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Unfortunately, tumor is often detected at late stages, when the chances of recovery are low. While the arsenal of modern medicine has all the tools to not only diagnose Cervical cancer in time but also to cope with the disease.
The development of cervical cancer can be prevented because in most cases, it develops against the background of long-existing precancerous diseases.
Cervical cancer: about the symptoms and treatment of the insidious disease - firsthand
What should I do to prevent the development of cervical cancer? What prevention measures exist? What if cervical cancer has already made itself felt?
What is cervical cancer?
Cervical cancer is a disease of the female sexual sphere, which is characterized by the appearance of a malignant tumor on the cervix (the part of it that is located between the vagina and the body of the uterus).
Unfortunately, cervical cancer is a fairly common cancer among young women aged 15 to 39 years.
It should be noted that the formation of cervical cancer is a long process that progresses over time. This allows you to diagnose the disease at an early stage, before invasive cervical cancer, in which the altered cells grow deep into the cervical tissue and even into neighboring organs.
As a rule, this is preceded by the development of precancerous conditions – cervical intraepithelial neoplasia (CIN), which do not affect the well-being and fate of a woman for 8-10 years.
If you imagine the gradations of tumor formation, then first there are pre-cancerous light and moderate intraepitalial lesions (CIN I and II), and now the third degree (CIN III) is the zero form of cervical cancer.
In the absence of treatment, the process for several years rises up the folds of the cervical canal and deep into the cervix, capturing more and more areas. Increasing in size, the tumor can grow beyond the uterus to neighboring organs (bladder, rectum), as well as through the lymph and blood to give metastases ("dropouts" of cancer in the lymph nodes and other organs).
Treatment in these cases is much more severe and already ineffective.
What is the main cause of cervical cancer?
Today it is known that the development of cervical cancer is facilitated by infection with the human papillomavirus (HPV) of high oncogenic risk.
Typically, these are the 16 or 18 types that occur most frequently. They are responsible for more than 70% of all cases of cervical cancer. But this does not mean that if an infection is detected, the woman will necessarily get sick.
Cervical cancer can only develop in individuals with a persistent viral infection, that is, if the virus is re-detected more than 2-3 years after initial detection.
Most cases of HPV infection (about 90%) end up self-healing due to the protective functions of the body. With persistence, only 10% develop different degrees of CIN, of which the largest part of light damage spontaneously regresses.
Papillomavirus infection, which often causes cervical cancer in women, is transmitted sexually through direct contact with the mucous genitals. This virus does not exist in the blood. In the male body, the virus may not cause any disease or even warts, but it can stay for years and infect healthy women.
A woman can get cervical cancer from men!
This is why frequent changes of sexual partners increase the risk of infection. If there were five partners, then there is a 100% probability that the encounter with the human papillomavirus of high oncogenic risk has already occurred...
To dispel doubts and make sure of their own health about cervical cancer, it is wiser for a woman to pass the so-called digest test.
Digen-test is a quantitative analysis of 13 types of HPV of high oncogenic risk. Despite the presence of traces of the virus in the cervix, it is positive only at clinically significant concentrations of the virus.
With the help of the test, you can, first, exclude patients who had an infection on their own without causing severe neoplasia (they have a negative test), and secondly, evaluate the effectiveness of treatment by changing the viral load (the amount of virus in the tissues of the cervix).
In women with preinvasive and microinvasive cervical cancer, the digest test is always positive and has a significant viral load. If the operation to remove cervical cancer is successful, the test will be negative.
What are other symptoms of cervical cancer?
Insidiousness of the disease is that cervical cancer is asymptomatic and for a long time practically does not manifest itself, is not detected when examined in mirrors, or looks like a normal "pseudo-erosion". The precancerous period can last up to 10 years before the process moves into an invasive (cancerous) stage.
At the initial stage, the disease can only be detected by abnormal smear results, a positive test for HPV (human papillomavirus), or colposcopy. However, it is necessary to be wary if there are bloody discharge or white with a small admixture of blood from the vagina during sexual contact.
The growing tumor can compress the nerve plexuses of the pelvis and cause pain in the sacrum, lower back, and lower abdomen, as well as in the back and legs. Further growth of the tumor is accompanied by its disintegration with the appearance of abundant liquid whites with an unpleasant smell.
Is early detection of cervical cancer only possible by accident?
In many countries, there is an organized state screening that allows detecting the disease at the CIN stage. To do this, cytology is used, often combined with HPV testing.
Research is carried out on a massive scale and covers the absolute majority of women from 20 to 65 years: before 50 years-every 3 years, after 50 years - every 5 years. Simultaneous HPV testing increases the likelihood of detecting the disease.
Women should also take care of their own health to diagnose cervical cancer early. Namely, regularly, at least once every 3 years, and preferably once a year, visit a gynecologist for a scheduled examination, in which the doctor can perform a number of diagnostic tests.
Diagnostic techniques and research for detecting cervical cancer:
1. Examination of the cervix and mucosa in mirrors.
2. Getting a smear-scrape for cytological examination to search for abnormal and cancer cells under a microscope. One of the most common tests is PAP test. It is important that the smear is not represented only by mucus, but contains epithelial cells, so the material should be taken with special brushes. Today, there is a new technology of cytological research — liquid, when from one "scrape" you can get several smears at once for additional research of HPV and tumor markers in them.
3. Colposcopy (simple) - examination of the mucous membrane of the vagina and cervix using an optical device. In the extended version of the study, the vaginal part of the cervix is treated with a 3% solution of acetic acid, which causes edema of the abnormal epithelium (becomes glassy-white). What matters is the rate at which the swelling occurs and the duration. The more time passes after exposure to acetic acid, the more severe the damage.
4. Limited biopsy is used less often — a histological examination of a small area, which does not always correctly reflect the degree of damage achieved. All over the world, electrosurgical loop excision of the entire zone where the tumor process develops, or conization, is increasingly performed as the most complete diagnostic and therapeutic measure with the study of the entire abnormal epithelium.
Quite often, the neoplastic process is detected during the desired pregnancy, when the expectant mother comes to the women's consultation to get registered.
What should we do in this situation?
In some countries it is considered that it is not necessary to carry a pregnancy with cervical cancer, women are offered to have an abortion, since this is the first trimester, up to 12 weeks.
However, world standards are focused on preserving the fetus. Treatment is usually postponed until the postpartum period.
Of course, there is a risk. During pregnancy, there is natural physiological immunosuppression (suppression of the immune system), which accompanies the gestation of the fetus.
Against this background, cervical cancer can progress, so doctors always monitor these women during pregnancy and 6-8 weeks after birth to assess the condition of the cervix and perform the necessary treatment.
Abortion does not give any guarantees that there will not be a relapse of the disease. In addition, the possibility of repeated pregnancy may be in question.
Can vaccinations protect women from the risk of developing cervical cancer?
Positive effect of vaccination is the creation of an immune response in the blood, which, as a rule, prevents infection with the virus. As a result, it is expected to significantly reduce the number of cervical cancer diseases and the development of severe neoplasms by up to 70%.
By the way, the vaccination is recommended to be done in adolescence before the beginning of sexual life. But, alas, there are lesions caused by other types of virus that are not included in the currently registered vaccines and even those who are vaccinated need regular screening.
What methods of treatment for cervical cancer exist?
Any destructive impact (abnormal tissue is destroyed) can destroy the epithelium with a high degree of damage, which you will never know about. And, as a result, due to insufficient diagnosis of invasion and incomplete destruction of damage in depth, to get further development of the cancer process.
Treatment of cervical cancer is always selected strictly individually. In patients with stage 1A1 (up to 3 mm of invasion without involving microvessels), conization is sufficient — excision of the tissue with a thin wire loop of a conical shape. It is important that this type of operation allows a woman to become pregnant and become a mother in the future.
If the cervical cancer is already at stage 1A2 (up to 5 mm of invasion or microvessels are involved), lymph nodes are additionally removed or radical trachelectomy is performed – a complex extended operation with high removal of the supravaginal part of the cervix, fiber, and pelvic lymph nodes.
If the tumor has a greater depth of invasion, then radiation therapy and extended hysterectomy are performed — an operation to remove the uterus, fiber, and pelvic lymph nodes. Patients with stage 2 or more receive radiation therapy without surgery. If necessary, chemotherapy is prescribed.
What advice can be given to women on how to protect themselves from the risk of developing cervical cancer?
Purity of intimate life. These words sound at least naive these days, especially in the context of such a serious disease as cervical cancer. But it is. Do not smoke, since smokers have significantly reduced the protective properties of the cervical epithelium, which becomes much more vulnerable to the virus.
And also try to explain to teenage girls that an early start of sexual life can also cause the development of the disease. In adolescence, the cervical tissue is still immature, which significantly reduces local immunity.