High mortality from oncology is the main problem of modern medicine. Each year, it kills about eight million human lives. For example, cervical cancer is a malignant disease that takes third place in the number of deaths from oncology among the female population.
This diagnosis is made about 7% of women under the age of 30 years and 16% - over 70 years. In about one third of cases, pathology is detected too late when invasive cervical cancer develops.
However, over the past three decades, the incidence rate 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 treatment methods.
Causes of the disease
In almost 100% of cases, the provoking factor is the presence of the human papillomavirus in the body of a patient. However, even with the infection of a woman, oncology does not always develop.
There are a number of factors that can serve as an impetus for the onset of the development of a malignant process. These include:
- Maintaining an intimate life simultaneously with several partners or their frequent change.
- Various sexually transmitted diseases.
- The presence of HIV or AIDS.
- Start having sex too early.
- Several births with a short period of time between them.
- Past malignant diseases of the genitourinary system.
- A meager diet devoid of enough vitamins and minerals.
- Long-term use of hormonal contraceptives.
It should also be noted that the risk of developing cancerous tumors in women suffering from diseases such as:
- Leukoplakia.
- Dysplasia.
- Cervical erosion.
Such women need to be especially carefully examined by a gynecologist.
Types of disease
This pathology can be divided depending on the degree of tumor germination.
- Non-invasive cancer. Malignant formation is located exclusively in the outer layers of the epithelium, that is, literally on the surface of the neck.
- Preinvasive cancer. The tumor penetrates deeper 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 large sizes and can affect the uterus, vagina, as well as the bladder and the walls of the rectum.
This 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, cancer cells are first located on the surface of the tissues of the uterine neck. If the disease is not diagnosed in time and measures are not taken to treat it, the cells penetrate the underlying cervical tissue (parametrium).
With this form of cancer, the cervix is hyperemic, compacted and enlarged.
Normally, the neck is covered with epithelial tissue, consisting of cells of a flat structure. When exposed to any negative factors, they may degenerate into malignant forms. These forms may be different.
- In some cases, cancer cells are capable of forming the so-called "cancerous pearls" - areas prone to keratinization. And then the disease will be called keratinizing carcinoma.
- We will be talking about invasive squamous non-keratinized cervical cancer in cases where malignant cells are not capable of forming such sites.
None of the female representatives are immune from this pathology. So, for example, invasive squamous cell carcinoma of the cervix can develop during pregnancy. Therefore, this category of women is examined especially carefully.
Each pregnant woman is examined at least twice in nine months by a gynecologist who takes an analysis for oncocytology, with the help of which the composition of the cervical epithelium and the structure of its cells are studied.
It is worth noting that there may be invasive cancer of the cervix and intraepithelial form. In this case, the malignant formation is only beginning to grow deep into the cervical tissues. The second name is preinvasive cervical cancer.
Symptoms
As with any other cancer, in the initial stages a woman can feel completely healthy. However, sometimes symptoms such as:
- weakness,
- decreased appetite
- fever without signs of a cold.
With invasive cervical cancer, the symptoms are more pronounced, because the tumor is actively progressing and this cannot fail to malfunction in the organs and systems of the body, causing certain signs of the disease, namely:
- Suspicious vaginal discharge, having an unpleasant pronounced smell and containing blood fragments.
- Unpleasant odor from the vagina.
- Blood, similar to menstrual in the middle of the cycle, after intercourse or examination by a gynecologist (especially typical for invasive squamous non-keratinized cervical cancer).
- Pain during urination or defecation.
- If fistulas occur in the walls of the vagina, fecal fragments may appear in the urine.
Diagnosis of the disease
In medicine, there are many ways to examine a woman for malignant tumors in the cervical region, however, to make an accurate and final diagnosis, a whole set of examinations consisting of laboratory tests and diagnostic procedures is necessary.
The optimal set of measures is 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 an image up to 20 times, and a light source.
During the procedure, the specialist studies her color, their appearance, the presence of lesions, their nature, size and boundaries of the formation, if any.
All this allows you to:
- Assess the general condition of the female genital organs and vaginal microflora
- Determine the nature of the formation (benign or malignant).
- Take a smear and biopsy to further study cell formation.
Histological analysis (biopsy)
It is considered a crucial method in the diagnosis of invasive cervical cancer. Without it, the doctor cannot make a final diagnosis, but only involves the development of the disease.
Using a scalpel, the specialist takes a piece of malignant tissue along with a healthy area. After that, the resulting material is examined in detail under a microscope. According to the results of the analysis, a verdict is issued.
With a positive histological analysis, there is no doubt that the patient is ill with 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 used with the help of a special gelatin or cellulose sponge, which effectively captures epithelial cells, including malignant ones. Then the sponge is treated with a 10% formalin solution, poured with 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, degree of invasion, transition to neighboring organs. Therefore, when diagnosing the disease to which this article is devoted, its implementation is preferable to computed tomography (CT).
In case of detection of secondary malignant foci (metastases) in the lymph nodes, computed tomography of the abdominal cavity as well as retroperitoneal space is possible. In this case, the 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 the diagnosis of 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 onset of the first symptoms. PET also gives an idea of the development of metastatic formations 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 methods.
Surgery
The priority way to treat a tumor is surgery for excision of a malignant tumor.
Before the operation, irradiation with radioactive gamma rays, which adversely affect malignant cells, must be prescribed, destroying them. This can lead to a reduction in the size of the tumor, as well as a decrease in its degree of aggressiveness.
Before the operation, the size of the tumor and its borders 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 it is possible to manage only by amputation of the cervix, then it is removed using one of the following methods:
- Laser
- Radiosurgical.
- Ultrasonic.
- Amputation with a knife.
- Cryodestruction.
In the event that the tumor has managed to spread to neighboring organs, the following types of operations are possible, depending on the scope of the work ahead:
- Removal of the neck along with the mark, ovaries and tubes.
- Removal of the cervix along with the label, lymph nodes and part of the vagina.
Radiation therapy
In addition to the addition to surgical intervention, this method can be used as the main anti-cancer therapy.
Radiation therapy is especially effective in the first two stages. With invasive cancer of the cervix, in addition to it, as a rule, they also resort to chemotherapy. The combination of these two methods is especially relevant for patients with an inoperable form of cancer, as well as for operated women in order to prevent relapse.
Chemotherapy
It can be used at all stages of the disease, as well as before surgery. Chemicals have anticancer activity and are able to reduce the size of the tumor, prevent or stop the process of metastasis. It is also the main way to treat women with invasive cervical cancer, as well as patients with the fourth stage, when the malignant formation is not operable and there are many metastases.
Most often, with cervical cancer, drugs such as Cisplatin, Fluorouracil, Vincristine, Ifosfamide and others are used. Especially their use is relevant for invasive cervical cancer.
Survival forecast
The presence of a malignant neoplasm on the neck is a serious disease, which, with late diagnosis and untimely adoption of measures for its treatment, can take the woman's life.
So, if the detection of cancer in the first or second stage is 78% and 57%, respectively, then with invasive cancer of the cervix, the prognosis is less favorable. After all, when the tumor has already grown deep enough, it begins to give metastases to the nearest and separated organs. Therefore, survival is 31% in the third stage and only 7.8% in the fourth.
Thus, the overall survival rate among patients with this pathology is slightly more than half (55%).
Conclusion
Invasive cervical cancer is a serious illness that usually comes to light very late. Despite the large number of diagnostic methods, the presence 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, you should regularly undergo examinations by a gynecologist, as well as take appropriate laboratory tests.