If we read the man, first of all, you should understand a little bit with female physiology. Briefly, clearly and without much equivocation. Thus, the neck – is the lower part of the uterus. It connects the body of the uterus (the seat of the fetus) from the vagina. Cervical plot adjacent to the body of the uterus is called the endocervix (read: the mucous membrane of the cervical canal), and to the vagina – ektotserviksa. The cervix is lined with two types of cells: squamous (ectocervix) and gland (endocervical). The meeting point of these two types of cells gynecologists called transformation zone. Here arises the majority of tumors.
The cells lining the cervix does not immediately become cancerous. First, they undergo a series of precancerous
changes, called cervical intraepithelial neoplasia, squamous intraepithelial lesions and dysplasia. All these changes are clearly seen in the Pap test (Papanicolaou George, whose name is called laboratory-diagnostic study, worthy of at least a monument for hundreds of thousands of saved lives of women).
Now – about the kinds of cervical cancer. By and large – there are only two (leave out the rare cervical melanoma, sarcoma, and lymphoma – referred to in the article will not talk about them): squamous cell carcinoma (squamous cell carcinoma) and adenocarcinoma . The first of these develops into squamous cells of ectocervix, but more often found in the area of transformation. As for adenocarcinoma, it begins in the glandular cells of the endocervical mucosa. Less common cancer and the mixed.
Statistics on cervical cancer
Cervical cancer has been one of the most frequent causes of death among women. Later, between 1955 and 1992 the the death rate from cervical cancer has decreased by almost 70%. The reason for this was already mentioned above, the Pap test by which precancerous degeneration of cells has become possible to detect malignancy before them, and if it has already happened, it is detected at an earlier stage.
Cervical cancer has a tendency to the appearance of the middle age group of patients, most often – up to 50 years. However, many older women underestimate the risk of developing this type of cancer: more than 20% of cases occur in women over 65 years.
Risk factors and causes of cervical cancer
- Women who are not related to any of the following risk factors develop cervical cancer is very rare. We can say more: the many women who have one or more of these factors, and never in my life do not occur with this terrible disease. Because when a woman gets sick, almost never tell which of the factors has led to this. You may ask: Excuse me, but what’s the point then in this chapter? There’s a meaning. It consists in the fact that many factors are dependent on the woman and if it reconsider its behavior, it may to some extent reduce the risk of cancer. Non-modifiable factors are also very important to know, because they are the basis for women premises at risk and more frequent screening using the Pap test. So, we list, finally, these risk factors:
Human papillomavirus (HPV). This is the most obvious cause of cervical cancer, so let me tell you more about it than about other factors. HPV brings together a group of more than 150 viruses. Some of them are able to give rise tumors called papillomas or warts. HPV can infect the cells at the skin surface, mucous membranes of the genitals, anus, oral cavity. It can be transmitted from person to person through skin contact, including vaginal, anal and oral sex. Anogenital warts (warts) are rarely the cause of cancer. They are caused by HPV types such as HPV 6 and HPV 11. The most dangerous against cervical cancer are HPV 16, 18, 31, 33 and 45. Oncologists believe the most likely algorithm is as follows: infection with HPV 16 or 18 (these 2 types cause more 70% of cervical cancer cases), followed by a gradual “nurturing” of cervical cancer. It is no secret that the majority of the world’s population are infected with HPV, but as a rule, the human body is quite successfully copes with the virus on their own. Otherwise, the virus may become chronic, and if it is carcinogenic HPV type, the end result may well be, and cervical cancer;
- Immunosuppression (meaning, including AIDS);
- chlamydia ;
- Diet (absence in the diet of fruits and vegetables, eating, obesity);
- Oral contraceptives; IUD ;
- A large number of full-term pregnancies;
- Full Term Pregnancy in early (before 17 years) age;
- Diethylstilbestrol (a hormonal drug, widely used in gynecological practice previously);
- Family history.
Prevention of cervical cancer
Prevention and early diagnosis of cervical cancer are the priority measures on which efforts should be directed not only to doctors but also women themselves.
If timely identify and properly treat diseases of the genital organs, which can trigger the risk of developing cervical
cancer (chlamydia, erosion and cervical dysplasia, and other diseases), then so it will be only one major risk factor – is the human papilloma virus (HPV), the fight which may protect a woman from occurrence of cancer of the cervix.
The new leadership of the World Health Organization on the prevention of and measures for the prevention of cervical cancer in women, announced more than a year ago at the summit of world leaders in the fight against cancer diseases in Melbourne (Australia), is based on three areas of activity:
1. Two-time HPV vaccination of female adolescents aged 9 to 13 years. Studies have shown that the use of an abbreviated two-dose vaccination scheme is as effective as vaccination trehdozovaya, used previously. Two-time vaccination scheme will reduce the cost of the procedure, which is important for countries with low income levels and small health budgets. Therefore, WHO recommends to waive the three vaccines (first introduced healthy girl with no HPV symptoms or other viral diseases, the second vaccine is used within 2 months after the first, and the third – after six months) in favor of the two, indicating that it allows more and to reduce the full-term vaccination. The vaccine protects against several strains of HPV, two of which HPV 16 and 18 of ¾ percent of cases provoke the development of cervical cancer. Because the virus is mainly spread sexual way, doctors recommend to vaccinate prior to sexual activity. If the woman has already had sexual intercourse, you should be tested to rule out the fact of the disease before vaccination. Vaccination of women with HPV latent form, is forbidden, because it stimulates the development of cancer.
2. The use of HPV tests WHO calls necessary for timely prevention of cervical cancer. Upon receipt of the negative results, i.e. information about the presence of HPV strains 16 and 18, the next test she must pass for 10 years. At positive results the screening is recommended every 5 years.
3. Increased awareness about cervical cancer. WHO guidance recommends that reach a wider audience than has been done before. As previously at risk are women over 29 years, but now there are also cases of the disease in younger women.
Symptoms of cervical cancer
- Symptoms and signs of cervical cancer at an early stage is practically absent. This calm lasts only until such time as the cancer becomes invasive and does not affect the surrounding tissue. When this happens, the woman begins to feel:
abnormal vaginal bleeding, for example, after sexual intercourse, after menopause, in between periods, after douching or a pelvic exam;
- prolonged menstruation extending heavier than usual;
- unusual vaginal discharge, which may contain traces of blood and occur between periods or after menopause;
- pain during intercourse.
By tradition, let us not forget to mention that all of these symptoms can be very different roots going, especially in the area of the esoteric relationship between the sexes, or setting aside the language of Aesop, let’s face it: the cause may be a variety of genital infections . In any case, hike to the gynecologist is inevitable, and the next – the card will fall: or it will be a Pap test, or Wasserman.
The saying “better safe than sorry” is here more than ever the place, so notorious Pap test is best held on a regular basis, regardless of the sum available symptoms. Your doctor should easily cope with precancerous conditions, to diagnose them (as well as the initial stages of cervical cancer) enough colposcopy and biopsy.
Stages of cervical cancer and survival
5-year survival of patients with cervical cancer, depending on the stage of the disease lies within the following values: 0 Stage – cancer cells do not extend beyond the cervical mucus, survival – 100%;
I of the stage – a tumor grows into the cervical tissue, but not It affects the uterus itself, the survival rate – 80-93%;
II of the stage – a tumor penetrates beyond the uterus, but does not extend to the pelvic wall and the lower part of the vagina, the survival rate – 58-65%;
III of the stage – a tumor grows in the wall of the pelvis and the lower part of the vagina can block the ureters, the survival rate – 32-35%;
IV of the stage – a tumor spreads to distant organs and tissues – 7-15%.
Treatment of cervical cancer
In addition to the standard set that abstracts of that therapeutic options for the treatment of cervical cancer are determined by the stage of the disease, characterized by the size and depth of germination of cancer, it is necessary to note one more very important point. It is the presence of factors such as the individual circumstances and preferences. Cervical cancer can significantly affect the sex life and the ability to have children. These issues must necessarily be discussed between the physician and patient with a choice of treatments. The patient should be aware of all possible risks and side effects of different treatment options.
A team of doctors who treat cervical cancer may include a gynecologist, cancers, oncologist, radiologist and chemotherapist. Traditional treatments for cervical cancer submitted to surgery, radiation therapy and chemotherapy.
Cryosurgery. The metal probe cooled in liquid nitrogen, is placed directly into the cervix, all abnormal cells freeze and die. After the operation may copious watery brown discharge, lasting for several weeks. Cryosurgery is used exclusively for the treatment of precancerous lesions and is not used for invasive cancer.
Laser surgery. The method is based on the evaporation of abnormal cells with a focused laser beam passing through the vagina. Local anesthesia is used. By analogy with cryosurgery, laser surgery is not used for treatment of invasive cancer.
Conization (wedge biopsy). Essence of the method is as follows. Because cervical cone-shaped piece of tissue is removed. For these purposes or laser surgical knife, or the loop electrode (so-called cervical electroexcision loop). Conization can be used for diagnostic purposes prior to the main treatment (surgery and irradiation), and diagnosed in the early stages of cervical cancer in those women who want to preserve the reproductive ability.
Hysterectomy. It is an operation to remove the uterus (including the body and cervix), but without affecting surrounding structures (parauterine fiber and sacro-uterine ligaments). The vagina, ovaries, fallopian tubes and the pelvic lymph nodes are also usually remain intact.
If the uterus is removed through a surgical incision in the abdominal wall, such an operation is called abdominal hysterectomy. If used for this purpose laparoscopy – the laparoscopic hysterectomy. In some cases, laparoscopy is performed using special instruments that are managed remotely by the surgeon: the so-called robotic surgery.
As for the sexual aspect of a hysterectomy, it in no way affects the possibility of obtaining pleasure from sexual activity, achieving orgasm.
There is a more radical version of hysterectomy, it is called: Radical hysterectomy . In this case, the uterus is removed, not only, but also the surrounding tissue, the upper part of the vagina, part of the pelvic lymph nodes. Radical hysterectomy is used at more advanced stages of the disease.
Trachelectomy. Most patients with cervical stages IA and IB cancer undergo hysterectomy. But there is another type of surgery, which, unlike the latter, it keeps the reproductive ability – is a radical trachelectomy. It involves removal of the cervix and upper vagina, but not the uterus body.
External beam therapy is typically used in combination with low doses of chemotherapy Cisplatin. This treatment is usually within 6-7 weeks.
Other treatment options for cervical cancer is brachytherapy (internal radiation therapy). For the treatment of patients who have undergone a hysterectomy, a radioactive material is placed in a special cylinder into the vagina. When you save the uterus pellets with a radioactive substance in a small metal tube (the so-called “tandem”), equipped with a round metal holders ( “ovoid”) are injected directly into the uterus.
Direct form of brachytherapy, where radioactive material through a thin needle is injected directly into the tumor, cervical cancer is used relatively infrequently.
Brachytherapy can be carried out on the background of both low and high doses of radiation. In the first case, the treatment takes only a few days, during which time the patient is in a hospital bed in constant contact with the special tools, holding the radioactive substance at the target point. In the second case of constant hospitalization is not required: high doses of radiation are introduced into the body for a few minutes and then removed away.
Chemotherapy for cervical cancer is recommended in two situations. In the first place – as part of the basic treatment. At some stages of cancer chemotherapy to stimulate the action of radiation therapy. Such a successful symbiosis of these two treatments is called competitive chemoradiotherapy. Most often combined with radiation therapy reception Cisplatin (sometimes – together with 5-fluorouracil). Another situation for the purpose of chemotherapy – a recurrence of cancer, when the tumor begins to grow again after treatment. Chemotherapy drugs can also be used in cases where the tumor has spread to distant organs and tissues.
In addition to cisplatin in cervical cancer may be used:
- Paclitaxel (Taxol);
- Gemcitabine (Gemzar), alone or in various combinations.
Accessories and alternative treatment of cervical cancer: what is the difference?
If you have cancer, in any case, you’ve heard about the approaches and methods of its treatment, not to mention your health care provider. Sources of information can be very diverse: from family and friends to the social networks and thematic sites on the World Wide Web. Vitamins, herbs, special diets, massages, acupuncture – what only do not speak in relation to the treatment of cancer.
This is called secondary or alternative treatment, but not everyone understands the difference between these two definitions. Auxiliary treatment – these are the methods and tools that are used in addition to the main treatment. Alternative treatments – it’s something that goes beyond the physicians developed a treatment plan.
Most of the helper methods are perceived as, and should be: they do not cure the disease itself, but it helps to soften its manifestations. Here are just some of the methods suggested by doctors with basic treatment: meditation for stress reduction, acupuncture for pain relief, mint tea to curb the gag reflex. Some of them work, not the effectiveness of other proven.
The big danger is not the “alternativschina”, and the possible loss of a chance to really effective treatment in the pursuit of ephemeral advantages.
As for alternative cancer treatments, they are presented as a kind of panacea that can cure cancer alone. These methods have not been investigated in clinical trials and may be not only useless, but also dangerous. But the greatest danger is not the “alternativschina”, and the possible loss of a chance to really effective treatment in the pursuit of ephemeral advantages. Suspension or complete rejection of traditional treatment may give the cancer time to grow, which naturally aggravates the final forecast.
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