Cervical cancer is a formidable disease, and the statistics of patients is disappointing and progresses every year. Cases of detecting the disease in the later stages are still dangerous and common - according to various sources, the indicator values vary up to 50%, but even at this stage the disease can be defeated. And the simplest knowledge about the distinctive symptoms will help to be fully equipped and prevent the development of the disease.
It can be concluded that mortality among women is quite high in 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).
The defeat of the cervix leads in the frequency of occurrence among all neoplasms of the female organs.
There is a proven direct link between the presence of papillomavirus in the body and an increased risk of cervical cancer. Also, the risk of developing cancer directly increases the multiple changes of sexual partners and the average age in women (the peak falls between 35 and 55 years). At present, cases of detecting the disease at a young age have become more frequent.
Classification: Standards
For the classification of cervical cancer, a standard international classification of malignant tumors is used. It is called the TNM classification. The classification of cervical cancer TNM is internationally accepted. And FIGO is an 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 tumor. N indicates the presence of affected lymph nodes, and M indicates the presence of metastases.
TNM and FIGO
The classification of cervical cancer by stages and FIGO is as follows:
Th | There is insufficient data to clarify the nature of the tumor. |
T0 | The primary tumor is not determined. |
Tis | Intraepithelial carcinoma. Stage 0 cancer according to FIGO. |
T1 | A tumor in the cervical cavity; Stage 1 according to FIGO. |
T1a | Invasive swelling. Stage 1A by FIGO. |
T1a1 | Spread up to 3.0 mm in the fabric and up to 7.0 mm on the outside. Stage 1a1 according to FIGO. |
T1a2 | Invasion up to 5.0 mm, and up to 7.0 mm outside. Stage 1a2 according to the classification of cervical cancer according to FIGO. |
T1b | The lesion is clinically confirmed, limited to the cervix; microscopically, a larger lesion is possible than T1A / 1A2. Stage 1b by FIGO. |
T1b1 | The lesion reaches 4 cm. FIGO stage 1b1. |
T1b2 | The lesion focus exceeds 4 cm. Stage according to 1b1 FIGO. |
T2 | The tumor is spread outside the uterus, germination in the walls of the pelvis and the lower third of the vagina is not fixed. 2nd stage according to FIGO |
T2a | Without secondary foci of distribution. Stage 2a by FIGO. |
T2b | With secondary foci of the tumor process. Stage 2b according to FIGO. |
T3 | Cancer with tumor invading the pelvic wall; the lower third of the vagina is affected, kidney function is impaired. Stage 3 according to FIGO. |
T3a | The lower third of the vagina is affected without spreading to the wall of the pelvis and damage to the kidney. Stage 3a by FIGO. |
T3b | The tumor penetrates the walls of the pelvis and leads to hydronephrosis of the kidney. Stage 3b by FIGO. |
T4 | The urinary system and / or rectum are affected; the tumor may extend beyond the pelvic area. Stage 4A by FIGO. |
M1 | Numerous and distant metastases. Stage 4b according to FIGO. |
ICD classification
The following article presents the classification of cervical cancer according to the ICD (International Classification of Diseases):
C53 | General classification for cervical malignancies |
C53.0 | In the inner region of the cervix |
C53.1 | Outside area affected |
C53.8 | The defeat extends beyond the cervix |
C53.9 | Unspecified neoplasm |
Etiology
Predisposing factors for cervical cancer are:
- HPV infection.
- Early onset of sexual activity.
- The presence of more than 3 sexual partners per year.
- Smoking.
The human papillomavirus type 16 and 18 is a provocateur of cancer. In almost 80% of cases with cervical cancer, these types of viruses are present in the woman’s body. The most common way to get the virus is through the sexual. Often, contraceptive methods do not guarantee absolute protection against HPV infection.
HPV infection during sexual contact occurs in 75% of cases, but the body's immunity is 90% able to withstand and quickly destroy it. And if the virus manages to overcome the immune barrier and penetrate the body, a persistent slow course of the disease occurs, followed by changes in the cervical epithelium.
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 have confirmed that their regular sexual partners have more than 20 sexual contacts over their lives, which is 5 times more likely than the usual 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 present, but the person does not attach any importance to them. Accustomed to discomfort, the patient considers them to be something ordinary and arising from time to time. Suspecting something was wrong and worried, they usually go to the doctor with the following symptoms:
- The patient complains of discomfort and pain in the pelvic area.
- Marks spotting that is not associated with menstruation.
- The duration and nature of the menstrual cycle changes.
- There are bleeding after a vaginal examination by a gynecologist.
- There is pain and bleeding during intercourse.
- The presence of pathological vaginal bleeding.
- The occurrence of bloody discharge in the vagina after menopause.
The symptoms above are conditional, some of them may be absent, some manifest themselves brighter than others. Typically, such clinical symptoms are accompanied by the following systemic disorders:
- The patient notes rapid fatigue and increasing weakness.
- Marks a sharp weight loss.
- Long-lasting subfebrile condition.
- A blood test indicates reduced hemoglobin, the presence of anemia, and increased ESR.
The disease is more dangerous and the course and outcome of the disease is more difficult, the fewer symptoms are present in the patient’s history - she seeks help from specialists when the tumor has time to take root in the body and begin its destructive effect. Late diagnosis and prolonged treatment significantly worsen the prognosis of recovery.
How this happens: pathogenesis
In our body, there is an amazing process of cell renewal called apoptosis. In the human body, on average, about 60-70 billion cells die every day, 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 the apoptosis, a favorable environment for the occurrence of malignant tumors is favorable. The p53 Rb gene exists in the body, which is responsible for the fight against cervical cancer. In the case when the human papillomavirus appears in the body, this gene is blocked by the proteins of the virus. Then the cancer cells begin to actively and uncontrollably divide. The human papillomavirus destroys the antitumor defense of the body, thereby increasing the risk and speed of cancer.
Cervical Cancer Classification: Histology
Regular gynecological examinations should be mandatory: an experienced specialist is able to note any kind of abnormality, even with erased symptoms and a hidden course of the disease. Following this, he will direct the patient to additional studies.
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.
Treatment methods
The treatment of cervical cancer should be individual and comprehensive. A standard procedure is a surgical operation, and then chemo- or radiation therapy is selected, usually a combination of these to increase the effectiveness of treatment with supportive immunotherapy.
Prevention
Is it possible to protect yourself from the development of this disease?
High efficiency was shown by a vaccination measure against papillomavirus infection. A favorable and suitable age for its implementation is considered the age of 13-15 years. Currently, some countries have also introduced vaccinations for boys in puberty.
With an increase in the incidence of an ailment such as cervical cancer, a measure to prevent human papillomavirus infection is vital.
It is also important to observe sexual hygiene - short-term, illegible sexual relations lead to dangerous consequences, infections are fraught with serious long-term complications. The seemingly banal recommendations for maintaining a healthy lifestyle and smoking cessation are in fact of great importance. They must be taken into account. This should be an integral part of life - not only to protect yourself from HPV infection, but to ensure better health, prolonging both life itself and its quality.
It is necessary to regularly undergo a gynecological examination and an ultrasound examination, take a smear for cytology once a year, and also listen carefully to your body and attach importance to any nonspecific ailment and unusual symptoms.