherapy, the patient experiences unpleasant side effects of the treatment. They may be aggravated by concurrent use of chemotherapy drugs. Most often there are:

· weakness and fatigue;

Nausea, vomiting and diarrhea;

· blood composition disorders: decrease in the number of erythrocytes and leukocytes;

· burns on the skin;

· hair loss;

· narrowing and shortening of the vagina;

· pain during sexual intercourse;

· early onset of menopause;

Pain during urination and impaired urine flow;

· swelling in the legs;

Increased risk of femur fractures.

A woman should know that all these unpleasant phenomena will pass after completing the course, the hair will grow back, and health and beauty will return.

How to overcome difficulties during radiotherapy

1. After the procedure, the woman should lie down and rest for 3 hours.

2. It is necessary to stop smoking. This habit worsens the condition during treatment.

3. You cannot go to the sauna, take a hot bath or warm up. It is recommended to take a warm shower.

4. It is necessary to breathe fresh air, spend more time outside and ventilate the room well.

5. Eat more fresh vegetables, herbs and fruits. A woman also needs protein dishes: cottage cheese, fish, poultry, meat. They should not be greasy.

6. It is necessary to avoid fried and smoked foods, unnatural food additives, and alcohol.

7. During this period, it is better not to use cosmetics and perfumes. It may cause skin irritation.

8. In order to avoid burns, apply rosehip and sea buckthorn oils or ointments to the skin: Dermozolon, Levosin.

9. Various traditional methods are used to strengthen the immune system. For example, tincture of ginseng, eleutherococcus, rosehip decoction.

In conclusion, I would like to say: if you have been diagnosed with cervical cancer, do not delay treatment, do not waste time on alternative medicine. Trust the doctors, because they saved hundreds of lives. Your positive attitude, optimism and faith in recovery will definitely help you overcome the disease.

With cervical cancer, symptoms can be so subtle in the early stages of tumor formation that women perceive them as signs of other diseases. For example, inflammatory lesions in the pelvis. Timely seeking medical help at an early stage of cancer will greatly facilitate treatment. The prognosis for fighting the tumor in this case is much better - recovery occurs in 90–95% of cases.

Causes and risk factors

The causes of cervical cancer are varied - from a negative hereditary predisposition to the penetration of such a dangerous virus as human papillomavirus. Research convincingly proves that 75-85% of women diagnosed with CC had traces of this virus in their blood. The predominant route of transmission is unprotected sexual contact. However, the use of barrier contraception does not always provide a high degree of protection.

Other causes of cervical cancer:

early onset of intimate contacts in women - in adolescence, reproductive structures do not yet have time to fully form and are often injured;
erosive lesions of the mucous membrane, including the vagina and cervix;
state of immunodeficiency, for example, due to exacerbations of chronic pathologies;
hidden course of sexually transmitted infections - ureaplasmosis, trichomoniasis;
frequent abortions;
abuse of alcohol and tobacco products - against this background, both local and general immunity decreases;
daily contact with chemicals of carcinogenic activity - work in hazardous industries.

A negative hereditary predisposition plays a huge role in the formation of cervical tumors.

Classification

Whether cervical cancer can be cured directly depends on what stage of the tumor the tumor is at, as well as what its structure is. Experts usually focus on the following classification of cancer:

According to the type of epithelium from which the tumor was formed:
squamous cell carcinoma;
adenocarcinoma.
In the direction of tumor growth:
preinvasive – cancer is intraepithelial;
non-invasive – slow tumor growth inside the cervical mucosa:
microinvasive – superficial nature of the cancer, the tumor does not grow deeper than 5–7 mm into the underlying tissue;
exophytic - the tumor visually appears in the shape of a cauliflower, often grows into the vaginal lumen;
endophytic - the tumor is externally similar to an ulcerative defect formed inside the cervical canal of the uterus, and has a tendency to bleed at the slightest touch.
According to the stage of the tumor:
precancerous condition - cancer in situ, when atypical cells have not yet formed a focus;
Stage 1 – the tumor is still localized inside the layer of the cervical mucosa;
Stage 2 – cancer grows into the underlying tissue, but has not yet left the organ; single lymph nodes on one side may be affected;
Stage 3 – the tumor spreads into the uterus, with release into the vaginal tissue, lymph structures are affected on both sides;
Stage 4 – the tumor is enormous in size, can occupy the entire pelvis of a woman, and metastasis to distant organs is observed.

In some cases, a specialist may make additions to the above classification points - indicate, for example, the reasons for the formation of cancer, or clarify the expanded characteristics of any of the subparagraphs of the description of the tumor.

Early symptoms of cancer in women

In the early stages of tumor formation, the symptoms of cervical cancer are almost invisible. Women continue to lead their usual lives, only periodically noting a deterioration in their health.

The cancerous focus has a minimal size - in the thickness of the mucosa. Therefore, negative clinical signs of cancer occur during menstrual flow - they are more abundant, longer lasting, and are accompanied by severe discomfort in the perineum.

Sexual contacts with a tumor in the uterus at an early stage can result in spotting from the vagina - the woman notices bloody spots on her underwear. In the intervals between the main menstrual flows, periodic scanty flow may also be observed. They are what alert women to a malignant process.

Other signs of cervical cancer include increasing weakness, increased fatigue, loss of appetite and decreased performance. However, these manifestations are nonspecific and can relate to many pathologies. Therefore, the first symptoms of tumors in women are necessarily assessed by specialists in the totality of clinical signs.

The prognosis for cervical cancer diagnosed at the in situ stage or at the first stage is extremely favorable - recovery occurs in 85-95% of women.

If the first signs of cervical cancer were ignored by a woman or incorrectly assessed, the tumor continues to progress and grow. Uterine bleeding becomes more intense - it bothers the woman not only during the monthly cycle, but also between the main discharges. In addition, they appear immediately after intimacy with a partner, examination by a gynecologist, or insertion of a hygienic tampon.

In addition to spotting in underwear, women experience symptoms such as abundant whitish, curdled lumps. When they suppurate, an extremely unpleasant odor is added. It indicates the beginning of tumor disintegration.

A characteristic sign that cervical cancer is developing is constant aching discomfort in the perineal area in a woman. Unpleasant sensations become more intense and last longer. They can be provoked not only by sexual contact, but also by physical activity, and even going to the toilet to have a bowel movement.

As the tumor compresses the ureters and intestinal loops, the woman experiences difficulties with defecation and urination - constipation, dysuric disorders. Against the background of intoxication of the body, flatulence, heaviness in the abdomen, and rotten belching are observed. Weight begins to decrease - cachexia develops quickly; in just a few months, a woman loses up to 20-30 kg.

The tumor also affects the lymphatic system. Due to the obstruction of lymph outflow, a woman’s lower extremities become constantly swollen and increased in size. This leads to difficulty moving and causes severe pain. All of the above features of the advanced stage of cancer in the cervix may be present in a woman in incomplete quantities.

Symptoms of the advanced stage

Symptoms of cervical cancer in women at a late stage of tumor development will be severe pain - the pursuit of exhausting sensations throughout the day. They are not eliminated by taking standard analgesics.

Signs of cancer intoxication must be observed:

at the initial stage, minimal weight loss becomes steady and rapid - the woman literally “melts” in front of her relatives;
neighboring organs are also involved in the cancer process - kidneys, intestines, stomach, ovaries, therefore, disorders of activity and functioning will form on their part;
suffering is certainly reflected in a woman’s appearance - the skin becomes pale, dull, dry, hair and legs become fragile, the appearance expresses the internal state;
Since the excretion of urine and feces is difficult, slagging of the body provokes the appearance of edema in the internal cavities - ascites, hydrothorax, which further aggravates the severity of the woman’s condition.

At the terminal stage of a tumor in the cervix, there is even no talk of the woman having to fulfill her work duties - she must be given a disability group and provided with constant outside care. After all, intense pain, exhaustion, and severe weakness are only increasing. Death at stage 4 cancer usually occurs by the end of the first year from the moment of diagnosis.

Diagnostics

In order to recognize early changes in the tissues of the cervix, understand what metaplasia is and take timely appropriate measures to eliminate it, every woman is recommended to work closely with her gynecologist.

The focus of cancer can develop on the intact mucous membrane of the cervix, however, more often this is preceded by various pathological failures - erosive defects, leukoplakia, trauma. All of them must be observed by a specialist.

A modern set of diagnostic procedures that allows high-quality and quick recognition of cancer in the structures of the uterus:

colposcopy – is it a standard or an extended option that allows for a detailed examination of a suspicious area of tissue;
cytological examination - allows you to determine the degree of malignancy even at the pre-visual stage of the tumor, its histological structure, as well as the stromal reaction;
histological examination with morphology - examination of a biopsy from the cervix;
a blood test for tumor markers is one of the modern methods for early diagnosis of cancer, which allows one to identify the predisposition of tissues to malignancy;
Ultrasound – clarification of the location of the tumor, its volume, the degree of involvement of neighboring tissues and organs in the process;
CT and MRI are modern, but not always available, methods for diagnosing tumors.

Innovative techniques include histochemical and mitotic examination of cervical tissue. With their help, it is possible to identify cancer at the premorphological stage - metabolic changes in tissues that precede the tumor.

Surgical method of treatment

Whether it is possible to cure cervical cancer, and what tactics to combat the tumor to prefer, the specialist will decide on an individual basis. If the process develops rapidly, or the lesion has already spread beyond the cervix, treatment of the neoplasm comes down to surgical intervention.

Surgical excision of the tumor can be performed in several ways. Thus, when the focus of cancer is localized directly in the tissues of the cervix, preference is given to conization - removal of the cone-shaped part of the organ, as well as the mucous membrane of the cervical canal.

If the tumor is localized, electrosurgical loop excision can also be used - pathological defects are excised with an electric knife. Subsequently, the lesion is cauterized, which allows healthy tissue to form.

In the case of diagnosing cancer at the third stage in the cervix, when metastases can develop in neighboring lymph structures, as a rule, they resort to high amputation - radical removal of the organ. If necessary, neighboring areas - vagina, lymph nodes - are also removed.

If the tumor is huge - with its exit into the uterine cavity or with external growth of the lesion, surgical tactics include extirpation of the uterus with complete or partial removal of the ovaries. This helps prevent further progression of cancer.

Radical hysteroscopy, with surgical removal of not only the structures of the uterus, but also its tubes, vagina and ovaries with nearby lymph nodes, is a method of combating stage 3–4 tumors. Whether cervical cancer can be treated at this stage or whether surgery is not possible, the doctor will decide in each case separately.

Other methods of fighting cancer

Treatment of cervical cancer involves not only removal of the primary tumor, but also radiation and chemotherapy. The lesion will be considered cured only if diagnostic measures do not reveal relapse processes in the tissues.

This is facilitated by complex treatment procedures. Thus, radiation therapy begins at the preoperative stage of preparation. The purpose of radiation exposure to a tumor is to reduce it in size and create favorable conditions for subsequent removal. If surgical excision of the lesion is not possible due to circumstances, irradiation is performed in order to reduce the negative impact of the tumor on the woman’s well-being.

Chemotherapy is another commonly used method to treat cervical cancer. Introducing modern medications with antitumor effects into a woman’s body through various routes can significantly suppress the activity of cancer cells. In most cases, timely chemotherapy allows cancer to be completely cured. Most often, they resort to combined treatment tactics - radiation and chemotherapy simultaneously. Such a step greatly increases the chances of defeating the tumor.

At the moment, cervical cancer is not a death sentence at all. The methods available to doctors to combat a tumor allow a woman not only to cope with the situation, but even become a mother in the future. The main condition for success in diagnosing cancer is timely seeking medical help. If the tumor was detected at a late stage of its course, treatment methods will be limited to maintaining a high quality of life for the woman, providing her with assistance and support.

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How quickly does cervical cancer develop? For each woman with this diagnosis, the disease develops differently, so at the first ailment it is necessary to seek help from a specialist.

How quickly do different types of cervical cancer develop?

How long cervical cancer will develop depends on many factors, including the environment, lifestyle, and nutrition.

Cervical cancer

This disease is not a rapidly developing disease. The whole process can take 10 or even 20 years. However, there are cases of rapid growth of tumor cells. Therefore, you should not delay with this; the very first signs should be a reason to contact a specialist. Using special equipment, it is possible to diagnose a precancerous condition, which is much easier to cure.

Note! If treatment is not started in time, then it is likely that after 10 years the tumor will enter an advanced and more dangerous stage, which can no longer be treated.

According to statistics, 0.3% of women have an advanced stage of malignant neoplasm. This means that metastases have begun to penetrate other organs and tissues, thus disrupting their functioning.

Squamous cell carcinoma

Despite the fact that this form of tumor is asymptomatic, it can be diagnosed during a routine examination by a gynecologist. Over time, the cancer tumor begins to grow, and then the first symptoms appear. Squamous cell carcinoma is a tumor in which immature cells are formed, and they multiply very quickly, so the course of the disease from the first to the last stage occurs rapidly.

Adenocarcinoma

This type of tumor is hormone dependent and is most common in menopausal women. The neoplasm is aggressive in nature and begins to metastasize to other organs, lymph nodes and blood. After this, the development of the disease is rapid.

Exophytic cancer

A malignant tumor of this form is noticeable already in the first stages. The pathology occurs with visible symptoms, these are compactions and growths on the neck.

Endophytic cancer

This type of malignant neoplasm is already in an advanced stage. The whole process takes place in the uterus itself, so diagnosis will require special equipment.

A malignant tumor has the ability to grow quickly and extend beyond the uterus itself. It metastasizes into human organs and tissues, and is also transported in the blood throughout the body. In this case, the lymph nodes are affected.

How quickly does cervical cancer develop by stage?

To begin with, we can distinguish the zero stage, or precancerous condition. Having noticed it at the first stage, there is a 100% guarantee of its complete removal from the body. In this case, cancer will develop with minor changes in the epithelium. This process happens slowly.

First stage

Cancer cells begin to grow and a tumor forms. The neoplasm does not affect nearby organs and tissues. Metastases may spread to the cervical canal.

Second stage

The tumor is significant in size and, in the absence of proper treatment, begins to grow beyond the uterus. The pelvis and vagina are affected.

Third stage

The tumor grows more and more, they affect the ureters and metastasize to the lymph nodes. Metastases also grow in the pelvic area and other nearby organs. The tumor also affects the walls of the vagina.

Fourth stage

This is a severe form of malignant tumor, in which metastases penetrate the bladder and rectum. At this stage of development of the tumor, metastases can affect the lungs, liver, kidneys and bones. How long it takes for stage 4 cervical cancer to develop will depend on the body. To a greater extent, the progression of the disease occurs very quickly, and the lymph nodes are also affected.

How quickly does cervical cancer develop from a precancerous condition?

How long a cancer will develop depends on a number of factors, including the histology of the tumor, existing pathologies, body resistance, etc.

The onset of a malignant tumor is preceded by dysplasia, when epithelial cells are modified and block the work of healthy cells. Most often this happens in the transition zone, i.e. in the place where the cervix and the cervical canal meet.

It is quite difficult to say exactly how quickly uterine cancer develops in the body. Therefore, it is worth undergoing an annual examination by a specialist. If cancer cells are not removed in time, then within 2 years, or even less, a malignant tumor will appear, which will become increasingly difficult to cure.

The progression of cervical cancer may take 2 years and during this time go through all 4 stages, or may not show signs for 10 years. However, you should not rely on universal statistics; in each case, the entire process of development of a neoplasm occurs differently. There are cases when dysplasia did not move further and went away on its own over time. It is best to contact a specialist and be observed by him, especially if there are predisposing factors to the development of a cancerous tumor. On average, the minimum time for transition from stage to stage is 2 years.

How long it takes for cervical cancer to develop largely depends on the woman herself. Lifestyle, proper nutrition and regular monitoring by a specialist play a role here. If any discomfort occurs, you should consult a gynecologist who will conduct an examination and identify its cause. After all, the process of formation of cancer cells can be rapid, and in the final stages it is incurable. Therefore, it is very important to monitor your health.

Content

Cervical cancer is manifested by the appearance of a malignant tumor in its epithelial layer. The disease is extremely common in women and ranks third in the number of cases after breast and endometrial cancer.

Cervical cancer occurs in representatives of different age groups, mainly after the age of forty. In recent years, the disease is rapidly becoming younger and is often detected in fairly young women of childbearing age.

Cervical cancer is an insidious disease. Despite the possibility of a complete cure, the mortality rate from this type of cancer is still considered high. This is due to the fact that the first symptoms and signs of the pathological process are usually absent until the last stages of the disease.

Cervical cancer develops due to the presence of background and precancerous pathologies.

The cervix is a cylinder-shaped tube that connects the vagina and uterine body through the cervical or cervical canal. This channel contains on the surface so-called cylindrical cells and special glands that produce mucus. The secretion of the glands is necessary to protect the uterine cavity from unwanted pathogenic flora that can enter from the vagina.

The cervix is divided into two parts:

vaginal;
supravaginal.

During a gynecological examination, only the vaginal part, which is covered with flat multilayered epithelial cells, is accessible for examination.

With the development of malignant pathology, symptoms of changes in the structure of epithelial tissue are observed. Normally, the epithelium has several layers. Cell division and development begins in the deep layer. As they mature, round cells containing a large nucleus rise to the surface, gradually flattening.

Under the influence of unfavorable factors, cellular elements can acquire symptoms and signs of atypia, which are characterized by loss of shape and proliferation of the nucleus. The division of the epithelium into layers is also not observed. As a result, cervical dysplasia develops.

Atypical or atypical cells do not yet indicate the presence of a malignant tumor. However, in the absence of timely diagnosis and treatment, the first signs of dysplasia eventually turn into cancer.

Factors and reasons for the appearance

Scientists have proven that cervical cancer has a viral etiology and pathogenesis. In most cases, histological samples of sick women contain human papillomavirus. This made it possible to prove that this particular virus is at the heart of the disease.

HPV is embedded directly into the cell's DNA after entering the body. Over time, it has an adverse effect on the epithelium of the cervix, causing mutation of cellular elements. Only some potentially dangerous types of HPV, which are characterized by a high degree of oncogenicity, can cause cervical cancer. These strains contribute to the appearance of symptoms of atypia, characteristic of dysplasia processes. In the absence of adequate treatment, atypical cells turn into cancer.

Types of HPV that have medium and low risk of developing cancer, lead to the formation of papillomas and condylomas.

Among the unfavorable factors that contribute to the development of cervical cancer are:

a combination of several infections, for example, HPV, herpes and CMV;
the presence of background as well as precancerous diseases of the cervical region;
chronic inflammation in the pelvic area;
deficiency of vitamins and microelements;
dysfunction of the immune system;
damaging environmental factors;
history of abortion, curettage, and multiple births;
beginning intimate relationships at an early age;
lack of monogamy in sexual relations;
the use of combined contraceptives rather than barrier methods of contraception;
excessive smoking;
excess weight;
regular stress.

The first signs and symptoms of cervical cancer are caused by a combination of several unfavorable factors that contribute to the degeneration of epithelial tissue.

Types and stages

In gynecology, several classifications of the oncological process of the cervix have been created, based on various criteria.

Scientists distinguish two types of cervical cancer depending on the affected epithelial tissue.

Squamous cell oncology. This cancer is considered the most commonly diagnosed malignant tumor, which develops from flat cellular elements of the surface layer of the epithelium. Its occurrence is caused by the rapid proliferation of immature malignant cells.
Adenocarcinoma. Cancer is diagnosed in the deep layers of the cervical epithelium.

The squamous form has three varieties:

keratinized, which differs in density;
low-differentiated, with rapid growth and a fairly soft structure;
non-keratinizing, considered an intermediate option between the first two varieties.

The first symptoms of cervical cancer directly depend on the type of cancer process.

The progression of cervical cancer occurs in several stages of the pathological process.

0. This is a precancerous stage, coinciding with in situ cancer or grade 3 dysplasia. As part of this pathology, superficial cancer cells are observed that have not spread deep into the epithelial layer. With timely treatment, the patient can count on a complete cure in the vast majority of clinical cases.

1. Malignant cellular elements penetrate into the tissue to a depth:

A – up to five millimeters;
B - up to four centimeters.

2. The cancerous tumor extends beyond the cervix. The possibility of cure at this stage is relatively high.

3. Spread of malignancy to the area of the pelvic wall and upper part of the vagina.

4. Damage to the pelvic organs, lymph nodes, as well as the formation of metastases. This stage has a low survival rate.

Most stages are not accompanied by the first signs of pathology, which causes late diagnosis and treatment. In some cases, metastases form even during the second stage of disease progression.

Symptoms and clinical picture

Often there are no signs of the disease in the first stages. The characteristic symptoms are unexpressed and are perceived by the woman as mild symptoms of malaise. As the tumor develops and enlarges, the first signs and symptoms appear, which are easily confused with manifestations of other gynecological diseases.

Contact discharge. This symptom appears one of the first. When cancer occurs, the cervix becomes sensitive to external influences, which is manifested by bleeding during sexual intercourse and gynecological examination.
Beli. Light, abundant discharge indicates intensive work of the immune system and often accompanies cervical cancer in the first stages.
Liquid discharge. The first signs of advanced stages include watery discharge, which is often dirty red in color and has an unpleasant odor. Such symptoms indicate the decomposition of the tumor.
Bleeding. This symptom is characteristic of both the first and last stages of oncology and appears in the middle of the cycle.
Pain of varying intensity. As a rule, pain appears not so much in the first as in the last stages of the disease. Pain can be localized in the lower abdomen, lower back and rectum.
Feeling of discomfort in the vagina. A woman may experience a sensation of a foreign body in the vaginal area, which is one of the first symptoms.
Compression of the pelvic organs. As a result of the growth of an oncological tumor, compression of the intestines and bladder occurs, as well as their destruction by cancerous cellular elements. Over time, the first signs of organ dysfunction appear, which is manifested by constipation, urinary retention, and the appearance of blood in the urine or feces.
Swelling. The development of edema is the first sign of an advanced stage and indicates the spread of the pathological process to local lymph nodes.
Deterioration in general health. This symptom appears one of the first and is accompanied by a rise in low-grade fever, pallor, loss of appetite, weakness, and weight loss.

The first symptoms and signs of cervical cancer are similar with manifestations of other gynecological diseases. To make an accurate diagnosis and prescribe treatment, a woman needs to see a doctor.

Diagnostic methods and treatment

In gynecology, various methods are used to diagnose oncology developing in the cervix:

visual examination of the cervical part on a gynecological chair;
smear for oncocytology;
extended colposcopy;
biopsy;
Ultrasound with a vaginal sensor;
X-ray, CT, MRI;
laboratory research.

Among the first diagnostic methods, a gynecological examination and a cytological smear are used. When determining signs of atypia, a woman is recommended to undergo colposcopy and biopsy. If a malignant tumor is detected, additional studies are performed to diagnose metastases.

Treatment is prescribed according to the signs and symptoms, as well as the stage of spread of the pathological process.

In the first stages of pathology in women of reproductive age, organ-preserving treatment is possible:

conization;
amputation of the cervix.

As a result of such treatment, a woman will be able to achieve childbearing function. During pregnancy, signs and symptoms of threatened miscarriage or premature birth may occur, which can be successfully stopped if proper treatment is selected.

Advanced stages of the disease require radical measures in treatment. As a rule, treatment is based on the following surgical tactics:

extirpation;
hysterectomy.

These interventions mean removal of a muscular organ with possible amputation of the ovaries, tubes, appendages, parts of the vagina, and lymph nodes.

Surgical treatment is complemented by radiation and chemotherapy. In some cases, treatment with hormones is indicated.

After appropriate therapy, the patient is monitored by a doctor for life and regularly undergoes the necessary examinations. We can speak of a complete cure when there are no relapses or signs of pathology during the first five years after treatment.

Cervical cancer is a type of cancer that develops in the cells of the cervix, the lower part of the uterus that connects it to the vagina. Different strains of the sexually transmitted human papillomavirus (HPV) play a role in causing most cases of cervical cancer.

When exposed to HPV, a woman's immune system usually wards off the virus without causing harm. In a small group of women, however, the virus survives for many years, promoting a process that causes some cells on the surface of the cervix to degenerate into cancer cells.

Mortality rates from cervical cancer are falling, largely due to timely screening and treatment. Doctors hope the vaccine can prevent most cases of cervical cancer in the future.

Globally, cervical cancer is the third most common cancer in women. It is much less common in the United States due to the continued use of the Pap smear as a diagnostic and preventive measure.

Cervical cancer usually develops very slowly. It begins as a precancerous condition called dysplasia. This precancerous condition can be detected with a Pap smear and is 100% treatable before the precancerous changes develop into cervical cancer.

Cervical cancer is considered a disease of middle-aged women (35 - 55 years old), at this age 70% of cases of this disease are detected. In 20% of cases, this disease is detected after 65 years of age and only in 10% of women under 35 years of age.

Causes and risk factors for cervical cancer

Cervical cancer begins when healthy cells develop a genetic mutation that turns normal cells into abnormal cells. Healthy cells grow and multiply at a certain rate, and eventually die at a set time. Cancer cells grow and multiply at an uncontrollable rate, and they do not die. Accumulating, pathological cells form a mass - a tumor. They invade nearby tissues and, breaking away from the primary tumor, can spread to other parts of the body - metastasize.

What causes cervical cancer is not completely clear. However, one cause is a sexually transmitted infection called human papillomavirus (HPV). There are many different types of HPV. Some strains can lead to cervical cancer. Other strains may cause genital warts, while others cause no problems at all.

Evidence of HPV is found in almost all cervical cancers. HPV is a very common virus, and most women with HPV never develop cervical cancer. This means that other risk factors, such as genetic predisposition, environment or lifestyle, also determine the development of cervical cancer.

Risk factors for cervical cancer include:

Women living in difficult financial conditions.
- Women whose mothers took the drug diethylstilbestrol during pregnancy in the early 1960s to prevent miscarriage
- Weakened immune system
- A large number of sexual partners or partners who participate in high-risk sexual activity groups. The greater the number of your sexual partners, the greater the likelihood of contracting HPV.
- Early onset of sexual activity increases the risk of HPV infection.
- Presence of sexually transmitted infections (STDs). If you have other STDs - such as chlamydia, gonorrhea, syphilis and HIV - the greater your chances of also having HPV.
- Smoking. Smoking and HPV infection together can accelerate the development of cervical cancer.
- Obesity. In women whose body weight is 10-25 kilograms above normal, the risk of developing cervical cancer is 3 times higher, and in women whose body weight is 25 kilograms above normal, the risk increases 9 times.
- Use of oral contraceptives.

Types of Cervical Cancer

The type of cells where the initial genetic mutation occurred determines the type of cervical cancer. The type of cervical cancer helps determine prognosis and treatment.
The main types of cervical cancer are:

1. Squamous cell carcinoma. It starts in the thin, flat cells that line the fundus of the uterus (squamous cells). This type makes up the vast majority of cervical cancer cases.

2. Adenocarcinomas. They occur in the glandular cells lining the cervical canal. These tumors make up a minority of cervical cancer cases.

Sometimes both cell types are involved in cervical cancer. Very rarely, cancer can occur in other cells in the cervix.

Symptoms of cervical cancer

In its early stages (stage I), cervical cancer usually causes no signs or symptoms. As it progresses, more severe symptoms may appear and get worse.

Symptoms of stage II-III may include:

Abnormal vaginal bleeding between periods, after sexual intercourse, or after menopause.
- Vaginal discharge, which can be pale, watery, pink, brown, bloody, and have an unpleasant, sometimes putrid odor. This is due to the fact that infections are added to the discharge.
- Vaginal bleeding after intercourse, between periods or after menopause.
- Menstruation becomes heavier and longer than usual.
-Moderate pain during sexual intercourse or lifting weights.

At stage IV, when cervical cancer can spread to the bladder, intestines, lungs and liver, all of the above symptoms may be added to:

Pelvic pain.
- Fractures of the pelvic bones.
- Urinary and fecal incontinence.
- Pain in legs.
- Losing weight.
- Loss of appetite.
- Swelling of the legs.
- Chronic fatigue.

Diagnosis of cervical cancer

If cervical cancer is detected in its earliest stages, treatment is more likely to be successful. Regular screening for cervical cancer and precancerous changes of the cervix is recommended for all women. Most experts suggest that screening should begin at age 21. Cervical cancer screening includes:

. During a Pap test, tissue samples are taken from the cervix and sent to a laboratory to be checked for abnormalities. A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes (dysplasia) that increase the risk of cervical cancer.

2. DNA - human papillomavirus test. This test helps determine whether you are infected with any of the types of HPV that are most likely to lead to cervical cancer. Like the Pap test, the HPV DNA test involves collecting cells from the cervix for laboratory testing. The HPV DNA test is not a replacement for regular Pap screening and is not used to screen women under 30 years of age with normal Pap results. The recommended screening period is three to five years for women ages 30 to 65. Most HPV infections in women in this age group clear up on their own and are not associated with cervical cancer.

If you are experiencing signs and symptoms of cervical cancer or if your Pap test shows cancer cells, further tests are required to diagnose the cancer. To make a diagnosis, your doctor may:

History taking - a thorough interview about your own and family history of the disease, risk factors and symptoms of cervical cancer.
- Physical examination of the cervix. In addition, the doctor carefully examines the condition of the lymph nodes for metastases (tumor spread).
- Colposcopy is a painless procedure in which a tiny sample of tissue is removed from the pathological area for research.

Colonoscopy.
- Cone biopsy (conization), in which a cone-shaped area of cervical cells is removed, allowing deeper layers of cervical cells to be obtained for laboratory testing.
- Cervical loop electroconization, where tissue is removed from the cervix using a thin wire loop that is heated by an electric current and acts like a scalpel. The procedure is performed on an outpatient basis, with local anesthesia.

Cryoconization of the cervix. During this procedure, a surgical scalpel is used to remove tissue instead of a heated wire. Cryoconization is performed under general anesthesia.
- Ultrasound.
- Chest X-ray.
- CT scan of the pelvic organs.
- Cystoscopy - visual examination of the bladder.
- Intravenous pyelogram.
- MRI of the pelvic organs.

The purpose of screening and other diagnostic measures is not only to detect cervical cancer, but also to determine the extent of its spread in the body, in other words, to determine the stage of cancer.

Typically, the stages of any cancer are indicated by Roman numerals. Stages of cervical cancer include:

Stage I: Cancer is localized only to the cervix.

Stage II. Cancer at this stage has affected the cervix and uterus, but has not spread to the pelvic wall or lower part of the vagina.

Stage III. Cancer at this stage has spread beyond the cervix and uterus to the walls of the pelvis or lower part of the vagina.

Stage IV. At this stage, the cancer has spread to nearby organs, such as the bladder or rectum, or it has spread to other parts of the body, such as the lungs, liver, or bone marrow.

Cervical cancer treatment

Treatment for cervical cancer depends on:
- Stages of cancer
- Tumor size and shape
- The woman’s age and general health
- From the desire to have children in the future

Getting rid of stage I and II cancer, when the tumor is limited to the outer layers of the cervix, usually requires removal of the abnormal area of cells that are responsible for growth, without removing the uterus or damaging the cervix. After such interventions, a woman can have children in the future. In this case, you do not need any additional procedures. A simple operation is needed to remove these tissues.

Removal of cancer cells can be done in several ways:
- Loop electroexcision of the cervix, a method that uses a thin wire to precisely cut out the affected tissue in the cervical area.

Conization. In this cervical cancer treatment, the surgeon uses a scalpel to remove abnormal tissue in the cervix.
- Cryotherapy - treatment using low temperatures, when the affected cells freeze, die, and are replaced by healthy cells.
- Laser therapy is a therapy that uses a laser beam like a knife to remove abnormal tissue.
- Hysterectomy (removal of the uterus, without removal of the ovaries). This operation is not often used if the cancer has not spread beyond the cervix, but at stage III it is not possible to get rid of cancer cells without removing the uterus, so women are prescribed a hysterectomy.

At stage IV, when the cancer has spread to the outer layers and invaded the deeper layers of cells on the cervix, more radical treatment is used, which includes:

Radical hysterectomy. In this hysterectomy, the uterus, surrounding tissue, lymph nodes, and the upper part of the vagina are removed.
- Pelvic exenteration is a surgical procedure in which the rectum, bladder, uterus, cervix, vagina, ovaries and adjacent lymph nodes are removed and artificial openings are created for the passage of urine and stool.
- Radiotherapy or radiotherapy. If the cancerous tumor is located in such a way that it is impossible to surgically remove it, then radiotherapy is used, which is divided into external and internal. Internal radiation therapy is performed using a device filled with radioactive material that is placed in a woman's vagina as close to the site of cancer cells as possible. This therapy is more gentle than external therapy. External beam radiation therapy is carried out by emitting beams of radioactive waves from a device that can be compared to an x-ray. With external radiotherapy, cancer cells are irradiated from the outside, resulting in damage to healthy tissue. In advanced stages, such treatment is more productive, since the cancer cells have spread quite widely and local radiotherapy does not bring results.
- Chemotherapy is the treatment of a cancer tumor using poisons or toxins that have a detrimental effect on cancer cells. The following drugs are used to treat the cervix: 5-fluorouracil (5-FU), cisplatin, carboplatin, ifosfamide, paclitaxel, and cyclophosphamide. These drugs are usually injected into the bloodstream through veins, which will destroy the growth of cancer cells in the body. Chemotherapy and certain side effects associated with it, such as diarrhea, nausea, vomiting, and hair loss, can, in some rare cases, lead to infertility and early menopause.

Radiation and chemotherapy can be used as the only treatment or as additional treatment after tumor removal.

What to do if diagnosed with cervical cancer

No one can be prepared in advance for a diagnosis of cervical cancer. Each woman perceives this diagnosis in her own way, but there is always shock and fear in her feelings. Regardless, you need to try to manage the shock and fear you feel by taking steps to control your situation:

First of all, learn enough about cervical cancer and decide about your treatment.
- Formulate and write down questions. To discuss them at your next appointment with your doctor.
- Ask a friend or family member to come with you to your doctor's appointment to take notes.
- Don’t be left alone with your diagnosis, withdrawing into yourself. Friends and family may also feel helpless and afraid. They want to help, so accept their help. Ask loved ones to take on some of the daily tasks, such as cooking, cleaning, or babysitting. Talk to close friends and family when you're feeling down.
- Other people with cancer can provide unique emotional support during diagnosis and treatment. Find support groups online.
- Find time for yourself. Take care of yourself during cancer treatment. Reading, listening to music or going for a walk can all help reduce stress and manage your emotions.

A sample list of questions you can ask your doctor about cervical cancer:

Do I have cervical cancer?
- How far has my cancer spread?
- What treatment do you recommend?
- What are the possible side effects or complications of this treatment?
- Is there a risk of relapse (recurrence) of this disease?
- How often should I visit the doctor after I finish treatment for cervical cancer?
- Are there any brochures or other printed materials that I can take with me? What sites do you recommend?

Your doctor will likely ask you a number of questions as well. Be prepared to answer them. Your doctor may ask:

What are your symptoms?
- When did you first notice these symptoms?
- Have your symptoms changed over time?
- What is your sexual activity?
- Have you had regular Pap tests? How did you become sexually active?
- Have you ever had abnormal Pap smear results in the past?
- Have you ever been treated for pathological conditions of the cervix in the past?
- Do you or your sexual partner have HPV?
-Have you had any other STDs?
-Have you ever taken medications that suppress the immune system?
- Do you smoke? How many?
- Do you want to have children in the future?

Expectations (prognosis) of cervical cancer

Invasive treatments for cervical cancer often make it impossible for a woman to become pregnant in the future. For many women, especially young women and those who have not yet started a family, infertility is a worrying side effect of treatment. If you are concerned about your ability to become pregnant in the future, discuss this with your doctor before your treatment begins. In most cases, maintaining reproductive functions is more successful than attempting to restore fertility after treatment.
Precancerous conditions are completely curable with timely and proper treatment.

Cervical cancer survival

If the tumor has not spread beyond the cervix, then the five-year survival rate is 92%, but if the tumor has spread further, then the survival rate drops sharply. For stage IV cervical cancer, the five-year survival rate is 8%.

According to summary data, the five-year cancer survival rate, depending on the stage, is distributed as follows:
Stage I - 92%
Stage II - 72%
Stage III - 32%
Stage IV - 8%

Complications and recurrences of cervical cancer

Some types of cervical cancer do not respond to treatment.
- Cancer may reappear after treatment.
- Women who have been diagnosed with cervical cancer but have decided not to have their uterus removed have a high risk of recurrence of the disease.
- Cancer treatment can lead to problems in your sex life, bowel and bladder problems.
- Infertility.

Prevention of cervical cancer

- Vaccination. A vaccine is now available to prevent cervical cancer. In June 2006, a vaccine called Gardasil was approved in the United States, which prevents infection against the two types of HPV responsible for most cases of cervical cancer. Studies have shown that the vaccine can prevent early stage cervical cancer and precancerous lesions. Gardasil is the first approved vaccine specifically aimed at preventing any type of cancer.

- Safe sex. Using condoms also reduces the risk of contracting HPV and other sexually transmitted diseases. The main cause of cervical cancer is human papillomavirus (65 - 75%), so if a woman practices sex with a condom, then the chance of developing cervical cancer decreases significantly. In any case, if a woman sees warts on her partner’s genitals, then she should avoid contact with him. To further reduce the risk of cervical cancer, women should limit their number of sexual partners and avoid partners who engage in high-risk sexual activity.

- Pap test. Precancerous changes can be detected by a Pap smear. This test is recommended periodically for all women leading an active sexual lifestyle.

- Smoking. If you smoke, quit smoking. Smoking is associated with an increased risk of cervical cancer. It should also be noted that cervical cancer is twice as common in women who smoke.