High mortality from oncology is the main problem of modern medicine. Every year it claims about eight million human lives. For example, cervical cancer is a malignant disease that ranks third in the number of deaths from oncology among the female population.
This diagnosis is made by about 7% of women under the age of 30 and 16% - over 70 years. In about one-third of cases, the pathology is discovered too late, when invasive cervical cancer develops.
However, over the past three decades, the incidence among the population has halved. However, mortality remains high. Therefore, it is so important to know the causes of the development of the disease, its symptoms, as well as diagnostic methods and methods of treatment.
Causes of disease development
In almost 100% of cases, the provoking factor is the presence of the human papillomavirus in the patient's body. However, even when a woman is infected, oncology does not always develop.
There are a number of factors that canserve as an impetus for the development of a malignant process. These include:
- Keeping an intimate life with several partners at the same time or changing them frequently.
- Various venereal diseases.
- Having HIV or AIDS.
- Starting sex too young.
- Multiple births with a short time between them.
- Past malignant diseases of the genitourinary system.
- A poor diet lacking enough vitamins and minerals.
- Long-term use of hormonal contraceptives.
It should also be noted that the risk of developing cancerous tumors is significantly increased in women suffering from diseases such as:
- Leukoplakia.
- Dysplasia.
- Cervical erosion.
Such women should be especially carefully examined by a gynecologist.
Types of diseases
This pathology can be divided depending on the degree of tumor growth.
- Non-invasive cancer. A malignant formation is located exclusively in the outer layers of the epithelium, that is, literally on the surface of the neck.
- Pre-invasive cancer. The tumor penetrates deep into the tissues by less than 5 mm.
- Invasive cancer. The cervix has a formation on its surface that has grown to a depth of 5 mm or more. In this case, it has already reached a large size and can affect the uterus, vagina, as well as the bladder and rectal walls.
In thisthe article will focus on invasive cervical cancer, a photo of the symptoms of which can be seen below. The fact is that a woman suffering from this pathology is often worried about pain in the lower abdomen.
Invasive cancer: concept
Invasive cancer is a disease of the cervix in the secondary stages of the development of a malignant neoplasm.
That is, at first, cancer cells are located on the surface of the tissues of the uterine cervix. If the disease is not diagnosed in time and no measures are taken to treat it, the cells penetrate into the underlying cervical tissues (parametria).
With this form of cancer, the cervix is hyperemic, thickened and enlarged.
Normally, the cervix is covered with epithelial tissue, consisting of cells of a flat structure. When exposed to any negative factors, their degeneration into malignant forms is possible. These shapes may vary.
- In some cases, cancer cells are capable of forming so-called "cancer pearls" - areas prone to keratinization. And then the disease will be called keratinizing carcinoma.
- We will talk about invasive squamous cell nonkeratinizing cervical cancer in cases where malignant cells are not capable of forming such areas.
None of the female representatives is immune from this pathology. For example, invasive squamous cell carcinoma of the cervix can develop during pregnancy. Therefore, this category of women is examined especially carefully.
Every pregnant woman is examined by a gynecologist at least twice in nine months, who takes an analysis for oncocytology, which studies the composition of the cervical epithelium and the structure of its cells.
It is worth noting that there may be invasive cervical cancer and intraepithelial form. In this case, the malignant formation is just beginning to grow deep into the cervical tissues. The second name is preinvasive cervical cancer.
Symptoms
As with any other oncological disease, in the initial stages, a woman can feel completely he althy. However, sometimes there are symptoms such as:
- weakness,
- appetite reduction,
- fever without signs of a cold.
With invasive cervical cancer, the symptoms are more pronounced, because the tumor is actively progressing and this cannot but fail in the organs and systems of the body, causing certain signs of the disease, namely:
- Suspicious vaginal discharge that has an unpleasant odor and contains blood fragments.
- Unpleasant vaginal odor.
- Menstrual-like blood in the middle of a cycle, after intercourse or a gynecological examination (especially common in invasive squamous cell nonkeratinizing cervical cancer).
- Pain when urinating or defecation.
- When fistulas occur in the walls of the vagina, fragments of feces may appear in the urine.
Diagnosis of disease
Bmedicine, there are many ways to examine a woman for malignant tumors in the cervix, however, to make an accurate and final diagnosis, it is necessary to conduct a whole range of examinations, consisting of laboratory tests and diagnostic procedures.
The optimal set of measures is a colposcopy, histology, tomography of various organs. Let's consider each method in more detail.
Colposcopy
A diagnostic method in which the doctor examines the walls of the vagina and cervix using a special device - a colposcope. It is a binocular capable of magnifying the image up to 20 times, and a light source.
During the procedure, the specialist examines the color of her, their appearance, the presence of lesions, their nature, size and boundaries of education, if any.
All this allows:
- Evaluate the general condition of the female genital organs and vaginal microflora
- Determine the nature of the formation (benign or malignant).
- Take a swab and biopsy for further study of cell formation.
Histological analysis (biopsy)
Considered a crucial method in the diagnosis of invasive cervical cancer. Without it, the doctor cannot make a final diagnosis, but only suggests the development of the disease.
Using a scalpel, the specialist takes a piece of malignant tissue along with a he althy area. After which the receivedThe material is examined in detail under a microscope. Based on the results of the analysis, a verdict is issued.
With a positive histological analysis, there is no doubt that the patient has cervical cancer. However, in practice there are cases when the result of oncology was negative, but there were clinical signs of cervical cancer.
In this case, despite the fact that the biopsy did not confirm the presence of malignant cells, the oncologist prescribes anti-cancer treatment to the patient. A negative result in this case only indicates that malignant fragments did not get into the piece of tissue that was taken during the biopsy.
To avoid such situations in oncological gynecology, the biopsy method is increasingly being used using a special gelatin or cellulose sponge, which effectively captures epithelial cells, including malignant ones. Then the sponge is treated with a 10% formalin solution, embedded in paraffin and examined under a microscope.
Different types of tomography
Magnetic resonance imaging (MRI) of the pelvic organs is used. This method gives the most accurate idea of the nature of the tumor, its size, the degree of invasion, the transition to neighboring organs. Therefore, when diagnosing the disease to which this article is devoted, it is preferable to conduct it rather than computed tomography (CT).
In case of detection of formation of secondary malignant foci (metastases) in the lymph nodes, it is possible to perform computed tomography of the abdominal cavity, as well as the retroperitoneal space. In this casethe accuracy of the results of these two methods is the same.
Positron emission tomography (PET or PT-CT). It is the newest and most effective method for diagnosing many malignant diseases. Cervical cancer is no exception. For example, the method is able to detect even education at the earliest stages of its development, even before the first symptoms appear. PET also gives an idea of the development of metastatic lesions and their boundaries with an accuracy of one millimeter.
Treatment
There are several treatments for invasive cervical cancer. As with any other cancer, there are three main ways.
Surgery
The priority method of treating a tumor is surgery to excise a malignant formation.
Before the operation, it is mandatory to prescribe exposure to radioactive gamma rays, which negatively affect malignant cells, destroying them. This can lead to a reduction in the size of the tumor, as well as a decrease in the degree of its aggressiveness.
Before the operation, the size of the tumor and its boundaries must be studied in order to have an idea of the scope of the work ahead and the choice of treatment tactics
Depending on this, a certain type of surgical intervention is selected. In the event that only amputation of the cervix can be dispensed with, then it is removed using one of the following methods:
- Laser.
- Radiosurgical.
- Ultrasonic.
- Amputation with a knife.
- Cryosurgery.
If the tumor has spread to neighboring organs, it is possible to perform the following types of surgery, depending on the scale of the work to be done:
- Removal of the cervix along with the label, ovaries and tubes.
- Removal of the cervix along with the mark, lymph nodes and part of the vagina.
Irradiation Therapy
In addition to being an adjunct to surgery, this method can be used as a primary anti-cancer therapy.
Radiotherapy is especially effective in the first two stages. With invasive cervical cancer, in addition to it, as a rule, they also resort to chemotherapy. The combination of these two methods is especially important for patients with inoperable cancer, as well as for operated women in order to prevent recurrence.
Chemotherapy
Can be used at all stages of the disease, as well as before surgery. Chemical preparations have anticancer activity and are able to reduce the size of the tumor, prevent or stop the process of metastasis. It is also the mainstay of therapy for women with invasive cervical cancer, as well as patients with the fourth stage, when the malignancy is not operable and there are many metastases.
The most commonly used drugs for cervical cancer are Cisplatin, Fluorouracil, Vincristine, Ifosfamide and others. Especially their userelevant for invasive cervical cancer.
Survival forecast
The presence of a malignant neoplasm on the neck is a serious disease that, with late diagnosis and untimely treatment, can take the life of a woman.
So, if the detection of cancer at the first or second stage is 78% and 57%, respectively, then with invasive cervical cancer, the prognosis is less favorable. After all, when the tumor has already grown deep enough, it begins to metastasize to the nearest and separated organs. Therefore, the survival rate is 31% in the third stage and only 7.8% in the fourth.
Thus, the overall percentage of survivors among patients with this pathology, the survival rate is slightly more than half (55%).
Conclusion
Invasive cervical cancer is a serious disease that is usually detected very late. Despite the large number of diagnostic methods, the availability of various methods of therapy for this pathology, the survival rate remains not very high. Therefore, in order to avoid the fate of many women, one should regularly undergo examinations by a gynecologist, as well as take appropriate laboratory tests.
