Cervical cancer is a formidable disease, and the statistics of the diseased are disappointing and progressing every year. Still dangerous and common are cases of detection of the disease in the late stages - according to various sources, the values \u200b\u200bof the indicator vary up to 50%, but even at this stage the disease can be defeated. And the simplest knowledge of the distinctive symptoms will help to be fully equipped and prevent the development of the disease.
It can be concluded that the mortality among women is quite high with cervical cancer. The WHO classification is presented in this article.
Cervical cancer is a malignant tumor. According to the results of histology, squamous cell carcinoma and adenocarcinoma are distinguished (the origin of the neoplasm is from the glandular epithelium).
Cervical lesion leads in frequency of occurrence among all neoplasms of female organs.
There is a proven direct link between havingpapillomavirus in the body and an increased risk of oncopathology of the cervix. Also, the risk of developing cancer directly increases the multiple change of sexual partners and the average age in women (the peak is between 35 and 55 years). Currently, cases of detection of the disease at a young age have become more frequent.
Classification: standards
The standard international classification of malignant tumors is used to classify cervical cancer. It is called the TNM classification. The TNM classification of cervical cancer is adopted in the international designation. And FIGO is the international federation of obstetrics and gynecology. Turning to the classification of cervical cancer according to the TMN system, it is worth deciphering that T denotes the size of the primary neoplasm. N indicates the presence of affected lymph nodes, and M indicates the presence of metastases.
TNM and FIGO
Classification of cervical cancer by stage and FIGO is as follows:
| Tx | There is not enough data to clarify the nature of the tumor. |
| T0 | Primary tumor undetectable. |
| Tis | Intraepithelial carcinoma. FIGO stage 0 cancer. |
| T1 | Tumor in the cervical cavity; 1 stage according to FIGO. |
| T1a | Invasive tumor. FIGO stage 1a. |
| T1a1 | Sprout up to 3.0mm in fabric and up to 7.0mm outside. FIGO stage 1a1. |
| T1a2 | Invasion up to 5.0 mm, and up to 7.0 mm outside. FIGO cervical cancer stage 1a2. |
| T1b | Clinically confirmed lesion limited to cervix; microscopically, a greater lesion of the site than T1A / 1A2 is possible. FIGO Stage 1b. |
| T1b1 | The lesion reaches 4 cm. FIGO stage 1b1. |
| T1b2 | Lesion greater than 4 cm. FIGO stage 1b1. |
| T2 | The tumor spread beyond the uterus, no invasion of the pelvic wall and the lower third of the vagina was recorded. FIGO stage 2 |
| T2a | Without secondary foci of distribution. FIGO stage 2a. |
| T2b | With secondary foci of the tumor process. FIGO Stage 2b. |
| T3 | Cancer with germination of the tumor on the pelvic wall; the lower third of the vagina is affected, the kidney function is impaired. FIGO stage 3. |
| T3a | The lower third of the vagina is affected without spreading to the pelvic wall and damaging the kidney. FIGO Stage 3a. |
| T3b |
The tumor penetrates the walls of the pelvis and leads to hydronephrosis of the kidney. FIGO Stage 3b. |
| T4 | Urinary system and/or rectum affected; the tumor may extend beyond the small pelvis. FIGO stage 4a. |
| M1 | Multiple and distant metastases. FIGO Stage 4b. |
ICD classification
The following article presents the classification of cervical cancer according to the ICD (International Classification of Diseases):
| C53 | General classification for malignant neoplasms of the cervix |
| C53.0 | In the inner region of the cervix |
| C53.1 | Outer area affected |
| C53.8 | The lesion extends beyond the cervix |
| C53.9 | Neoplasm of unspecified area |
Etiology
Predisposing factors for cervical cancer are:
- HPV infection.
- Early onset of sexual activity.
- Having more than 3 sexual partners per year.
- Smoking.
The provocateur of cancer development is the human papillomavirus type 16 and 18. In almost 80% of cases with cervical cancer, these types of virus are present in the body of a woman. The most common mode of infection with the virus is sexual. Often, contraceptive methods do not guarantee 100% protection againstHPV infection.
HPV infection through sexual contact occurs in 75% of cases, but the body's immunity is 90% able to resist it and quickly destroy it. And if the virus manages to overcome the immune barrier and enter the body, a persistent slow course of the disease occurs, followed by changes in the epithelium of the cervix.
According to the results of observations, it can be concluded that the presence of more than 10 sexual partners in a woman's life increases the risk of developing cervical cancer by 3 times. It is also worth noting that women suffering from HPV confirmed that their regular sexual partners had more than 20 sexual intercourses in their lifetime, which is 5 times more often than a normal male sexual constitution.
Clinical picture
The danger of the disease lies in the fact that in the early and even later stages, the symptoms are either absent, or they are, but the person does not attach importance to them. Having become accustomed to discomfort, the patient considers them something ordinary and arising from time to time. Suspecting something was wrong and worried, they usually get to the doctor with the following symptoms:
- Patient complains of discomfort and pain in the pelvic area.
- Notes spotting unrelated to menses.
- The duration and nature of the menstrual cycle changes.
- Bleeding after vaginal examination by gynecologist.
- There is pain and bleeding during intercourse.
- Presence of abnormal vaginal bleeding.
- The occurrence of bleeding duringvagina after menopause.
The symptoms above are conditional, some of them may be absent, some are more pronounced than others. Typically, such clinical symptoms are accompanied by the following systemic disorders:
- The patient notes rapid fatigue and increasing weakness.
- Notices dramatic weight loss.
- Long-lasting subfebrile condition.
- A blood test indicates reduced hemoglobin, anemia and elevated ESR.
The more dangerous the disease and the more difficult the course and outcome of the disease, the fewer symptoms present in the patient's history - she seeks help from specialists when the tumor has already taken root in the body and begins its destructive effect. Late diagnosis and prolonged treatment significantly worsen the prognosis of recovery.
How it happens: pathogenesis
In our body there is an amazing process of cellular renewal called apoptosis. In the human body, on average, about 60-70 billion cells die daily, they are replaced by updated ones. If dead cells are not removed from the body, are not absorbed by neighboring new ones and are retained, this leads to intoxication of the body, to the development of an inflammatory reaction. As a result of damage to apoptosis, a favorable environment for the emergence of malignant tumors. The p53 Rb gene exists in the body, which is responsible for the fight against the formation of cervical cancer. In the event that the human papillomavirus appears in the body, this geneblocked by viral proteins. Then cancer cells begin to actively and uncontrollably divide. The human papillomavirus destroys the body's antitumor defenses, thereby increasing the risk and rate of cancer.
Classification of cervical cancer: histology
Regular gynecological examinations should be mandatory: an experienced specialist is able to note any kind of deviation from the norm, even with erased symptoms and a latent course of the disease. Then he will send the patient for additional research.
The most informative diagnostic methods are colposcopy and cytological examination of the material. The specialist classifies the stage of cervical cancer according to the results of histology. The further course of treatment depends on this.
Treatments
The approach to cervical cancer treatment must be individualized and complex. The standard procedure is to perform surgery, and then chemotherapy or radiation therapy is selected, as a rule, their combination to increase the effectiveness of treatment with maintenance immunotherapy.
Prevention
Is it possible to protect yourself from the development of this disease?
Vaccination against papillomavirus infection showed high efficiency. A favorable and suitable age for its implementation is the age of 13-15 years. At present, some countries have also introduced vaccinations for boys in puberty.period.
With the increasing incidence of cervical cancer, prevention of human papillomavirus infection is vital.
It is also important to observe sexual hygiene - short-term promiscuity leads to dangerous consequences, infections are fraught with serious long-term complications. Seemingly banal recommendations for maintaining a he althy lifestyle and quitting smoking are in fact of great importance. They must be taken into account. It should be an integral part of life - not only to protect yourself from HPV infection, but to ensure better well-being, prolonging both life itself and its quality.
Regular gynecological exams and ultrasounds, Pap smears once a year, and listening to your body and paying attention to any non-specific ailments and unusual symptoms are essential.
