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Cancer of the uterus. Symptoms and signs, causes, stage, prevention of the disease

Cervical cancer is the fourth most common cancer in women. What is this? (the disease may be referred to as the abbreviation “CC”) is a malignant tumor of the female genital organs.

Most often it affects the female population after 45 years. But over the past few years, this disease has become somewhat younger.

In most cases, this terrible disease is gaining momentum unnoticed and with virtually no signs, and treatment for stage 1 cervical cancer is not prescribed on time. It can only be identified at an appointment with a gynecologist.

Causes of cancer

  • a large number of abortions;
  • inflammatory genital infections;
  • sexually transmitted diseases;
  • long-term use of hormone-based medications;
  • a large number of partners, both for the woman and her man;
  • intimate life that began early;
  • pregnancy at too early an age;
  • bad habits (mainly smoking);
  • violation of sexual hygiene.

Malignant formations can appear if you do not get rid of chronic erosion, endorcevicosis, dysplasia, adenomatosis, and endorcervitis.

Signs of stage 1 cervical cancer are almost invisible. The patient does not have any anxiety or concern, and therefore she does not go to the doctor.

As a rule, a cancerous tumor is discovered by chance, but then it is no longer stage 1 of development, but already the second, if not worse. That is why girls need to be regularly observed by a gynecologist as much as possible, so that the initial stage is missed.

Over the past 30 years, incidence rates have decreased. Awareness and screening help reduce mortality from a diagnosis of cervical carcinoma, but its occurrence is still striking.

In 2014, there were approximately 13,000 new cases of invasive cervical cancer.

Some symptoms of stage 1 cancer

Here are the signs of cervical cancer that will most often help you recognize the symptoms in the early stages of the disease and reduce the risk of mortality from this disease:

  1. Leg pain.
    This indicator can often go unnoticed, but is one of the first physical signs of a problem. When attacked by cancer cells, the organ will swell and blood flow to the lower extremities will be reduced, causing the legs to ache and swell.
  2. Painful urination.
    The cervix and urinary tract are more interconnected than you might think. Urinary tract infections can be the result of bacterial contamination from the vaginal walls and therefore, metastatic cervical cancer will cause irritation and inflammation of the muscles around the bladder and make urination very painful. As a rule, this will be a sure sign of the spread of the disease, which will metastasize to surrounding tissues, and must be immediately diagnosed by a doctor in order to begin treatment.
  3. Abnormal discharge.
    Vaginal discharge should be relatively odorless and without any particular color. One of the first signs of a problem in the vagina is discharge, which has an unpleasant color and odor. Fungal infections should not be left untreated, as they can become a barrier to further control of the disease.
  4. Unusual bleeding.
    One of the most common and alarming symptoms is heavy and unscheduled bleeding. When fighting abnormal cells, the female organ will try to form a protective coating, and as a result, unscheduled menstruation.
  5. Uncomfortable sensations.
    Uncomfortable or unpleasant sensations in the vagina during sexual intercourse may be a sign of other diseases; this should never be ignored.
  6. Irregularity of menstruation.
    For most women, there is a level of normality or consistency in their menstrual cycle, and any sudden changes or missed periods can be a sign of poor health and may be malignant in nature. If the irregularity persists, then you should take note of any daily diet or medication changes and talk to your doctor so that therapy can be prescribed.
  7. Irregular urination.
    Similar to the menstrual cycle, the urinary tract must function in a cycle and irregular urination or incontinence, or a very small amount, is one of the early symptoms of the disease. Even more significant is the appearance of blood in the urine, which may indicate a severe stage of the disease.
  8. Pelvic pain.
    Pelvic pain is not uncommon for many women, but severe or acute pelvic pain outside of menstruation may indicate cancer.
  9. Lower back pain.
    Sometimes pelvic pain can affect the supporting muscles of the lower back, causing them to tighten. It is important that you pay attention to the cause of any lower back discomfort, as this is often the most undiagnosed symptom of this terrible disease.
  10. Radical weight loss and fatigue.
    Cervical cancer stage 1, stage 2, 3 and 4, no different from other types of this disease, reduces the production of healthy red blood cells, as a result, the number of white blood cells can make the body weak and tired, as well as lack of appetite are all symptoms early stage cervical cancer.

Of course, every patient with such a diagnosis has the question: “How long do they live?” A normal life with a cancer tumor is possible until the onset of metastasis.

And this happens differently for every woman. You can live with such a diagnosis as the first stage of cervical cancer for a very long time. It all depends on how quickly it begins to develop.

Oncological pathologies of the female reproductive system are quite common. One of the common diseases of this kind is uterine cancer.

This disease is called differently - endometrial cancer, cancer of the uterine body, cancer of the uterine mucosa, etc. All these oncological processes are uterine cancer.

Disease concept and statistics

Uterine cancer is a malignant tumor process that develops from the inner epithelial layer - the endometrium.

On average, this disease is found in 2-3% of the female population. Endometrial cancer can occur in every woman, however, women over 45 are most susceptible to this type of cancer.

Classification

Oncologists classify uterine cancer into two types: autonomic and hormonal.

Autonomous cancer accounts for 1/3 of all cases of uterine oncology. This form of the disease occurs suddenly without any prerequisites or reasons.

Experts believe that such oncology is of hereditary etiology or occurs under the influence of traumatic injuries.

The picture shows a uterine cancer cell under a microscope

The hormonal type of uterine cancer develops due to hormonal changes in the female body. This type of cancer accounts for 2/3 of all cases of endometrial cancer. It is characterized by pronounced disturbances of endocrine-metabolic origin.

According to histological data, cancer of the uterine body can be:

  • Leiomyosarkinoma;
  • Glandular squamous cell oncology, etc.

Depending on the degree of differentiation of cellular structures, cancer can be highly differentiated, poorly differentiated or moderately differentiated.

Causes

As mentioned above, endometrial cancer can be hormone-dependent or autonomous in nature. Based on this, we can identify several characteristic causes of uterine body cancer:

  • Increased stimulation of the epithelial uterine layer by estrogen hormones;
  • Metabolic disorders such as obesity, diabetes, hypertension;
  • Hormone-producing ovarian tumors;
  • Adenoma of the adrenal cortex;
  • Treatment with hormone-containing drugs;
  • The presence of severe liver pathologies accompanied by disturbances in metabolic sex-hormonal processes (hepatitis, etc.);
  • Negative heredity, such as the presence in blood relatives of oncological formations in the intestines, mammary gland, ovaries or in the body of the uterus;
  • Late onset of menopause;
  • Lack of pregnancies with natural births;
  • Long-term use of oral contraceptives like Dimethisterone;
  • Irradiation of pelvic organs, etc.

Symptoms of uterine cancer in women

Signs of oncological formations of the uterine body are very diverse, however, in the early stages of the development of the cancer process, any symptoms are usually absent.

First signs

Among the first alarming symptoms of uterine cancer, uterine bleeding not associated with menstruation stands out.

A similar sign, according to oncologists, is observed in almost 7-9 out of ten patients.

Such bleeding may vary in nature:

  • Abundant;
  • Scarce;
  • Multiple;
  • Breakthrough;
  • Single use;
  • Intermittent, etc.

Contact bleeding that occurs as a result of sexual intercourse, gynecological examination, lifting heavy objects, douching, etc. is very typical for uterine cancer.

In addition to discharge, when uterine body cancer reaches advanced stages of development, it can be recognized by the following symptoms:

  1. Hyperthermia with low-grade fever;
  2. Nagging pain in the lumbar area, perineum, abdomen;
  3. A noticeable reduction in performance, excessive and rapid fatigue, even to the point of exhaustion;
  4. Sexual intercourse is accompanied by pain, which can also appear after it;
  5. Refusal to eat;
  6. Problems with bowel movements such as constipation or diarrhea;
  7. Severe weight loss.

How to identify uterine cancer by symptoms before menopause?

In women who are premenopausal, it is considered quite normal to have uterine bleeding, which gradually becomes scarce and bothers you less and less.

If an oncological process begins to develop in the uterine body, then the typical reduction in symptoms does not occur, and it often happens that uterine discharge, on the contrary, becomes more abundant and frequent.

What manifestations can be observed in postmenopause?

During menopause, women usually do not have menstruation. Therefore, if sudden vaginal discharge occurs, you should always suspect the presence of a uterine cancer process.

Moreover, the frequency of such bleeding, its duration, intensity and abundance at this age no longer matter.

Stages and their lifespan

Oncologists distinguish several sequential degrees of uterine cancer:

  • At the first stage Oncological formation is located directly in the uterine body. The probability of recovery is about 80-90%;
  • At the second stage During the oncological process, the tumor formation penetrates beyond the boundaries of the uterine body and affects the cervical canal (cervix), however, nearby organs are not affected. Recovery occurs in approximately ¾ of cases;
  • On third stage of cancer, the oncological process spreads to the appendages and vagina. Survival rate is about 40% of patients;
  • On fourth stage of cancer of the uterine body, tumor processes spread beyond the pelvic region, the formation grows into the intestinal and bladder tissues. Survival rate – no more than 15%.

Consequences

Cancer of the uterine body is a very dangerous pathological condition. If there is no adequate therapy, then uterine cancer will certainly lead to the death of the patient.

Often, cancer of the uterus requires its removal along with the appendages, part of the vagina and the cervix. However, this factor usually does not play a significant role, because cancer is found mainly in women aged 45-60 years with adult children.

Pathways of metastasis

In case of cancer in the body of the uterus, the main routes of metastasis are vessels and nodes, and at the terminal stage the circulatory system also participates in the spread.

First, the lesion spreads to the lymph node structures in the iliac region and hypogastric zone. Much less often, the lesion affects other groups of pelvic lymph nodes.

Metastasis extends to the cervical canal and beyond the uterine body. In a hematogenous manner, metastases penetrate from the upper uterine region into the appendages; in addition, the vagina, and sometimes even the kidney or liver or bone tissues are affected.

Diagnostics

The diagnostic process for uterine cancer begins with a gynecological examination using speculum. The patient is then sent for an ultrasound examination, which reveals the true size and structure of the uterus, as well as the structure and thickness of the endometrium.

The photo shows what uterine cancer looks like on ultrasound diagnostics

The resulting biomaterial is often scraped. This procedure is performed using general anesthesia in a hospital setting.

When analyzing for the detection of tumor markers for uterine cancer, the following markers are used:

  • Carcinoembryonic antigen;
  • HCG or human chorionic gonadotropin.

Thanks to its introduction into gynecological oncology practice, it was possible to save the lives of many patients.

How quickly does the disease develop?

The rate of development of the oncological process in the uterine body is determined by the histological type of formation, concomitant pathologies, the strength and intensity of the body's anticancer resistance, the adequacy of therapy, the age of the patient and other similar factors.

Therefore, it is impossible to say for sure how long it will take for the final development of the cancer process in the uterine body.

The difference between pathology and fibroids

They call the process of hyperplastic enlargement of uterine tissue that occurs as a result of traumatic factors, frequent abortions, curettage, a large number of sexual partners, genitourinary inflammation, lack of orgasms in women, etc.

Cancer of the uterine body and fibroids have absolutely nothing to do with each other. These are completely different pathologies, so fibroids never degenerate into cancer.

Benign uterine hyperplasia is formed in the muscular layer of the organ, and oncology - in the epithelial layer. When fibroids are detected, observation tactics are usually chosen to determine whether the fibroids are growing or not.

For this purpose, the patient undergoes a gynecological examination every six months. As for direct scientific evidence of the relationship between cancer and fibroids, there is no evidence.

Treatment and prevention

In general, it depends on individual prognostic results:

  1. The basis of treatment is surgery, which involves removing the uterine body along with the ovaries.
  2. Sometimes radio irradiation is performed before and after surgery to reduce the risk of cancer recurrence, but such treatment has absolutely no effect on survival rates;
  3. In addition to surgery, chemotherapy is used. Such an approach to treatment is justified when the tumor process is widespread, as well as when the tumor is autonomous, has active metastasis, and relapses. Platinum drugs such as Cisplatin, Carboplatin, Adriamycin, as well as Doxorubicin, Taxol, Epirubicin, etc. are used. For hormonal-dependent oncology of the uterine body, chemotherapy treatment is ineffective;
  4. Hormone therapy provides good therapeutic results. For such treatment, progestogen drugs are usually used: Megeis, Depostat, Provera, 17-OPK, Farlugal, Depo-Provera, etc. These drugs can be combined with Tamoxifen or prescribed without it. If active metastasis occurs and treatment with progestogens is ineffective, Zoladec is prescribed. Sometimes I combine hormonal treatment with chemotherapy.

When determining the appropriate therapeutic method, the oncologist takes into account several decisive factors such as the physiological state of the patient, the presence of endocrine disorders, histological parameters, tumor size and extent, etc.

Preventive measures are the most effective anti-cancer measure. Primary preventive actions involve avoiding factors that provoke such cancer, such as obesity, diabetes and infertility.

In other words, you need to strictly control weight, treat fertility and diabetes.

There are also secondary preventive measures that involve timely detection and treatment of inflammatory pathologies and precancerous conditions.

Women over 40 are recommended to undergo annual screening examination using transvaginal ultrasound. This procedure makes it possible to detect cancer of the uterine body in its infancy, which significantly increases the chances of recovery and long life.

If a precancerous disease is discovered in the patient, then it must be treated.

Patient survival prognosis

Every year the number of cancer patients with cancer of the uterine body increases; every year this pathology is detected in half a million patients. But timely diagnosis and an adequate approach to the treatment process make it possible to achieve a high and favorable survival prognosis.

In general, the prognosis for the survival of cancer patients is determined by the stage of initiation of therapy, the degree of cell differentiation, etc.

For example, with a highly differentiated formation with the first degree of development, the survival rate will be 96%, and with a low degree of cell differentiation and 4 degrees of development, the survival rate does not exceed 18%.

The following video will tell you how to recognize and treat uterine cancer:

Uterine cancer is a malignant neoplasm that develops from the endometrium (cylindrical epithelium that covers the internal cavity of the reproductive organ).

In recent decades, there has been a steady increase in the incidence of cancer pathologies of the female genital area throughout the world, including such common ones as uterine cancer.

Among malignant neoplasms in women, this pathology ranks second, second only to breast cancer. According to statistics, today about 2-3% of women develop endometrial cancer during their lifetime.

Cancer of the uterine body can develop at any age, but it mainly affects women over 45 years of age (the average age of patients who first consulted a doctor about symptoms of endometrial cancer is 60 years).

To understand the causes and mechanisms of development of uterine cancer, consider the anatomy and physiology of the female reproductive organ.

Anatomy and physiology of the uterus

The uterus is an unpaired organ of the female reproductive system, responsible for bearing and giving birth to a child.

In front of the uterus, located deep in the pelvis, is the bladder, and behind is the rectum. This proximity causes the occurrence of urination and defecation disorders in the presence of pronounced pathological processes in the uterus.

The normal dimensions of the non-pregnant uterus are relatively small (length about 8 cm, width 4 cm and thickness up to 3 cm). The reproductive organ is pear-shaped; its structure consists of a fundus, a body and a neck.

From above, in the area of ​​the expanded fundus of the uterus, the fallopian tubes flow into the right and left, through which the egg enters the organ cavity from the ovary (as a rule, the process of fertilization occurs in the fallopian tube).
Downwards, the body of the uterus narrows and passes into a narrow canal - the cervix.

The uterus is pear-shaped and consists of three layers, such as:

  • endometrium (inner epithelial layer);
  • myometrium (the muscular lining of the uterus, the contractions of which ensure the birth of a child);
  • parametrium (superficial shell).
In women of the reproductive period, the endometrium undergoes cyclic transformations, externally manifested by regular menstruation. Constant renewal of the superficial functional layer is ensured by the inner basal layer of the endometrium, which is not rejected during menstrual bleeding.

The growth, flourishing and rejection of the functional layer of the endometrium are associated with cyclical changes in the level of female hormones in the blood, which are secreted by the female sex glands - the ovaries.

The production of hormones is controlled by a complex neuro-endocrine regulation system, therefore any nervous or endocrine disorders in the female body have a detrimental effect on the functioning of the endometrium and can cause serious diseases, including uterine cancer.

What factors increase the risk of developing uterine cancer?

Factors that increase the risk of developing uterine cancer include:
  • unfavorable heredity (presence of endometrial cancer, ovarian cancer, breast or colon cancer in close relatives);
  • late menopause;
  • no history of pregnancy;
  • ovarian tumors that produce estrogen;
  • treatment of breast cancer with tamoxifen;
  • long-term oral contraception using dimethisterone;
  • estrogen replacement therapy;
  • irradiation of the pelvic organs.

Causes and mechanisms of development of uterine cancer

There are two most common types of uterine cancer: hormone-dependent and autonomous. It has been proven that genetic predisposition plays a significant role in the development of both variants.

Hormone-dependent endometrial cancer– the most common form of the disease (about 70% of all cases of diagnosed pathology), which develops due to increased stimulation of the epithelium of the uterine cavity by female sex hormones – estrogens.

An increased content of estrogen is often observed in metabolic and neuroendocrine disorders, therefore, risk factors for the development of hormone-dependent endometrial cancer include diabetes mellitus, obesity and hypertension (the combination of these pathologies is especially dangerous).

Clinically, hyperestrogenism is manifested by the following symptoms:

  • menstrual irregularities with uterine bleeding;
  • hyperplastic processes in the ovaries (follicular cysts, stromal hyperplasia, etc.);
  • infertility;
  • late onset of menopause.
It should be noted that estrogen levels can also increase in severe liver diseases, when the metabolism of sex hormones is impaired (chronic hepatitis, cirrhosis of the liver).

In addition, significant hyperestrogenism is observed with hormone-producing ovarian tumors, hyperplasia or adenoma of the adrenal cortex, as well as with the artificial introduction of estrogens into the body (treatment of malignant breast tumors with tamoxifen, estrogen replacement therapy in postmenopause, etc.).

As a rule, hormone-dependent malignant endometrial tumors are highly differentiated and therefore characterized by slow growth and a relatively low tendency to metastasize. Primary multiple development of malignant tumors (in the ovaries, in the mammary gland, in the rectum) often occurs.
The development of hormone-dependent endometrial cancer can be divided into several stages:

  • functional disorders associated with hyperestrogenism (menstrual irregularities, uterine bleeding);
  • benign hyperplasia (growth) of the endometrium;
  • precancerous conditions (atypical hyperplasia with stage III epithelial dysplasia);
  • development of a malignant tumor.
Autonomous endometrial cancer occurs in less than 30% of cases. This pathogenetic variant develops in patients who do not suffer from metabolic disorders. The risk group consists of elderly women with reduced body weight who have a history of uterine bleeding during the postmenopausal period.

The mechanisms of development of autonomous endometrial cancer are still not fully understood. Today, many experts associate the occurrence of pathology with profound disorders in the immune system.

Autonomous cancer of the uterine body is often represented by poorly differentiated and undifferentiated tumors. Therefore, the course of this pathogenetic variant is less favorable: such tumors are characterized by faster growth and metastasize earlier.

How is the stage of uterine cancer determined?

According to classification of the International Federation of Obstetricians and Gynecologists (FIGO) There are four stages of development of uterine cancer.

Stage zero (0) is considered to be atypical endometrial hyperplasia, which, as has already been proven, will inevitably lead to the development of a malignant tumor.

The first stage (IA-C) is said to occur when the tumor is limited to the body of the uterus. In such cases there are:

  • Stage IA – the tumor does not grow deep into the myometrium, being limited to the epithelial layer;
  • Stage IV – the tumor penetrates the muscular layer of the uterus, but does not reach the middle of its thickness;
  • Stage ІС – carcinoma grows through half of the muscular layer or more, but does not reach the serous membrane.

At the second stage, endometrial cancer grows into the cervix, but does not spread beyond the organ. In this case they share:

  • Stage ІІА, when only the glands of the cervix are involved in the process;
  • Stage II, when the stroma of the cervix is ​​affected.
The third stage of the disease is diagnosed in cases where the tumor extends beyond the organ, but does not grow into the rectum and bladder and remains within the pelvis. In such cases there are:
  • Stage III, when carcinoma grows into the outer serous membrane of the uterus and/or affects the uterine appendages;
  • Stage III, when there are metastases in the vagina;
  • Stage III, when metastases have occurred in nearby lymph nodes.
At the fourth stage of development, the tumor grows into the bladder or rectum (IVA). The last stage of development of the disease is also spoken of in cases where distant metastases have already occurred outside the pelvis (internal organs, inguinal lymph nodes, etc.) - this is already stage IVB.

In addition, there is still a generally accepted International classification system TNM, which allows you to simultaneously reflect in the diagnosis the size of the primary tumor (T), tumor involvement of the lymph nodes (N) and the presence of distant metastases (M).

The size of the primary tumor can be characterized by the following indicators:

  • T is - corresponds to the zero stage of FIGO;
  • T 0 – the tumor is not detected (completely removed during the diagnostic study);
  • T 1a – carcinoma is limited to the body of the uterus, with the uterine cavity not exceeding 8 cm in length;
  • T 1b – carcinoma is limited to the body of the uterus, but the uterine cavity exceeds 8 cm in length;
  • T 2 – the tumor spreads to the cervix, but does not extend beyond the organ;
  • T 3 – the tumor extends beyond the organ, but does not grow into the bladder or rectum and remains within the pelvis;
  • T 4 – the tumor grows into the rectum or bladder and/or extends beyond the pelvis.
Tumor involvement of lymph nodes (N) and the presence of distant metastases (M) are determined by the indices:
  • M 0 (N 0) – no signs of metastases (damage to lymph nodes);
  • M 1 (N 1) – metastases detected (affected lymph nodes detected);
  • M x (N x) – there is not enough data to judge metastases (tumor damage to the lymph nodes).
So, for example, diagnosis T 1a

N 0 M 0 - means that we are talking about a tumor limited to the body of the uterus, the uterine cavity does not exceed 8 cm in length, the lymph nodes are not affected, there are no distant metastases (stage I according to FIGO).

In addition to the above classifications, the G index is often given, characterizing the degree of tumor differentiation:

  • G 1 – high degree of differentiation;
  • G 2 – moderate degree of differentiation;
  • G 3 – low degree of differentiation.
The higher the degree of differentiation, the better the prognosis. Poorly differentiated tumors are characterized by rapid growth and an increased tendency to metastasize. Such carcinomas are usually diagnosed at later stages of development.

How does uterine cancer metastasize?

Cancer of the uterine body spreads lymphogenously (through lymphatic vessels), hematogenously (through blood vessels) and implantation (in the abdominal cavity).

As a rule, metastases of uterine cancer appear in the lymph nodes first. The fact is that lymph nodes are a kind of filters through which interstitial fluid passes.

Thus, the lymph nodes act as a barrier to tumor spread. However, if the “filter” is significantly contaminated, the tumor cells settled in the lymph nodes begin to multiply, forming metastases.
In the future, it is possible for malignant cells to spread from the affected lymph node to more distant parts of the lymphatic system (inguinal lymph nodes, lymph nodes near the aorta, etc.).

Cancer of the uterine body begins to spread hematogenously, when the tumor grows into the blood vessels of the organ. In such cases, individual malignant cells are transported through the bloodstream to distant organs and tissues.

Most often, hematogenous metastases in uterine cancer are found in the lungs (more than 25% of all types of metastases), ovaries (7.5%) and bone tissue (4%). Less commonly, foci of malignant tumors are found in the liver, kidneys and brain.

The uterine cavity communicates with the abdominal cavity through the fallopian tubes, so the appearance of implantation metastases is possible even before the primary tumor invades the serous membrane of the uterus. The detection of malignant cells in the abdominal cavity is an unfavorable prognostic sign.

What factors influence the ability of uterine cancer to metastasize?

The risk of metastases depends not only on the stage of development of the disease, but also on the following factors:
  • localization of the tumor in the uterine cavity (the risk of developing metastases ranges from 2% when localized in the upper-posterior part of the uterus to 20% when localized in the infero-posterior part);
  • age of the patient (in patients under 30 years of age, metastases practically do not occur; at the age of 40-50 years, the probability of developing metastases is about 6%, and in women over 70 years old - 15.4%);
  • pathogenetic variant of uterine cancer (with a hormone-dependent tumor - less than 9%, with an autonomous tumor - more than 13%);
  • degree of differentiation of a malignant tumor (for highly differentiated tumors - about 4%, for poorly differentiated tumors - up to 26%).

What are the symptoms of uterine cancer?

The main symptoms of body cancer are uterine bleeding, leucorrhoea and pain. It should be noted that in 8% of cases, the early stages of development of a malignant tumor are completely asymptomatic.

The clinical picture of uterine cancer differs between women of reproductive and non-reproductive age. The fact is that acyclic bleeding of varying degrees of severity (scanty, spotting, copious) occurs in approximately 90% of cases of this pathology.

If the patient has not yet reached menopause, then the initial stages of the pathology can be diagnosed by suspecting the presence of a malignant process due to menstrual irregularities.

However, acyclic uterine bleeding in women of reproductive age is nonspecific and occurs in various diseases (ovarian pathology, disorders of neuroendocrine regulation, etc.), so the correct diagnosis is often made late.

Uterine bleeding.
The appearance of uterine bleeding in postmenopausal women is a classic symptom of uterine cancer, so in such cases, as a rule, the disease can be detected at relatively early stages of development.

Beli
These discharges characterize another characteristic symptom of uterine cancer, which most often appears when the primary tumor is of significant size. In some cases, the discharge may be heavy (leukorrhea). The accumulation of leucorrhoea in the uterine cavity causes nagging pain in the lower abdomen, reminiscent of pain during menstruation.

Purulent discharge
With cervical stenosis, suppuration of leucorrhoea can occur with the formation of pyometra (accumulation of pus in the uterine cavity). In such cases, a characteristic picture develops (bursting pain, increased body temperature with chills, deterioration in the patient’s general condition).

Watery discharge
Abundant watery leucorrhoea is most specific for cancer of the uterine body, however, as clinical experience shows, a malignant tumor can also manifest as bloody, bloody-purulent or purulent discharge, which, as a rule, indicates a secondary infection. As the tumor disintegrates, the leucorrhoea takes on the appearance of meat slop and an unpleasant odor. Pain unrelated to bleeding and leukorrhea appears already in the later stages of development of uterine cancer. When a tumor grows into the serous membrane of the genital organ, a pain syndrome of a gnawing nature occurs; in such cases, as a rule, the pain often bothers patients at night.

Pain
Often, pain syndrome appears in a widespread process with multiple infiltrates in the pelvis. If the tumor compresses the ureter, lower back pain appears, and attacks of renal colic may develop.

With a significant size of the primary tumor, pain is combined with disturbances in urination and defecation, such as:

  • pain when urinating or defecating;
  • frequent painful urge to urinate, which is often of an orderly nature;
  • tenesmus (painful urge to defecate, usually not resulting in the release of feces).

What diagnostic procedures are necessary to undergo if uterine cancer is suspected?

Diagnosis of uterine cancer is necessary to draw up an individual treatment plan for the patient and includes:
  • establishing a diagnosis of malignant neoplasm;
  • determining the exact location of the primary tumor;
  • assessment of the stage of disease development (prevalence of the tumor process, the presence of tumor-affected lymph nodes and distant metastases);
  • determining the degree of differentiation of tumor tissue;
  • study of the general condition of the body (the presence of complications and concomitant diseases that may be contraindications to one or another type of treatment).
Typical complaints
Diagnosis of uterine cancer begins with a traditional survey, during which the nature of the complaints is clarified, the history of the disease is studied, and the presence of risk factors for the development of a malignant endometrial tumor is determined.

Gynecological examination
The doctor then conducts an examination on a gynecological chair using mirrors. Such an examination allows us to exclude the presence of malignant neoplasms of the cervix and vagina, which often have similar symptoms (spotting, leucorrhoea, aching pain in the lower abdomen).

After conducting a two-manual vaginal-abdominal wall examination, it will be possible to judge the size of the uterus, the condition of the fallopian tubes and ovaries, and the presence of pathological infiltrates (seals) in the pelvis. It should be noted that this examination will not detect pathology in the early stages of the disease.

Aspiration biopsy
The presence of a malignant neoplasm in the uterine cavity can be confirmed using aspiration biopsy, which is performed on an outpatient basis.

In women of reproductive age, manipulation is performed on the 25-26th day of the menstrual cycle, and in postmenopausal women - on any day. Aspiration is performed without dilating the uterine canal. This is a minimally invasive (low-traumatic) and absolutely painless technique.

Using a special tip, a catheter is inserted into the uterine cavity, through which the contents of the uterus are aspirated (sucked in with a syringe) into a Brown syringe.

Unfortunately, the method is not sensitive enough for the early stages of uterine cancer (it detects pathology in only 37% of cases), but with common processes this figure is much higher (more than 90%).

Ultrasound
The leading method in diagnosing uterine cancer today is ultrasound examination, which detects malignant neoplasms in the early stages of development and allows you to determine:

  • precise localization of the tumor in the uterine cavity;
  • type of tumor growth (exophytic - into the uterine cavity or endophytic - germination into the wall of the organ);
  • the depth of tumor growth into the muscular layer of the uterus;
  • the spread of the process to the cervix and surrounding tissue;
  • defeat by the tumor process of the uterine appendages.
Unfortunately, ultrasound examination is not always possible to examine the pelvic lymph nodes, which are targets for early metastasis of uterine cancer.

Therefore, if a common process is suspected, ultrasound data are supplemented with the results computer or magnetic resonance imaging, which allow us to judge with extreme accuracy the condition of the organs and structures of the pelvis.

Hysteroscopy
The list of mandatory tests for suspected uterine cancer includes hysteroscopy with targeted biopsy. Using an endoscope, the doctor examines the inner surface of the uterus and collects tumor tissue for histological examination. The accuracy of such a study reaches 100%, in contrast to other methods of obtaining material to determine tumor differentiation.

In the early stages of the disease, such a new promising method of endoscopic diagnosis as fluorescence study using tumor-tropic photosensitizers or their metabolites (aminolevulinic acid, etc.). This method makes it possible to detect microscopic neoplasms up to 1 mm in size using the preliminary introduction of photosensitizers that accumulate in tumor cells.

Hysteroscopy is usually accompanied by separate gynecological curettage of the uterus. First, the epithelium of the cervical canal is scraped, and then fractional curettage of the uterine cavity is performed. Such a study makes it possible to obtain data on the state of the epithelium of various parts of the uterine cavity and cervical canal and has a fairly high diagnostic accuracy.

All patients with suspected uterine cancer undergo general examination of the body, to obtain information about contraindications to a particular method of treating a malignant tumor. The examination plan is drawn up individually and depends on the presence of concomitant pathologies.

If the presence of distant metastases is suspected, additional studies are performed (ultrasound of the kidneys, x-ray of the chest organs, etc.).

When is surgical treatment of uterine cancer indicated?

The treatment plan for uterine cancer is prescribed individually. Since the majority of patients are elderly women suffering from serious diseases (hypertension, diabetes mellitus, obesity, etc.), the choice of treatment method depends not only on the stage of development of the malignant tumor, but also on the general condition of the body.

The surgical method is the main one in the treatment of uterine cancer in the early stages of development, with the exception of cases of severe concomitant pathology, when such intervention is contraindicated. According to statistics, about 13% of patients suffering from uterine cancer have contraindications to surgery.

The scope and method of surgical intervention for uterine cancer is determined by the following main factors:

  • stage of tumor development;
  • degree of differentiation of tumor cells;
  • patient's age;
  • presence of concomitant diseases.

Are organ-conserving surgeries performed for uterine cancer?

Organ-conserving operations for uterine cancer are performed less frequently than, for example, for breast cancer. This is due to the fact that the majority of patients are postmenopausal women.

In young women with atypical endometrial aplasia (FIGO stage zero), endometrial ablation.

In addition, this manipulation may be indicated in selected cases of stage 1A disease (endometrial tumor that does not spread beyond the mucous membrane) and in elderly patients with severe concomitant diseases that prevent a more traumatic intervention.
Endometrial ablation is the total removal of the uterine mucosa along with its basal germinal layer and the adjacent surface of the muscular layer (3-4 mm of myometrium) using controlled thermal, electrical or laser effects.

The removed uterine mucosa is not restored, therefore, after endometrial ablation, secondary amenorrhea (absence of menstrual bleeding) is observed, and the woman loses her ability to bear children.

Also in young women in the early stages of developing uterine cancer During hysterectomy surgery, the ovaries can be preserved(only the uterus with fallopian tubes is removed). In such cases, the female reproductive glands are preserved to prevent the early development of menopausal disorders.

What is hysterectomy surgery and how does it differ from hysterectomy?

Uterine amputation
Supravaginal amputation of the uterus (literally cutting off the uterus) or subtotal hysterectomy is the removal of the body of the reproductive organ while preserving the cervix. This operation has a number of advantages:
  • the operation is more easily tolerated by patients;
  • ligamentous material is preserved, which prevents prolapse of the internal pelvic organs;
  • lower likelihood of developing complications from the urinary system;
  • Violations in the sexual sphere are less common.
The operation is indicated for young women in the earliest stages of the disease, in cases where there are no additional risk factors for developing cervical cancer.

Hysterectomy
Hysterectomy or total hysterectomy is the removal of the uterus along with the cervix. The standard scope of surgery for stage I uterine cancer according to FIGO (the tumor is limited to the body of the uterus) is removal of the uterus along with the cervix and appendages.

At the second stage of the disease, when the likelihood of malignant cells spreading through the lymphatic vessels is increased, the operation is supplemented with bilateral lymphadenectomy (removal of the pelvic lymph nodes) with a biopsy of the para-aortic lymph nodes (to exclude the presence of metastases in the lymph nodes located near the aorta).

What is open (classical, abdominal), vaginal and laparoscopic hysterectomy?

Operation technique
Classic or open abdominal hysterectomy is referred to as when the surgeon gains access to the uterus by opening the abdominal cavity in the lower abdomen. This operation is performed under general anesthesia, so the patient is unconscious.

Abdominal access allows surgical interventions of varying volumes (from supravaginal amputation of the uterus to total hysterectomy with removal of the uterine appendages and lymph nodes).
The disadvantage of the classical technique is the increased trauma of the operation for the patient and a fairly large scar on the abdomen.

A vaginal hysterectomy is the removal of the uterus through the back wall of the vagina. Such access is possible in women who have given birth and with small tumor sizes.

Vaginal hysterectomy is much easier to tolerate by the patient, but a significant disadvantage of the method is that the surgeon is forced to act almost blindly.

This disadvantage is completely eliminated with the laparoscopic method. In such cases, the operation is performed using special equipment. First, gas is injected into the abdominal cavity so that the surgeon can gain normal access to the uterus, then laparoscopic instruments to remove the uterus and a video camera are inserted into the abdominal cavity through small incisions.

Doctors monitor the entire course of the operation on a monitor, which ensures maximum accuracy of their actions and safety of the operation. The uterus is removed through the vagina or through a small incision in the front wall of the abdomen.

Using the laparoscopic method, any volume of surgery can be performed. This method is optimal because it is best tolerated by patients. In addition, complications are significantly less common with laparoscopic hysterectomy.

When is radiation therapy for uterine cancer indicated?

Radiation therapy for uterine cancer is usually used in combination with other measures. This treatment method can be used before surgery to reduce tumor volume and reduce the likelihood of metastasis and/or after surgery to prevent relapses.

Indications for radiation therapy may include the following conditions:

  • transition of the tumor to the cervix, vagina or surrounding tissue;
  • malignant tumors with a low degree of differentiation;
  • tumors with deep damage to the myometrium and/or with spread of the process to the uterine appendages.
In addition, radiation therapy can be prescribed in the complex treatment of inoperable stages of the disease, as well as in patients with severe concomitant pathologies, when surgery is contraindicated.
In such cases, this treatment method makes it possible to limit tumor growth and reduce the symptoms of cancer intoxication, and, consequently, prolong the patient’s life and improve its quality.

How is radiation therapy performed for uterine cancer?

For uterine cancer, external and internal irradiation is used. External irradiation is usually carried out in a clinic using a special device that directs a beam of high-frequency rays to the tumor.

Internal irradiation is carried out in a hospital, in which special granules are inserted into the vagina, which are fixed with an applicator and become a source of radiation.

According to indications, combined internal and external irradiation is possible.

What side effects occur during radiation therapy for uterine cancer?

Reproducing cells are the most sensitive to radioactive radiation, which is why radiation therapy destroys, first of all, intensively reproducing cancer cells. In addition, to avoid complications, a targeted effect on the tumor is carried out.

However, some patients do experience some side effects, such as:

  • diarrhea;
  • frequent urination;
  • pain during urination;
  • weakness, increased fatigue.
The patient should report the appearance of these symptoms to the attending physician.
In addition, in the first weeks after radiation therapy, women are advised to abstain from sexual activity, since during this period there is often increased sensitivity and soreness of the genital organs.

When is hormone therapy for uterine cancer indicated?

Hormone therapy is used for hormone-dependent uterine cancer. In this case, the degree of differentiation of tumor cells is preliminarily assessed and the sensitivity of the malignant tumor to changes in hormonal levels is determined using special laboratory tests.

In such cases, antiestrogens (substances that somehow suppress the activity of female sex hormones - estrogens), gestagens (analogs of female sex hormones - estrogen antagonists) or a combination of antiestrogens and gestagens are prescribed.

As an independent treatment method, hormone therapy is prescribed to young women in the initial stages of highly differentiated hormone-sensitive uterine cancer, as well as in the case of atypical endometrial hyperplasia.

In such situations, hormone therapy is carried out in several stages. The goal of the first stage is to achieve complete healing from oncological pathology, which must be confirmed endoscopically (endometrial atrophy).
At the second stage, using combined oral contraceptives, menstrual function is restored. In the future, they achieve complete rehabilitation of ovarian function and restoration of fertility (ability to bear children) according to an individual scheme.

In addition, hormone therapy is combined with other methods of treating uterine cancer for common forms of hormone-sensitive uterine cancer.

What side effects can occur during hormone therapy for uterine cancer?

Unlike other conservative treatments for uterine cancer, hormone therapy is generally well tolerated.

Hormonal changes can cause dysfunction of the central nervous system, in particular sleep disturbances, headaches, increased fatigue, and decreased emotional levels. For this reason, this type of treatment is prescribed with great caution to patients who are prone to depression.

Sometimes, during hormone therapy, signs of pathology of the digestive tract appear (nausea, vomiting). In addition, metabolic disorders are possible (feeling of hot flashes, swelling, acne).

Unpleasant symptoms from the cardiovascular system such as increased blood pressure, palpitations and shortness of breath appear less frequently.

It should be noted that high blood pressure is not a contraindication to hormone therapy, but it should be remembered that some drugs (for example, oxyprogesterone capronate) enhance the effect of antihypertensive drugs.

The occurrence of any side effects should be reported to your doctor; tactics for dealing with unpleasant symptoms are selected individually.

When is chemotherapy indicated for uterine cancer?

Chemotherapy for uterine cancer is used exclusively as a component of complex treatment for advanced stages of the disease.

In such cases, the CAP regimen (cisplastin, doxorubicin, cyclophosphamide) is most often used for maintenance therapy.

What complications can develop during chemotherapy for uterine cancer?

Chemotherapy uses drugs that inhibit dividing cells. Since antitumor drugs have a systemic effect, in addition to the intensively multiplying cells of the tumor tissue, all regularly renewed tissues come under attack.

The most dangerous complication of chemotherapy is the inhibition of proliferation of blood cells in the bone marrow. Therefore, this method of treating oncological diseases is always carried out under laboratory monitoring of blood conditions.

The effect of anticancer drugs on the epithelial cells of the digestive tract often manifests itself in such unpleasant symptoms as nausea, vomiting and diarrhea, and the effect on the epithelium of the hair follicles results in hair loss.

These symptoms are reversible and completely disappear some time after stopping the drugs.
In addition, each drug from the group of antitumor drugs has its own side effects, which the doctor informs patients about when prescribing a course of treatment.

How effective is treatment for uterine cancer?

The effectiveness of therapy for uterine cancer is assessed by the frequency of relapses. Most often, the tumor recurs during the first three years after the end of primary treatment (in every fourth patient). At a later date, the relapse rate decreases significantly (up to 10%).

Cancer of the uterine body recurs mainly in the vagina (more than 40% of all relapses) and in the pelvic lymph nodes (about 30%). Tumor foci often occur in distant organs and tissues (28%).

What is the prognosis for uterine cancer?

The prognosis for uterine cancer depends on the stage of the disease, the degree of differentiation of tumor cells, the age of the patient and the presence of concomitant diseases.

Recently, it has been possible to achieve a fairly high five-year survival rate in patients with uterine cancer. However, this only applies to women who sought help in the first and second stages of the disease. In such cases, the five-year survival rate is 86-98% and 70-71%, respectively.

The survival rate of patients in the later stages of the disease remains stable (about 32% in the third stage, and about 5% in the fourth).

All things being equal, the prognosis is better in young patients with highly differentiated hormone-dependent tumors. Of course, severe concomitant pathology significantly worsens the prognosis.

How can you protect yourself from uterine cancer?

Prevention of uterine cancer includes the fight against avoidable risk factors for the development of pathology (elimination of excess weight, timely treatment of liver diseases and metabolic-endocrine disorders, identification and treatment of benign changes in the endometrium).

In cases where benign endometrial dysplasia does not respond to conservative treatment, doctors advise turning to surgical methods (endometrial ablation or hysterectomy).

Since the prognosis for uterine cancer largely depends on the stage of the disease, so-called secondary prevention, aimed at timely diagnosis of a malignant tumor and precancerous conditions, is of great importance.

A malignant process in the cervix is ​​called cervical cancer. If glandular tissue is affected, the disease is histologically classified as adenocarcinoma, otherwise as squamous cell carcinoma.

Stage 1 cervical cancer is classified in accordance with the rules of the international TNM system, which can be used to determine the spread of the tumor, the presence or absence of distant metastases, and metastases in the lymphatic system.

In this system, stage 1 of cervical cancer is designated as T1, where T (tumor) is an indicator of the extent of the primary tumor. This means that the malignant process exclusively affects the cervix. The body of the uterus is not affected. But stage 1 also has its own classification:

  1. The tumor process affects the cervix - T1.
  2. Tumor penetration into tissue can be detected microscopically - T1a:
  • Tumor growth into the stroma (the basis of the organ, consisting of connective tissue in which blood and lymphatic vessels pass) to a depth of up to 3 mm and up to 7 mm on the surface - T1a1;
  • Tumor growth into the stroma up to 5 mm deep and up to 7 mm on the surface – T1a2.
  1. The tumor can be detected visually during a physical examination, or microscopically, but the size will exceed T1a and its subtypes - T1b:
  • Visually detectable lesion up to 4 mm in size – T1b1;
  • Visually detectable lesion larger than 4 mm – T1b

There is another classification of cervical cancer stages according to FIGO:

  • Stage I, corresponding to T1 according to TNM;
  • Stage IA divided into I.A.1 And I.A.2 and is equivalent to stages T1a1 and T1a2 according to TNM;
  • Stage I.B. divided into I.B.1 And I.B.2 and is equivalent to stages T1b1 and T1b2 according to TNM;

Despite the fact that the TNM classifier is better known, in diagnosis the tumor is initially described by FIGO. Russian specialists often use letters of the Russian alphabet. It looks like this: A1, B1 etc.

The initial stage of cervical cancer includes the so-called cancer in situ (stage 0). Unlike stage 1, malignant cells have not yet invaded (have not grown) into the underlying tissue. Tumor cells proliferate, but at the same time die, which prevents the tumor from growing.

With adequate and timely treatment, the prognosis for stage 1 cervical cancer is favorable. According to statistics, the five-year survival rate of patients with this pathology exceeds 90%.

Treatment

Treatment of stage 1 cervical cancer can be carried out in several ways, including a combination of them. The choice of one or another treatment method or their combination depends on the histological type of tumor (squamous cell carcinoma or adenocarcinoma), its stage, the presence of concomitant pathologies in the patient, etc.

Important! If you are diagnosed with cervical cancer at any stage, it is very important to consult a specialist in a timely manner. You should not look for treatment methods on forums and other resources. Treatment of cancer requires a systematic approach and should take place in a hospital setting under the supervision of a doctor. Traditional medicine is powerless.

There are several types of surgeries for excision of cervical tumors. These include:

  • Amputation of the cervix;
  • Knife conization;
  • Radical trachelectomy;
  • Pelvic exenteration;
  • Various types of hysterectomy.

In the case of treatment of stage 1 cervical cancer (T1a and T1b), hysterectomy is predominantly used, and in some cases radical trachelectomy.

Trachelectomy is the complete or partial removal of the cervix, part of the vagina, groups of iliac and lymph nodes, as well as some groups of ligaments. The advantage of such an operation will be the preservation of the woman’s reproductive function.

A hysterectomy is an operation to remove the uterus. Several types of such manipulation are classified. When treating stage 1 cervical cancer, types I, II and III are used (there are 4 in total).

  • Type I – Performed for stage T1a1 and cancer in situ. Involves removal of the uterus and a small part of the vagina (up to 1 cm);
  • Type II – Performed for stages T1a1, T1a2, T1b This type involves radical hysterectomy. The uterus and a small part of the vagina (up to 2 cm) are completely removed along with the ureters;
  • Type III - Performed at stage T1b. It involves the removal of paravaginal and paracervical tissue, part of the vagina, uterus and uterosacral ligaments.

In the treatment of stage 1 cervical cancer, such therapy is predominantly used as an auxiliary therapy. Used in cases where there are contraindications to combined radiation therapy or when the patient does not tolerate it well. In this case, the tumor must be reduced to allow surgical treatment. For this purpose, special schemes for the administration of cytostatics have been developed. Typically, the patient undergoes 3 courses of polychemotherapy; if the tumor responds positively to the cytostatic drug (it decreases), excision of the tumor is possible.

Radiation therapy

This treatment method can be carried out alone or in combination with chemotherapy and surgery. There are several types of radiation therapy:

  • External beam radiation therapy - with this method, the radiation source (usually a linear accelerator) does not come into contact with the tumor;
  • Intracavitary radiation therapy – the radiation source is in direct contact with the tumor;
  • Combined radiation therapy – combines both of the above methods.

Radiation therapy can stabilize the oncological process, improve the patient’s quality of life, reducing the severity of symptoms, and also lead to a complete recovery.

It has a number of contraindications: fibroids, adhesions, endometritis, some diseases of the genitourinary organs.

When treating cervical cancer at stages defined as T1a1 and T1a2, hysterectomy is usually used in combination with radiation therapy (external + contact).

When treating stage T1b1, hysterectomy is used in combination with external beam radiation or chemotherapy. It is possible to use exclusively combined radiation therapy.

Stage T1b2 is usually treated with chemotherapy and radiation therapy. In some cases, it is possible to use hysterectomy in combination with radiation therapy.

After complete cure of the disease, the risk of relapse cannot be excluded. It may occur after six months (or more). Indicates the incurability of the malignant process. The tumor can be located both in the cervix and in any other organ in the form of metastases. Decisions about treatment methods are made individually. Usually they combine all possible methods. Polychemotherapy is prescribed to improve the patient’s quality of life (palliative therapy).

Etiology and pathogenesis

Scientists have identified several factors that increase the risk of cervical cancer. Among them: smoking, early sexual activity and frequent changes of sexual partners. But the most likely cause of the disease is human papillomavirus types 16 and 18, which is sexually transmitted. Up to 75% of cases of malignant process in the cervix are associated with this virus.

During normal functioning of the body's immune system, the human papilloma virus is destroyed. But if it is suppressed, then the virus instantly develops, takes on a chronic form and has a negative effect on the epithelial layer of the cervix.

Clinical manifestations

In the early stages of the malignant process, cervical cancer practically does not manifest itself at all, which makes diagnosis much more difficult. Therefore, it is very important to undergo regular gynecological examinations. In the presence of an oncological process in the body, there are common somatic manifestations in the form of general weakness, increased sweating at night, weight loss and persistent low-grade fever. When taking a general blood test, leukocytosis (increased white blood cells), possibly slight anemia and an increased erythrocyte sedimentation rate (ESR) will be observed.

Symptoms such as: bleeding, spotting and other discharge, pain in the pelvic area, difficulty urinating, etc. are characteristic of stages 3-4 of cervical cancer; at stage 1 they appear extremely rarely.

An integrated approach must be taken to the diagnosis of cervical cancer.

Physical examination

Involves a general examination of the woman. Palpation of peripheral lymph nodes and abdominal cavity. Examination of the cervix in a chair using mirrors and bimanually. A rectal examination is required.

Laboratory diagnostics

First of all, the gynecologist takes smears from the cervical canal and human papilloma. Next, biochemical and general clinical tests of blood and urine are required. Blood serum, tests for tumor markers.

Non-invasive diagnostic methods

The main methods of non-invasive diagnostics include ultrasound of the pelvic organs and internal organs. Tomographic examination (MRI, PET). Positron emission tomography will help determine the presence of metastases in organs and tissues. If necessary, additional methods can be used: cystoscopy, sigmoidoscopy, colonoscopy, etc.

Invasive diagnostic methods

These methods include taking a biopsy for an accurate diagnosis, determining the stage, tumor proliferation. In some cases (presence of metastases), diagnostic laparoscopy may be necessary.

If stage 1 cervical cancer is suspected, when making a diagnosis it must be differentiated (distinguished) from sexually transmitted diseases. Sometimes with syphilis, the surface of the cervix becomes covered with small ulcers, which may resemble a malignant process. Next, it should be distinguished from ectopia, papillomas, and other similar diseases of the cervix. From sexually transmitted infections and from uterine cancer that has spread to the cervical canal and vagina.

Preventive measures in the fight against cervical cancer included human papillomavirus, which are successfully used in developed countries. At the same time, positive statistics have already been determined to reduce the incidence of cervical cancer and (dysplasia). It is recommended that girls and boys aged approximately 9-13 years be vaccinated before sexual activity. Vaccination is also recommended for women under 45 years of age.

Video: Early stage cervical cancer surgery

Video: Treatment of dysplasia and cervical cancer in situ

23.10.2018

The main problem that cancerous tumors of the female reproductive organs are detected at a later stage is the problem of diagnosing it in the early stages.

Uterine cancer can be classified as stage 1 cancer; its development occurs without any symptoms. If it is recognized and treatment is started on time, then a positive outcome of therapy is guaranteed.

Uterine cancer is one of the oncological neoplasms on the cervix or damage to the endometrium. This cancerous disease is diagnosed in the fair sex after fifty years, but the disease has begun to “rejuvenate.”

Symptoms of the disease

Doctors have found that the disease does not manifest symptoms in the early stages of development, but there are signs by which it can be recognized.

Stage 1 uterine cancer is recognized by five main symptoms:

  1. Bleeding from the uterus. Doctors consider this the first sign of cancer. When this symptom occurs after the onset of menopause, it indicates the onset of cancer. The therapy started is quite successful.
  2. Discharge similar to mucus. These secretions indicate that oncological education has reached a certain level of development. Sometimes you can observe the accumulation of such secretions in the uterine cavity. During this, a woman may experience pain similar to premenstrual pain.
  3. Watery discharge. This symptom indicates that a cancerous tumor is developing. As the disease develops, such discharge becomes purulent and an unpleasant odor appears.
  4. Purulent discharge. This is a symptom for uterine cancer, which indicates accumulated purulent discharge in the organ cavity.
  5. Painful sensations. Some kind of pathology develops in the reproductive system. The nature of the pain is nagging and it appears mainly in the evening and at night. As the disease develops, the pain becomes similar to kidney pain.

Diagnosis of the disease

Diagnosis of cancer is aimed at the stage of development of the tumor. She will help you choose a treatment method. If the disease can be diagnosed at an early stage of development, then the disease can be cured.

To make an accurate diagnosis, it is necessary to apply a comprehensive diagnosis. Only with the help of this method will it be possible to establish the stage of the disease and the affected area.

The following methods are used for diagnosis:

  • Patient complaints. In other words, it is necessary to collect an anamnesis. This means that the doctor conducts a survey, carefully studies the patient’s medical history, her previous tests and palpation. After processing this information, the doctor suggests possible causes for the development of cancer.
  • Visual gynecological examination, this procedure is carried out using a gynecological speculum. Thus, the doctor can see the presence or absence of pathology in the uterus. In addition, an examination of the fallopian tubes, ovaries and other pathological formations is carried out. If, however, a pathology has been identified, then a biopsy is prescribed.
  • Biopsy. This is a painless procedure that is performed in an outpatient setting. As a result, a piece of the affected biological material is taken from the patient for examination. With its help, you can identify oncology before stage 1 has passed. Although as a result of the educational process it is possible to identify it in 40% of cases.
  • Cytological examination. It is carried out when the doctor suspects the presence of a cancerous tumor. To do this, it is necessary to examine a sample of the resulting affected tissue.
  • Ultrasound. It is considered the most effective and therefore the most common diagnostic method. Ultrasound examination will help to accurately determine:
  1. Cancerous tumor in the uterine cavity.
  2. Damage area.
  3. Tumor structure.
  4. Localization area.
  5. Damage to the appendages.
  6. Possible metastases.
  • MRI and CT. They are carried out as an additional study to an ultrasound scan. With their help, it will be possible to determine whether the lymph nodes and bones are affected by metastases. Because ultrasound cannot show this.
  • Hysteroscopy. This is a modern diagnostic method that is used to establish or refute a cancer diagnosis. The procedure is carried out using an endoscope, which is used to examine uterine cancer and remove damaged tissue for examination. This method is 100% effective.

Treatment of the disease

There are many ways to treat cancers that occur in the female genital area and they are all quite effective. All of them are used in parallel with traditional methods.

Having determined stage 1 uterine cancer, it is impossible to say how long they will live. This depends on what treatment was chosen, but also on the development of the disease.

There are several methods of therapy:

  • Surgical intervention. First-degree cancer is characterized by the presence of a cancerous formation in the uterine cavity that has not had time to metastasize. During this period, surgery will be performed. The result of this treatment is positive.

Removal is carried out in several ways:

  • Radical removal, in which the uterus itself is removed, but the ovaries, tubes and cervix remain.
  • Subtotal excision, in which only the cervix is ​​preserved.

Only this method has its contraindications, for example, diabetes, hypertension, atherosclerosis. Then other treatment methods are needed:

  1. Irradiation. It can be used as an independent method of therapy or in combination. The patient is usually irradiated before surgery, so that the size of the tumor decreases slightly, or as a prophylaxis after surgery, so that the disease does not recur. This method can be used if other methods are contraindicated. Radiation can be carried out in two ways: internal and external. Internal, carried out only in a hospital, and external can be used in an outpatient setting. Quite often, to improve the effect, two methods are carried out simultaneously.
  2. Hormonal treatment. It is believed that this method will only help if the disease is diagnosed early. It can be used as a separate therapeutic method or in parallel with surgery.
  3. Chemotherapy. This means that the tumor will be exposed to various chemicals that can stop the development of cancer. It must be used in combination with therapeutic methods. Such treatment can begin when the stage of the disease is diagnosed; it has side effects. It has a detrimental effect on cancer cells; this method can also kill healthy ones, which negatively affects the patient’s condition.

Disease prognosis

The prognosis, when stage 1 cancer is detected, is quite good with a five-year survival rate. How long the patient will live will depend on the timely diagnosis of the disease, the selected method of therapy, the age of the patient and the condition of her body.

If the disease is detected in time, then the five-year survival rate can reach 90%. We can say that this is a victory over cancer. Not every doctor can boast of results.

Preventive measures

Women who may be at risk for this disease are advised by doctors to undergo regular preventive examinations, use special medications, and undergo replacement therapy during menopause. It is necessary to take care of nutrition and weight loss.

Today's scientists have developed a vaccine that helps prevent the development of cancer, this is the first drug - Gardasil. You can also use barrier contraception. This method will help reduce the risk of cancer and prevent the occurrence of sexually transmitted diseases and the human papillomavirus.

The preventive measures and examinations carried out will help to avoid cancer of the uterus.