What is cervical cancer

Every 8-11 women out of 100,000 during the inspection and examination revealed cervical cancer. According to statistics, the prevalence of cervical cancer is second only to the malignant breast tumor.

In most cases, the pathology is detected during the inspection at an advanced stage. Early stages in the process of inspection are not characteristic features. Thus, the cervix usually looks unaltered. Determine the disease at an early stage is possible only by instrumental and laboratory methods.

Cervical cancer involves the emergence and development of malignant tumor cells, which is often located in the vaginal area. Oncology patients Usually strikes after forty years. Gynecologists say that the risk of age-related disease in women is about 20 times higher than that of girls, for example, in 25 years. However, the young representatives of the early stages detected more frequently.

The disease is at an early stage detected in 15% of cases. When viewed from is recorded up to 40% of cases of advanced disease. In the latter stages of the examination the cervix looks specifically, which indicates the possible presence of cervical cancer.

Pathogenesis

Cervical cancer in the medical literature is also called carcinoma. The tumor develops from cells that are part of the epithelium. The cervix is ​​covered by two types of epithelium:

• cylindrical;
• flat.

Cylindrical multilayered epithelium covers the cervical canal, which is located inside the cervix. Epithelial cells of the mucous give a reddish hue and kind of velvet. Moreover, inside the cervix actively functioning glands that produce mucus continuously. This protective mucus and the narrowness of the cervical canal provide a protective mechanism.

The neck looks like a muscular tube that connects the uterus and vagina. This compound is provided cervical canal. The upper edge of the channel forming an internal throat opening into the uterine cavity. The lower edge forms the outer mouth that opens into the vagina.

Vaginal part looks when viewed as a portion with a pale pink, smooth epithelium. Supravaginal part is not visualized during the inspection. Stratified squamous epithelium lining the vaginal portion of the cervix is ​​represented by several layers:

• basal, containing young immature cells rounded shape with one round large nucleus;
• intermediate, consisting of flattened cells maturing;
• surface, comprising old cells matured flat shape with a small core which may exfoliate and update epithelium.

Negative factors internal and external influence on epithelial cell structure. When cells become misshapen and the number of nuclei increases, they can not function adequately. Thus dysplastic develops a process which can lead to cancer.

The severity of dysplasia is defined by three degrees.

1. There are light violations that occur in the defeat of one third of the epithelial layer. The development of cervical cancer can occur after five years.
2. There have been violations of moderate severity. Defeat covers most of the epithelial thickness. Cervical cancer can be diagnosed in three years.
3. Defined severe disorders as epithelium completely amazed. The occurrence of cervical cancer occurs in the course of the year.

Dysplasia is a precancerous process. However, when mild changes are usually reversible. When strong immunity usually cervical cancer does not develop. In the second and third degree regression unlikely.

When dysplastic processes during the inspection of the cervix may look unchanged. That is why the examination of a gynecologist includes a number of studies to exclude dysplasia and cervical cancer.

tissue malignancy involves several steps.

1. There active cell division at the site of damaged tissue.
2. Occurrence dysplasia, embracing the cell structure.
3. The occurrence of malignant change, which results in uncontrolled cell division of epithelial cells. Thus, it develops preinvasive cancer.
4. The penetration into the stroma of malignant tumors and the formation of microinvasive cancers.
5. Germination of malignant cells into the stroma more than 3 mm. Developing invasive cervical cancer. At this stage of the clinical symptoms appear. The cervix looks sometimes altered, allowing the physician to suspect oncology at the examination.

At an early stage cervix may look when viewed normally. However, an experienced physician, through conducted research can determine the pathology. Early treatment is the key to its success.

Factors and causes

There are many factors that can lead to disease. Numerous studies have established that the main cause of the degeneration of cells and the formation of cancer is the human papilloma virus (HPV).

The virus is transmitted primarily through sexual contact. After infection, it enters the cell and may cause it change. The probability of these changes depends on the particular strain of HPV.

There are more than a hundred subtypes of HPV. Some of them possess producing action, thereby contributing to the formation of papillomas, and warts. Others cause cellular degeneration. Nevertheless, the HPV strain can be divided into three groups according to their ability to cause degeneration of cells:

• strains with high tumorigenicity;
• species with an average level of tumorigenicity;
• subtypes of low-tumorigenicity.

Cause cervical cancer are 16 and 18 subtype in most cases. And cervical cancer usually appears unchanged during the general gynecological examination. That is why it is necessary to visit a gynecologist in a timely manner, to inspect and carry out the necessary research.

Contribute to the development of cervical cancer are the following factors:

• weakened immunity;
• smoking;
• combination of several genital infections, such as herpes and HPV;
• multiple sexual partners;
• early sexual activity;
• multiple births;
• abortion and other interventions in the cervix;
• chronic inflammatory processes;
• Background Cervical diseases, in particular, and pseudo leukoplakia;
• benign tumors, including polyps.

It is noteworthy that the lack of hygiene of sexual partner also seen as a factor in the development of cervical cancer. Accumulated under the foreskin smegma has on the stratified squamous epithelium of a carcinogenic effect.

species

Classification cervical cancer includes several varieties, which are defined according to various criteria. According to the morphological structure of cervical cancer is:

• keratinizing squamous;
• neorogovevayuschy squamous;
• low-grade;
• adenocarcinoma, or glandular.

Stratum form a high degree of maturity of the cells. This type is more favorable in terms of prognosis. However, it neorogovevayuschy form is most common. Its incidence is about 65%.

Adenocarcinoma, which develops in the region of the cervical canal occurs in approximately 15% of cases. Squamous embodiment is diagnosed in approximately 85% of clinical cases.

Gynecologists emphasize that high-grade cervical cancer, a high degree of their malignancy, is quite rare. In this connection, most species of cervical cancer with timely examination and diagnosis, adequate treatment have a favorable prognosis.

For more rare types of cervical cancer include:

• mukoepidermoidny;
• clear cell;
• small cell.

The prevalence of such forms do not exceed 1.5%.

The prognosis of cervical cancer affects both the speed and the direction of the growth of tumors. Taking into account the tumor growth direction are the following options:

• endophytic, implying the development inside the transition to uterine body vaginal wall and appendages;
• exophytic, meaning the progression into a vaginal lumen;
• mixed.

From what direction is the growth of malignant tumors, the cervix may look different. That is why some forms are determined during the inspection. And the other - no.

stage

The severity and the prognosis is favorable defined stages. The differentiation process depending on the stage is essential to the preparation of the treatment plan.

Gynecologists distinguish several stages in which there is also a certain gradation.

• stage 0 It means preinvasive cancer, coinciding with the third degree of dysplasia. Clinical symptoms and signs may be absent during the inspection. Often the cervix looks no characteristic changes. There is a lack of penetration into the stroma of malignant cells. Treatment at this stage may lead to a complete cure.
• stage 1 It means microinvasive cancer. Several distinct subtypes, depending on the depth of invasion. A1 - invasion to 3 mm. A2 - infestation to 5 mm. In the case of germination than 5 mm, say about B.Naprimer embodiment, B1 - invasion to 4 cm. B2 - invasion more than 4 cm. In this case, the affected cervix looks.
• stage 2 characterized by lesions of the uterus. And - without germination in parauterine fiber. B - with germination in the parameters.
• stage 3 characterized by involving the lower third of the vagina, kidney and pelvic wall. A - it affected only a third of the vagina. In - the development of hydronephrosis.
• stage 4 accompanied by the spread of cancer to other organs. And - in the defeat of the pelvic organs and other systems. B - presence of metastases.

At an advanced stage in the pathological process involved pelvic lymph nodes. To determine their involvement conduct research at least ten nodes.

step defined by viewing the data, colposcopy and biopsy. Instrumental studies are complementary. Sometimes there are difficulties in relating to a specific disease stage. In this case, experts give an easy stage.

Symptoms and signs of external

More than 10% of cases of cervical cancer are asymptomatic. This means that the symptoms are absent, and the cervix may look unremarkable. Can detect abnormalities only when viewed through a special equipment and with the aid of instrumental and laboratory methods.

The degeneration into a malignant tumor takes up to ten years. With regular inspection and examination by a gynecologist doctor can recognize the symptoms of the disease by the way looks neck. This greatly increases the chances of successful treatment.

The transition from one stage to another It takes an average of two years.

Manifestations of cervical cancer usually occur in the third step. The patient may notice the following symptoms:

• spotting or bleeding acyclic nature;
• watery or meat slops color separation, which may have an unpleasant smell;
• contact separation during inspection and intimacy;
• whites due to damage the integrity of the lymphatic capillaries;
• pain in the abdomen, lower back and sacrum due to compression of nerve endings, the spread of malignancy;
• disruption of the urinary bladder and the rectum, which is manifested by constipation, frequent urination, and the emergence of pain;
• swelling of the extremities;
• prolonged low-grade fever;
• weakness;
• fast fatiguability.

Cervical cancer can be complications that are an indication for hospitalization:

• excessive bleeding;
• bowel obstruction;
• acute renal failure in shape;
• strong pain.

External signs during the inspection is not always present since the early stages of the disease does not manifest itself. At advanced stages of the cervix during the inspection it looks uncharacteristically, its shape is often barrel-shaped. In addition, the cervical mucous may look the affected:

• color non-uniformity;
• expressions of the presence;
• elevations;
• seals.

During the inspection of the cervix may appear contact discharge. The gynecologist may also notice whites, purulent discharge with an unpleasant putrid odor which indicate disintegration of the tumor.

If the cervix is during the inspection looks unaltered, can help in the diagnosis of modern research methods.

methods of diagnosis

Timely diagnosis can effectively treat the disease and increase the chances of a cure. Diagnosis of cervical cancer includes a set of necessary studies, as well as auxiliary methods. The basis of the survey are a few basic methods of diagnosis.

Gynecological examination

This baseline study allows many to suspect the disease by the way looks cervical mucus. Nevertheless, the doctor takes into account that visually identify the disease in its early stages is not always possible. The cervix may appear without the characteristic symptoms. However, with advanced forms can be visualized expressions, heterogeneity and elevation color. In cancer of the cervix often looks barrel-shaped. Nevertheless, thanks to the peculiarities of the tumor growth may look somewhat different.

cytological examination

This screening method of diagnosis, which complements the gynecological examination. The cervix may appear unaltered, but is lined with cells with signs of atypia. Smear on onkotsitologiyu reveals abnormal cells and to conduct timely treatment. Smear taken from different areas of the cervix cytobrush, and then applied to the glass. In the laboratory, the biological material is carefully examined under a microscope. Cytological examination, as well as a general inspection is recommended every six months.

colposcopy

Colposcopy is an examination of cervical mucus under a microscope. The study is carried out using a colposcope. It is known that visually cervix may look without pathological changes. Colposcopy allows us to consider in detail the epithelium.

If necessary the expanded version of the procedure. Mucous treated with a solution of acetic acid. At the same plots, the affected papillomavirus acquire a whitish color. Lugol's solution was then applied. According to information received colposcopic picture can identify areas with atypia. Stunned by the mucosa is not stained with brown and looks like a stain.

On the affected areas need to take a sample of tissue for subsequent histological examination. Such analysis is called a biopsy. This study is to determine the malignant process.

Additional tests They include ultrasound test to determine tumor marker, MRI, CT and X-ray light. In some cases, you may need to study the bladder, bowel, and consultation with other professionals.

Treatment

Therapeutic measures are assigned to each patient individually. The choice of treatment depends on the patient's age, its individual characteristics and severity of the disease.

Treatment is carried out by the following methods:

• surgical;
• irradiation in combination with the intervention;
• radiotherapy;
• chemotherapy.

At an early stage it is carried out surgery and irradiation. It is noteworthy that young women preferred to appoint surgery gentle nature.

Surgical intervention

Non-invasive and microinvasive cancer treated with cone biopsy or cervical amputation in young patients. In the second and subsequent runs degree amputation of uterus and appendages. In severe lesions removed the surrounding tissue, lymph nodes, ovaries. The intervention may be performed by laparoscopy.

Radiotherapy

Irradiation is carried out both before and after the intervention. Before surgery, radiation therapy can reduce the magnitude of neoplasms. After the intervention of exposure is necessary to eliminate the remaining cells.

Radiotherapy is:

• remote;
• intracavitary.

The combination of these techniques with the impossibility of operation.

By irradiation effects include:

• atrophy, causing the cervix looks istonchonnoy;
• ovarian failure, which can cause infertility;
• premature menopause;
• the formation of pathological communications between the vagina and surrounding tissues.

Chemotherapy

Usually, chemotherapy is used after surgery. However, preparations in the framework of chemotherapy can be administered before surgery to reduce the size of education. As a rule, conducted by chemotherapy after the tumor is less bulk, which facilitates the operation and the recovery period. Chemotherapy can be used as an independent method of treatment. In particular, in advanced stages only used chemotherapy, which is experimental.

Treatment also includes compliance with certain lifestyles, such as diet. It is recommended to eat foods rich in antioxidants, green tea, fruits and vegetables. Highly undesirable consumption of refined carbohydrates, canned foods, fatty foods and alcohol.

After conducted treatment of a woman's body is recovered in the course of the year. Doctors recommend avoiding infections, emotional and physical stress.