Cervical cancer - symptoms, signs, stages, diagnosis and treatment

Cervical cancer is a malignant tumor that forms in its epithelium. This type of oncology is extremely common in women, especially after the age of forty. In recent years, experts have recorded the process of rejuvenation of cervical cancer, which is often diagnosed in women under thirty years of age.

The cervical cancer prevalence table illustrates the diagnosis of the disease among different age groups.

The table also compares the number of cervical cancer cases in developed and developing countries.

The pathology has different stages and symptoms, and develops due to the presence of background and precancerous diseases of the cervical part of the uterus. It is noteworthy that residents of Latin America and Africa suffer from cancer of this localization twice as often as European women.

The cervix connects the vagina and the cavity of the muscular organ through a canal called the cervical canal. It has the shape of a cylinder and is divided into two parts:

• supravaginal;
• vaginal

The cervical or cervical canal is lined with cylindrical cells. The epithelium contains special glands whose function is to produce mucus. The mucus of the cervical canal protects the uterine cavity from the spread of various pathogenic microflora from the vaginal area.

The vaginal part is visualized during a gynecological examination and has squamous epithelium. This part is characterized by the presence of a special zone, representing the transition of one type of epithelium to another. It is in the area of ​​transformation that cervical cancer often occurs.

Cervical cancer develops due to cell mutation. Epithelial cells, under the influence of unfavorable factors, lose their round shape. Changes also affect the cell nucleus. Normally, a mature cell has one large nucleus. As atypia develops, the cells become atypical. Several nuclei may be observed in such atypical or atypical cells.

Atypical cellular elements acquire symptoms of malignancy over time. Such processes are characterized by the rapid division of immature cells, which are characterized by aggressiveness.

What is uterine cancer

In medical terminology, uterine carcinoma is the development of a malignant tumor in the female genital organ. It is the main one for bearing a child and is responsible for a woman’s reproduction. In appearance, the uterus resembles a hollow, flattened sac with an angle, consisting of a body and a cervix. Inside, it is lined with endometrium, which is shed and released out with each menstruation. Oncology of this organ is extremely dangerous and can lead to death.

Causes

Doctors have identified a number of reasons that influence the occurrence of cancer inside the uterine cavity and cause the rapid growth of cancer cells:

• absence of childbirth;
• obesity;
• diabetes;
• taking hormonal medications due to hormonal imbalance, but not birth control pills;
• infertility, menstrual irregularities;
• early menstruation and late menopause;
• polycystic ovaries, their tumors;
• breast cancer due to lack of breastfeeding;
• hereditary colon cancer without polyps:
• past endometrial dysfunction;
• age over 45 years;
• difficult pregnancies, miscarriages, abortions.

Classification

According to oncological data, there are several types of classifications of malignant neoplasms:

1. According to the morphological form - adenocarcinoma, sarcoma, clear cell (mesonephroid) adenocarcinoma, squamous cell carcinoma, glandular squamous cell oncology, serous, mucinous, undifferentiated cancer.
2. According to the form of growth - with predominantly exo- or endophytic, mixed autonomous growth.
3. By localization - in the area of ​​the bottom, body, lower segment.
4. According to the degree of differentiation (the lower, the worse) – highly differentiated, moderately differentiated, poorly differentiated cancer.
5. According to the ICD code, according to the FIGO classification - its own types with digital and letter codes.

Forecast

In 90% of cases, cervical and ovarian cancer is completely cured through surgery and subsequent radiotherapy. If cancer is detected in time, it is possible to prevent the development of metastases and improve the survival prognosis. Depending on the stage, the prognosis will be as follows:

• in the first – 78% of patients survive the first five years;
• on the second – 57%;
• thirds – 31%;
• fourth - 7.8%.

Stages of uterine cancer

Oncology develops gradually, starting from stage zero, when only the first rudiments of cancer cells can be detected. The main stages of development are considered:

• first – the tumor affects the endometrium or grows into the muscle layer (myometrium);
• the second is the development of a tumor on the neck (collus uterus);
• third – the cancer goes beyond the uterus, spreads to the vagina, pelvic or lumbar lymph nodes;
• fourth - germination into the bladder, rectum;
• metastasis – the appearance of metastases in the liver, lungs, and inguinal lymph nodes.

Endometrial cancer

A malignant tumor of the mucous membrane lining the cavity from the inside is the initial cancer of the endometrium of the uterus. It occurs after menopause, 72% of detection occurs in the first stage. The cause of development is estrogenization - due to an excess of the female sex hormone, endometrial hyperplasia begins. Types of endometrial oncology:

• simple hyperplasia without atypia;
• complex adenomatous without atypia;
• simple atypical – precancerous condition of a malignant neoplasm (MN);
• complex atypical – degenerates into cancer with a probability of 80%.

Cancer of the uterus

The next stage after damage to the endometrium is considered to be a tumor of the uterine body. Oncology of the uterus develops from the tissues of the mucous membrane (adenocarcinoma) or muscular tissue (leiomyosarcoma). The growth of a malignant tumor occurs in the fundus, isthmus, and uterine cavity. Cells metastasize to adjacent tissues, to the cervix, fallopian tubes, ovaries, lymph nodes, and blood vessels.

Cervical cancer

A malignant tumor often found in women is cervical cancer. 85% of its cases are due to the emergence of neoplasms from flat epithelial cells, the remaining 15% are adenocarcinoma, arising from cells that produce mucus. There are exo- and endophytic forms that affect the vagina or uterine body. The papillary type is characterized by the growth of small papillae (looks like cauliflower), and the crater-shaped type is characterized by the covering of the tumor with ulcers and a gray coating. The cause of tumor growth is often the human papillomavirus (HPV).

Uterine and ovarian cancer

After damage to the cervix and in the absence of treatment, oncology reaches the ovaries, which serve to produce hormones. The disease is asymptomatic, but can manifest itself in pain, constipation, and compression of the bladder. Types of ovarian oncology:

• mucinous;
• serous;
• endometrioid;
• Brener's tumor;
• clear cell;
• mixed epithelial;
• carcinoma;
• sex cord stroma;
• lipoid cell;
• soft tissue lesions;
• germinal;
• secondary;
• gonadoblastoma;
• cysts.

An ovarian tumor develops in one organ, quickly spreads to the second, and affects one of them completely. The formation affects the fallopian tubes, body, and abdominal cavity. The third stage is manifested by infection of the lymph nodes, inguinal, and ends with metastases in the liver and lungs. 80% of patients at the first stage can be successfully cured of cancer; at later stages this figure is only 10%.

Metastasis

Metastases are understood as secondary foci of growth of malignant tumors. Endometrial tumor manifests itself in three types of metastasis:

• implantation - a path of decay involving the visceral peritoneum;
• lymphogenous – damage to the pelvic lymph nodes;
• hematogenous - damage to the lymph nodes and infection of the bones, liver, lungs.

Symptoms of the disease in later stages

As the disease progresses, the symptoms of cervical cancer become pronounced and are complemented by other symptoms, such as:

• increased urge to urinate;
• the appearance of blood in the urine;
• anal bleeding;
• swelling of the legs;
• excessive sweating;
• stool disorders;
• heavy uterine bleeding that is not associated with menstruation;
• hydronephrosis, i.e. kidney damage caused by abnormal expansion of the renal pelvis due to impaired urine outflow;
• nagging pain that is localized in the lower abdomen or rectal area.

Symptoms of uterine cancer

The first stages of uterine cancer are asymptomatic; only in postmenopause can one notice acyclic uterine bleeding or heavy, prolonged menstruation. Signs of uterine cancer in the early stages are watery vaginal discharge streaked with blood. A less common symptom is pain in the pelvis and abdomen, accompanied by short duration. Older women may experience stenosis (fusion) and accumulation of pus in the uterine cavity.

First signs

Doctors identify the following first signs of uterine cancer, which characterize the disease, and if present, you should immediately consult a doctor:

• bleeding from the genitals, reminiscent of menstruation, but occurring suddenly;
• pain.

Discharge

Depending on the stage of tumor development, the type, format and volume of discharge differs, both during menstruation and pathological:

• with oncology of the uterine body - serous leucorrhoea, pain, bleeding without reference to the cycle;
• at the first stage - light one-time uterine bleeding, watery discharge, odorless mucous membranes;
• in the last stages - foul-smelling discharge, blood-stained, pus, fever.

Prevention measures

To prevent cervical cancer, the following is important:

• have as few sexual partners as possible;
• use condoms for protection;
• undergo a timely examination by a doctor.

Given that HPV is important in the development of cervical cancer, there is a vaccine against some strains of the virus. It is performed on girls and boys during adolescence before the onset of sexual activity. These are Cervarix and some others.

We recommend reading about what cervical ectropion is. From the article you will learn about the causes of ectropion, symptoms and consequences of the pathology, differences from erosion, and treatment. And here is more information about why cervical erosion occurs.

Cervical cancer is a serious disease. Detection of a tumor in the early stages helps almost everyone to completely recover from the pathology. Treatment is selected taking into account the type of tumor, its size, and the involvement of adjacent structures.

Diagnosis and treatment of uterine cancer

If symptoms of oncology are detected, you should urgently contact a gynecologist for examination and diagnosis. The doctor examines, palpates the uterus, and scrapes the cervix. The smear is examined for the presence of cancer cells; if the result is positive, the inner layer of the uterus is cleaned out under general anesthesia and a sample of the mucous membrane is performed. To confirm a cervical tumor, a CT scan is done to determine exactly where the tumor is located. Biopsy, hysteroscopy, immunohistochemical study, cytological method, MRI help to establish the etiology.

Oncology treatment is carried out in several ways, depending on the stage of development and severity of the disease:

1. The operation is the complete removal of the uterus and ovaries, if the tumor has affected them too. The fallopian tubes are removed. The surgical method leads to early menopause and deals a blow to the woman’s psyche.
2. Radiation therapy is prescribed for signs of disease after removal of the uterus. The procedure reduces the risk of cervical lesions and metastases. Radiotherapy can be carried out remotely (irradiation of all pelvic organs in several series) or internally (introduction of radioactive emitters at the site of pathology).
3. Hormone therapy – to exclude recurrence of cancer. Progesterone, hormonal drugs that reduce estrogen production, is prescribed.
4. Chemotherapy – to reduce tumor volume and in severe advanced cases.

Diagnosis of the disease

Diagnostic procedures for detecting cervical carcinoma can be divided into several stages. Initially, the gynecologist conducts an examination in a gynecological chair. After this, the patient is sent for laboratory tests. This includes both general studies, such as general and biochemical blood tests, and specific ones, including testing for HPV, as well as bacterioscopic and bacteriological examination of vaginal discharge.

To confirm the diagnosis, studies such as x-rays, renal urography, colposcopy, biopsy of cervical tissue, as well as ultrasound examination of the pelvic organs, CT and MRI can be used.

By the way, there is a so-called Pap test, which can detect carcinoma of the cervical walls at the earliest stages. The sensitivity of this method is 90%, which means that 9 out of 10 women have every chance of detecting the disease when it can be easily gotten rid of. All representatives of the fair sex aged 25–50 years are recommended to take a smear and undergo this test every 3 years.