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Cancer of a neck of uterus
September 12, 2012
After breast cancer the oncological illness, most widespread in the world, among women is the cancer of a neck of uterus. Specialists note gradual increase in number of sick women in the developed countries. According to medical statistics, every year in the world the cancer of a neck of uterus is diagnosed for 500 thousand women.
Reasons of development of cancer of neck of uterus
Formation of cells which provoke developing of cancer later happens as an effect of a mutation of genetic character. As a result healthy cells will be transformed to atypical. They are also called precancerous cells. If such cells do not find at early stages and do not undertake adequate treatment, then their regeneration in a cancer of a neck of uterus can become a result.
By scientists it is proved that the major factor predetermining such regeneration is the virus of papilloma of the person. This virus is transmitted between people sexually, owing to its influence vaginal papillomas develop.
The virus strain of papilloma is oncogenous, that is it that can provoke developing of cancer. At the same time it is necessary to know that even use of a condom at sexual contacts completely does not protect from this virus as it can pass from the person to the person at skin contacts, and also at contacts of mucous membranes.
It should be noted still some factors which provoke a mutation of cells of a neck of uterus: it is mature age of the patient, the early beginning of sexual life, incubation of polycarpous pregnancy, a large number of constantly changing sexual partners, smoking, the wrong approach to hygiene of genitalias, bad food. The cancer of a neck of uterus often develops at patients with HIV infection, diseases which are transmitted sexually. Most often necks of uterus are suffered by women of the advanced and middle age from cancer. However the disease is diagnosed for patients of any age.
Types of cancer of neck of uterus
The cancer of a neck of uterus at the woman forms from a multilayer flat epithelium of vulval area of a neck of uterus and from a ferruterous epithelial covering in the channel of a neck of uterus. Initially on a neck of uterus small consolidation appears. In process at the woman one of cancer forms can develop. Most often the endophytic cancer of a neck of uterus is diagnosed for patients. Growth in a vagina from earlier hypertrophied neck of uterus is characteristic of this form of a disease. Generally the tumor is similar to a cauliflower, in more exceptional cases at an ekofitny form of cancer the tumor which reminds a polyp of a neck of uterus is observed. If at the patient the exophytic cancer of a neck of uterus develops, then the necrosis in that case is very quickly shown, and fabrics break up. If in the course of progressing of an illness the cervical channel is surprised, then gradually the neck of uterus becomes barrel-shaped.
Considering the histologic characteristic of cancer of neck of uterus, doctors allocate several types of cancer. Planocellular cancer is most often diagnosed. Will be defined ferruterous cancer less often.
Distribution of cancer happens very quickly, at the same time vagina walls, a parametrium are surprised. Less often cancer passes to uterine tubes, ovaries. Pathological cancer cells extend in an organism in two ways: lymphogenous and hematogenous. There is a damage of regional lymph nodes.
If cancer continues to develop, then later at the patient metastasises in lungs and a liver are defined.
The following stages of this illness will be allocated:
Cancer is defined on 0 stages preinvazivny (so-called intra epithelial). At this stage germination of a basal membrane of an epithelium does not happen.
At development of the first stage of cancer defeat does not pass out of limits of a neck of uterus. A tumor exit out of limits of a neck of uterus is characteristic of the second stage of cancer. Therefore, if at the patient the parametralny form of cancer develops, then the parametrium without transition to a basin wall is surprised. At a vulval form of cancer the tumor affects upper part of a vagina. If at the woman the uterine option of an oncological illness develops, then the tumor extends to all body of the womb.
At the third stage of an illness on condition of development of parametralny cancer there is a transition of cancer to walls of a small pelvis. If the vulval option of cancer develops, then at the third stage it strikes also lower part of a vagina. Manifestation of the isolated metastasises in pelvic lymph nodes is characteristic of metastatic option of cancer.
At the fourth stage of cancer the tumor gradually passes to a bladder, a rectum, later metastasises are also shown in the remote bodies. Metastasises often extend in a liver, lymph nodes in inguinal area, lungs, bones.
Symptoms of cancer of neck of uterus
Initially symptoms of cancer of neck of uterus at the patient can not be shown in general. The woman can feel as usual, without noting any changes in a state of health. If already developed cancer of a neck of uterus takes place, disease symptoms in this case at first are shown by increase in quantity is more white, and also periodic contact allocations from generative organs which have bloody character (it is about allocations after sexual intercourse). The patient can also feel pain in the course of an urination, it shows a sensation of discomfort in a vagina.
Right at the beginning bleach are watery, availability of blood in them is noted later. More plentiful bloody allocations from generative organs appear not only after sexual contact, but also at defecation, at a strong physical tension. Gradually bleach get a putrefactive smell. Such allocations are result of process of rejection of sites of a tumor which underwent a necrosis, and also exposures of lymphatic cracks and vessels. If the tumor extends very intensively, and cancer conglomerates squeeze neuroplexes, the woman can feel pain.
Besides, at gradual display of cancer of neck of uterus the woman can note disturbances of a monthly cycle, morbidity in the course of sexual intercourse, manifestation of weakness and anemia, long loss of weight, constant subfebrile body temperature without existence on that certain reasons.
Gradually also changes in functioning of a rectum, a bladder are observed, the diseases connected with infections of urinary tract are often shown.
Often at further development of cancer of neck of uterus in the woman rectovaginal fistulas develop. As a result there is a pelting of contents of a bladder and rectum in a vagina. If cancer extends to area of a basin, the patient can note development of hypostases of legs, a hydronephrosis.
At gradual development of an oncological disease of a neck of uterus the patient can feel rather normally throughout a long time: the illness without treatment can proceed about two years.
If cancer not to treat timely, then the woman can die owing to bleedings, peritonitis, exhaustion, uraemia.
Diagnosis of cancer of neck of uterus
In the course of diagnosis of cancer of neck of uterus the special tests during gynecologic survey allowing to define existence of changes in a structure of a neck of uterus are carried out. It is very difficult to find similar pathology if usual inspection is performed. For the purpose of early detection of similar pathology cytologic research of a smear of a neck of uterus is conducted.
Besides, in the course of establishment of the diagnosis some other methods are often applied. The method of a kolposkopiya assumes research with use of a special microscope – a kolposkopa. By means of such research the doctor has an opportunity to study a condition of a neck of uterus and walls of a vagina.
Carrying out a biopsy is one and most informative ways of detection of oncological diseases. By means of the special tool the fragment of fabric which is subjected then to histologic and cytologic inspection is withdrawn.
Research using an endocervical curettage provides use of the curette. With its help the scraping of a surface of the channel of a neck of uterus is made inside. One more method — conization – assumes in-depth study of fabrics as the fabric piece in the form of a cone is excised.
Specialists claim that regular delivery on the analysis of smears allows to reduce risk of development of an oncological illness of a neck of uterus approximately by 70%, by means of a vaginoskopiya, unlike other diagnostic methods, direct research of consolidation is made. This method provides use of the optical devices allowing to provide 6-40 multiple increase. If at such research uncharacteristic education is defined, the biopsy or a kolkoskopiya is in addition appointed.
Except the mentioned researches in the presence of suspicions on an oncological disease DNA the test which defines existence of a virus of papilloma of the person is carried out. Those patients in whom VPCh is found constantly stay under supervision of the doctor in view of high risk of formation of a tumor.
Cancer therapy of a neck of uterus
Distribution of cancer of neck of uterus among women in the genital period very high. Speaking about this illness, it should be noted that the survival of patients with a cancer of a neck of uterus significantly is influenced by at what stage the disease was diagnosed.
Initially in the presence at the woman of precancerous diseases (an erosion of a neck of uterus, a dysplasia of a neck of uterus) all measures for their treatment are undertaken to prevent development of oncological pathology.
The cancer therapy of a neck of uterus provides use of two main techniques: surgical treatment and carrying out radiation therapy. Treatment using radiation is appointed to women to any of illness stages, however its use is more reasonable at late stages of cancer. The surgery is performed at early stages if insignificant intervention is necessary. The purpose of such operation is clearing of the place where there was a tumor, and also areas which are potentially infected. Therefore, methods of surgical intervention are defined depending on a stage of an illness and extensiveness of a tumor. It can be both low-traumatic methods, and full removal of a neck, uterus, lymph nodes.
Removal of abnormal zones of a neck of uterus is made by means of a method of electrosurgical excision by a loop. In this case the electric discharge influences as the surgeon's knife, deleting fabrics.
Also operation on removal of abnormal sites of a neck of uterus is performed by cryotherapy (freezing of the struck zones), laser therapy (allows to remove cone-shaped sites of fabrics). All these techniques give the chance to provide histologic research on the operation course. Spices use of such techniques efficiency of therapy makes 97%.
If in the course of an illness serious deformations of a neck of uterus were already designated, then the doctor can make the decision on need of a trachelectomy. Such operation is performed with use of different techniques, under the general anesthesia.
The hysterectomy is carried out if there are additional indications to such operation. In particular, such surgical intervention is carried out to women who already were 50 years old, at a tumor arrangement in the cervical channel if conization was inefficient, preinvazivny cancer is combined with a hysteromyoma, or also tumors of appendages developed.
If the patient is appointed radiation therapy, then it is necessary to pick up surely the most optimal conditions for carrying out radiation. It is important that nearby bodies underwent the minimum radiation. For providing such conditions additional examination is conducted previously: computer tomography, ultrasonography, MRT.
In complex treatment also the chemotherapy is applied. Sometimes such method is also appointed separately, however it practices only at the fourth stage of cancer.
In the course of treatment of this serious illness one of the major factors is early detection of pathology and treatment of precancerous illnesses.
Vaccine from a cancer of a neck of uterus
For ensuring protection of women against infection with a virus of papilloma of the person vaccination practices. It is reasonable to enter such vaccine to young women who do not conduct sexual life yet. Vaccination allows to prevent further development of a dysplasia, sharp-pointed condyloma, a neoplasia, a cancer of a neck of uterus, other precancerous conditions of a proctal reproductive system.
The inoculation from a cancer of a neck of uterus is effective as it allows to provide protection against four types of a virus of papilloma of the person provoking an oncological disease.
The vaccine is most effective if to provide carrying out inoculations to girls prior to the beginning of sex life. However, there are also some data that the vaccine protects from a disease and women of more advanced age.
To carry out full vaccination, three injections intramusculary for half a year with observance of the necessary interval are made.
Women who have serious chronic illnesses, and also that who suffers from blood illnesses cannot carry out vaccination. The inoculation cannot be done to pregnant women, and also those who suffers from individual intolerance of a vaccine.
Prevention of cancer of neck of uterus
As the main method of prevention of development of an oncological illness of a neck of uterus it is necessary to consider ensuring regular surveys at the specialist gynecologist with capture and the subsequent research of smears. Women at whom the high risk of display of an illness takes place need to make such visits to the doctor at least once a year. After thirty-year age of the woman which several times passed research on existence in an organism of a virus of papilloma of the person and received negative result, can be limited to visit to the gynecologist once in three-four years. If in the course of inspection a certain pathology was revealed, it is necessary to provide immediate adequate treatment of an illness without fail. It is very important to pass inspection annually to patients with an immunodeficiency, HIV infection.
Besides, also the vaccination directed to protection against a virus of papilloma of the person belongs to methods of prevention. It is important to eat, follow properly all rules of hygiene, to have the arranged sex.