hypertension, smoking, infection with papilloma virus
person with HIV, early sexual activity, and late menopause
menstrual irregularities, infertility, a large number of
sexual partners, early first birth, sexually transmitted diseases,
acceptance of oral contraceptives.
One of the most important risk factors is obesity:
female weighing in excess of the rate of 10-25 kg, the risk of
endometrial cancer 3 times higher than the normal body weight, while the
Women with excess body weight more than 25 kg in disease risk 9
Widely known precancerous conditions,
playing a significant role in the occurrence of cervical cancer. This erosion,
ulcers, scars after birth trauma, epithelial growths (warts,
polyps) and leukoplakia, and chronic inflammatory processes -
endocervicitis and endometritis.
What is cervical cancer?
the nature of the uterine epithelium of various departments distinguish between squamous
cancer of the cervix and glandular cancer (adenocarcinoma) of the cervical canal and cavity
uterus. Adenocarcinoma - the main morphological variant (70%).
It should be noted that a relatively rare tumor, affecting the uterus,
It is a sarcoma. There are three degrees of tumor differentiation
(Highly differentiated, moderately differentiated and
When cancer of the uterus are 4 stages of development:
- Stage I - the location of the tumor in the body of the uterus,
- Stage II - the body and damage the cervix,
- II stadiya- spread on parametrial tissue or metastasized into the vagina,
- Stage IV - spread beyond the pelvis, the germination of the bladder or rectum.
What appears uterine cancer?
symptomatology consists of complaints about the whites, bleeding and pain. but
all three of these symptoms occur in the decay period of the tumor, and time
appearance depends on the date of commencement of ulceration. Therefore, in some cases
for an extended period of uterine cancer can not give any symptoms.
There are various character: watery, mucous, blood stained,
no odor and foul-smelling. The admixture of blood gives belyam kind of meat slops.
Delay secretions in the vagina and join the infection leads to
the appearance of purulent leucorrhea with the scent. In cancer, III and IV isolation steps
carry out a putrid nature of the genital tract. Bleeding can wear
the nature of small bleeding, as well as single or
multiple heavy. For cervical cancer are very typical way
called contact bleeding (during sexual intercourse, when
douching, vaginal examination or after the lifting of gravity). If
the woman has stopped menstruating, then the appearance of bleeding
vaginal discharge in most cases is a sign
The pains are late
symptoms suggestive of involvement in the cancer process
lymph nodes of the pelvis and fiber forming infiltrates
compressing the nerve trunks and plexus. Common symptoms and, in particular,
cachexia (weight loss) occur very late, in a very
advanced stages, and usually women suffering from cervical cancer, retain
apparently flourishing, healthy appearance.
As revealed cancer of the uterus?
uterine cancer begins with the study of patient complaints and course of the disease. In all
suspected by history cases, patients are subject to immediate
examination by a gynecologist. It is unacceptable to assign any
Treatment of such patients without a detailed examination.
The survey includes vaginal bimanual study, rectal bimanual research and examination with the help of mirrors.
vaginal examination in cases fairly pronounced tumor
the process can not determine these or other changes in the cervix, depending
from the growth of the tumor type (exophytic, endophytic and mixed). how
Generally, the study is accompanied by bleeding as a result of
injury tumor exploring finger. In advanced disease
uterus additionally conduct research through the rectum for
clarify the transition of the tumor on the pelvic wall and sacro-uterine ligaments.
To detect early stages of cervical cancer
can not be limited to vaginal examination; necessarily
carrying out inspection by means of mirrors. To detect early cancers in
all cases of any changes in the cervix take swabs for
cytology or biopsy. If cancer is suspected,
the cervical canal and the uterine cavity is performed diagnostic separation
curettage of the cervical canal and uterine cavity and subsequent
These studies can be carried out already in the clinic if
necessary tools and aseptically. For
illustrate the importance of a comprehensive survey is sufficient to indicate that
Cervical cancer remains undiagnosed in more than half of the patients,
which the survey was only two-handed vaginal
study. At the same time, when viewed by a number of errors in the mirror
diagnosis decreased almost 5 times, and when they use biopsy
observed only in rare cases.
In recent years, widespread
distribution and importance acquired ultrasound imaging
(US), allowing to identify the changes in the uterus are not available to others
research methods and has become a mandatory method of research at
any suspected benign and malignant neoplasms in
To establish the lymph nodes and
metastasis, which is very often accompanied by cervical cancer, have resorted to
X-ray methods - lymphography and ileokavagrafii. For the same
order to carry out X-ray of the chest, intravenous
pyelography, ergography, cystoscopy and sigmoidoscopy. maybe
conducting CT, MRI, limfangiografii, fine needle biopsy of the tumor.
These studies are very important in cancer of the uterus to develop a plan of radiation or combination therapy.
How to treat uterine cancer?
treatment depends on the patient's age, general condition and clinical
the stage of cancer. Treatment is mainly surgical (hysterectomy with
appendages and sometimes the removal of the pelvic lymph nodes). maybe
combined treatment - surgery, radiation and then remote to
the vaginal stump, intracavitary gamma therapy. Wires and
preoperative radiotherapy mainly in stage III.
Radiation therapy as an independent method is used in the local
dissemination of the tumor process, with contraindications to surgery.
Anticancer drugs are effective in low-grade
tumors at stages III and IV disease.
When cervical cancer with the same successprovide treatment as a method of combined radiotherapy and surgery (extended hysterectomy with appendages). Treatment depends on the stage of the disease. In Ia stage (microinvasive carcinoma) produce a hysterectomy with appendages. In stage Ib
(The cancer is confined to the cervix) is shown the remote or intracavitary
irradiation followed by extended hysterectomy with appendages,
or conversely generate first operation and then the remote
In stage II (involvement
the upper part of the vagina, a transition to the body of the uterus and infiltration
option without going to the pelvic wall) the main treatment
It is radiation, surgeryrarely used. In stage III (the transition to the lower part of the vagina, infiltration parameters with the transition to the pelvic bone) shows radiation treatment. Finally, in step IV
(Transition to the bladder, rectum, or distant
metastasis) apply only palliative radiation. In late
symptomatic treatment stages may use
mandatory periodic visits to the doctor for examination bodies
pelvic and swabs. Also, the study include X-rays
of the chest, ultrasound and intravenous pyelography. During
First, the physician visits every 3 months, then for 5 years -
every 6 months. After 5 years, control is carried out annually.
if the process is localized, carried out a partial or total pelvic
exenteration (removal single unit uterus, cervix, vagina,
The parameters of the bladder and the rectum). If you have a remote
metastases, patients usually receive chemotherapy. Radiation therapy can be
used for the palliative treatment of painful metastases.
tumors often metastasize to the pelvic lymph nodes, at least in
inguinal. Distant metastases are more often in the kidneys, liver, lungs, have
uterine cancer 5-year survival rate after surgery from 84 to
45% depending on the stage of the disease. In 25% of patients relapse,
initially underwent surgery, may be spared
from relapse using pelvic radiotherapy. at
cure metastatic relapse cases are extremely rare, and
the therapeutic effect is unique and short. In stage IV disease
5-year survival rates - up to 9%.
diagnosis and prevention of cervical cancer are only possible through
systematic preventive examinations of all women older than 30 years (not
at least 2 times per year). it is desirable to begin regular surveys
onset of sexual activity. Regular checkups, ultrasound imaging and
cytology (every 2 years) facilitate the identification
precancerous diseases and their treatment - prevention of cancer.
Equally important is the timely and correct treatment
cervical precancers. Especially characteristic features,
unique to precancerous cervical disease, no, they
proceed as normal inflammatory diseases. common to
precancerous disease symptoms are chronic long-term
for, persistence of symptoms, and most importantly the lack of effect on
conservative (anti-inflammatory) treatment. Treatment of precancerous
cervical disease should be radical and is
electrosurgical, electrocautery lesions or even
cervical amputation. Resorts to the ray method of treatment in the form of
applicative radium therapy. Among patients treated by radical
about the various precancerous lesions, cervical cancer mortality
It decreased by 6 times.