Cervical cancer. Symptoms and signs, causes, stages, disease prevention

Cervical cancer is considered a dangerous pathological process that causes severe consequences for the whole body. It is important to identify it in a timely manner and conduct effective therapeutic therapy. Radiation therapy is considered an effective method of treatment, it allows you to completely suppress the abnormal development of cells.

But following the recommendations during the recovery period plays an important role in recovery. Many fear that cervical cancer after radiation therapy may reappear and cause serious problems, even death. For this reason, it is worth knowing what to do after treatment and what measures to follow.

Cervical cancer recurrence after radiotherapy

After radiation surgery in the treatment of cervical cancer, a recurrence may occur. This usually occurs in the second or third stage of the disease with complications. Such cases are not uncommon and they entail serious health complications.

Interesting! According to statistics, among sick women, cervical cancer recurrences account for only about 30% of cases. And this can happen if the therapy was carried out by highly qualified specialists in compliance with all the rules.

Be sure to pay attention to the main symptoms that may indicate the development of recurrent tumor growth in the cervical region:

• general exhaustion, which is accompanied by symptoms of chronic fatigue;
• the patient may have no appetite, apathy is observed, body weight decreases;
• there may be a feeling of fullness in the lower abdomen;
• while maintaining the patency of the uterine canal, bloody and purulent discharge from the external genital organs may be present;
• there is an obstruction of the ureter with a progressive character;
• the process of obliteration of the cervix with tumor tissues may additionally be accompanied by regular attacks of pulling and aching pain in the lower abdomen;
• showing signs of cancer.

If you notice all these symptoms, you should immediately consult a doctor. The specialist will definitely carry out the necessary diagnostics, which should include various procedures - a bimanual examination, laboratory tests,.

Once a recurrence is confirmed, the following treatments may be prescribed:

• Probing of the cervical canal;
• Radical intervention, during which an organ resection can be performed;
• Radiation therapy;
• Chemotherapy.

After radiation therapy during the treatment of cervical cancer, various unpleasant manifestations may occur. Mild side effects include general and local.

Common symptoms include the following:

• manifestation of nausea;
• gagging;
• dizziness;
• headache;
• signs of fatigue;
• symptoms of indigestion;
• brokenness.

In addition to general symptoms, local adverse reactions may occur. They usually occur in the area of ​​radiation therapy. The most popular local manifestations include the following:

• The manifestation of the inflammatory process of the skin of the suprapubic part;
• Burning sensation during urination;
• Frequent urge to urinate;
• narrowing of the vagina;
• Serous and bloody discharge may appear from the vagina.

Note! If you experience any of the above discomforts, you should immediately report them to your doctor. The specialist will conduct an examination and, if necessary, prescribe effective treatment therapy. But usually all side effects go away on their own in 1-6 weeks.

It should be borne in mind that radiation therapy is a rather dangerous procedure that can cause serious complications. However, it helps prevent the development of a dangerous oncological process and spread to other organs.

Many women experience menopause after radiation therapy. This condition occurs due to the increased load during treatment. Sometimes this condition normalizes and goes away, but this requires special treatment.

Radiation therapy can have a depressing effect on the activity of the organs of the hematopoietic system. Lymphedema usually occurs when radiotherapy is combined with surgery. It is accompanied by a violation of the outflow of lymph from the lower extremities, which leads to swelling of the legs and pelvis.

To prevent inhibition of the activity of the organs of the hematopoietic system, it is required to take a blood test every three months for the first few years. And in the subsequent period, this procedure is recommended to be carried out at least twice a year. If leukopenia and anemia occur, the analysis is performed more often.

Depression of the hematopoietic system in the bone marrow after radiation therapy requires special treatment. It is important that it be correct and comprehensive. In this case, the following important conditions must be met:

• taking vitamins and minerals;
• observance of regular rest;
• a full night's sleep;
• enhanced balanced nutrition;
• additional transfusion of blood or leukocytes, erythrocytes may be required;
• the use of drugs that provoke an increased production of leukocytes is prescribed;
• taking drugs that cause the release of red blood cells.

During oncological pathologies, special attention should be paid to nutrition. It is it that allows you to strengthen the immune system and speeds up the recovery process after radiation therapy for cervical cancer.

Particular attention should be paid to berries, vegetables, fruits, and cereals should also be included in the menu. These products contain antioxidants that speed up the process of cleaning the body of free radicals.

When eating after radiation therapy, the following important recommendations should be observed:

• As a preventive measure or during an illness, it is imperative to consume up to 5 servings of plant products per day;
• It is advisable to eat plant foods fresh, it should not be subjected to heat treatment. Steam cooking is allowed;
• During cancer and after radiation therapy, it is required to consume fatty acids. The menu should include sunflower oil and fish;
• Protein intake. This element is found in dairy products, as well as in meat, but it is better to replace it with fish;
• Meat should be eaten a maximum of 2 times a week. In this case, preference should be given to low-fat varieties;
• Do not forget about tinctures, herbal decoctions, these drinks have a positive effect on health. Drink more green tea, it contains a high level of antioxidants.

If you want to recover faster after radiation therapy for cervical cancer, then be sure to exclude from your nutrition menu:

• semi-finished products;
• fried and fatty food;
• salty food;
• strongly spicy and smoked dishes;
• cocoa;
• chocolate;
• tea with a high strength;
• sweets, confectionery with a high content of cream;
• alcoholic drinks.

Important! You don't have to give up sugar and salt completely. Be sure to control the content of these components in cooked food. Add them in limited quantities.

Intimate life after cervical cancer

If radiation therapy was successful and without complications, then many women undergo rehabilitation after it and continue to live a full intimate life. However, sometimes problems may arise in this regard, which can negatively affect not only health, but also.

A full intimate life is possible under the following conditions:

• if a woman has a vagina. If the uterus is not affected during the operation, then the woman will be able not only to live an intimate life, but even become pregnant, bear and give birth to a child;
• . In women, libido is fully preserved if she has preserved ovaries. Sexual life will eventually fully recover and return to normal;
• complete removal of the organs of the reproductive system, as well as. To restore the health and hormonal background of a woman, special hormonal treatment is used. Doctors also perform some plastic procedures.

Folk remedies help rapid recovery after radiation therapy. For cervical cancer, you can use recipes:

• aloe based product. 150 grams of aloe should be passed through a meat grinder or grind in a blender. Next, a glass of honey and ½ glass of red wine are added to the gruel. The finished mixture should be removed for a couple of days in a cold place. Take 1 tablespoon per day;
• for douching, you can use a decoction based on chamomile, calendula, thistle;
• tincture based on wormwood root. The ground root is mixed with alcohol in a ratio of 1:5. The container is closed and cleaned in a dark place for a week. Every day, 30 drops of tincture are diluted in 1 glass and taken.

Prevention

In order to avoid the manifestation of recurrence of cervical cancer in the future, as well as to preserve your women's health, it is worth observing important preventive measures:

• Maintaining a healthy lifestyle;
• Regular hygiene procedures;
• Vaccination against cervical cancer;
• Be sure to do cervical screening, which allows you to detect cervical cancer;
• In order to quickly bring the organs of the reproductive system back to normal, it is worth using special suppositories, which the doctor must prescribe.

Be sure to carefully monitor the health of the organs of the reproductive system. It is better to visit a gynecologist twice a year, this will allow you to timely determine the presence of dangerous diseases on. At the very beginning, the disease can be eliminated with medicines, proper nutrition and prevention, while this will not have a negative impact on health. It is worth remembering that radiation therapy can provoke many complications that will remain for life.

Video: radiation therapy and radiooncology

Video: innovations in radiotherapy for cervical cancer

Video: radiation therapy for gynecological cancer

The fight against cancer can end in different ways, but the outcome always depends on many factors, such as other health problems. If the cancer comes back, as mentioned earlier, it is called a recurrence. Some people may develop a new cancer unrelated to the first one. Usually it is new, that is, it is in no way connected with the previous one.

Unfortunately, overcoming cancer does not mean not getting sick with a new one. Sometimes you can get sick again with the same. This is rarely predictable. Even if you survived even two cancerous tumors, this does not mean that now you will never get it again. In fact, some treatments may increase the risk of future relapses.

• vaginal cancer;
• Cancer of the oral cavity and pharynx;
• cancer of the larynx;
• Lungs' cancer;
• Cancer of the anal canal;
• cancer of the vulva;
• Cancer of the bladder and ureter;
• Stomach cancer;
• Rectal cancer;
• Pancreas cancer.

Many of these cancers are linked to smoking or infection. human papillomavirus (HPV), which is also strongly associated with cervical cancer.

The risks of cancer of the stomach, rectum, vagina, vulva, and bladder are even higher in women who have been treated with radiation. Radiation treatment is also associated with an increased risk acute myeloid leukemia (AML) and bone cancer.

Follow-up after treatment

After treatment for cervical cancer is completed, regular visits to the doctor should be made to quickly look for signs of a return of cancer, if necessary, and to watch for possible new occurrences of cancer, especially in the intimate area.

Experts do not recommend additional testing without symptoms. Your doctor needs to know about all your diseases and ailments in order to send you in time for tests that can detect the recurrence of cancer.

For those who do not want to go back to the hospital with a recurrence, you should not smoke any tobacco products. Since smoking causes not only lung cancer, but also other types of cancer, and those who have been ill are subject to an increased chance of getting sick again.

• To maintain optimal weight, with its excess or lack, you need to force yourself to get in shape;
• To live an active lifestyle;
• Eat only healthy food, and drink as much water as possible;
• Strictly limit the use of alcohol, but it is better to refuse it altogether.

These actions will help bring the body in order and prevent the appearance of not only cancer, but also other diseases.

This is a malignant tumor that develops from the mucous lining of the cervix in the zone of transition of the cervical epithelium to the vaginal. Cervical cancer is one of the most common malignant tumors in women and is the second most common after breast cancer. More than 500,000 new cases of cancer are diagnosed annually. In a significant proportion of patients, the tumor is detected at a late stage, this is due to the insufficient diagnostic coverage of the female population, as well as the very rapid growth of the tumor.

Causes of cervical cancer

Usually there is a combination of several factors. More often, the tumor occurs in women aged 40-55 from low-income social strata, living in rural areas and having more than 6 children.

The following factors influence the development of cervical cancer:

Early onset of sexual activity - from 14 to 18 years, at this age, the epithelium of the cervix is ​​immature and is especially susceptible to damaging factors.
- frequent change of sexual partners (equal to or more than 5 increases the risk of developing cancer by 10 times) both in the woman herself and in her spouse;
- smoking more than 5 cigarettes per day;
- taking hormonal contraceptives and, as a result, refusal of barrier contraception (condoms and caps), while there is a risk of contracting sexually transmitted infections;
- non-compliance with sexual hygiene; sexual partners who have not been circumcised (since cervical cancer can provoke smegma);
- immunodeficiency, food deficiency of vitamins A and C;
- infection with genital herpes and cytomegalovirus viruses;
- Infection with the human papillomavirus (HPV).

Currently, through international studies, the direct carcinogenic role of HPV in the development of cervical cancer has been proven. It was revealed that from 80 to 100% of cervical cancer cells contain human papillomavirus. Entering the cell, the virus is integrated into the DNA chains of the cell nucleus, forcing it to "work for itself", creating new viral particles, which, leaving the cell through its destruction, are introduced into new cells. HPV infection is transmitted sexually. The virus can have a productive (formation of genital warts, papillomas on the genitals) and a transforming effect on cells (causes degeneration and cancer).

There are several forms of existence in the body of HPV infection:

Asymptomatic - despite the fact that the virus goes through a full life cycle in the patient's cells, it is practically not detected during examination and, after a few months, with good immunity, can be excreted from the body spontaneously;

Subclinical form - when viewed with the naked eye, the pathology of the cervix is ​​\u200b\u200bnot determined, but colposcopy reveals small multiple warts of the cervical epithelium;

Clinically expressed forms of infection: genital warts are clearly defined in the area of ​​the vulva, anus, less often on the cervix.

More than 80 types (varieties) of the virus are known, about 20 of them are capable of infecting the mucous membranes of the genital organs. All of them affect the development of cervical cancer in different ways: "high risk" viruses: 16, 18, 31, 33, 35.39, 45, 50, 51, 52, 56, 58, 59, 64, 68, 70 types ; "low risk" viruses: 3, 6, 11, 13, 32, 42, 43, 44, 72, 73 types.

It has been established that types 16 and 18 are most often found in cervical cancer, 6 and 11 - in benign tumors and only occasionally in cancer. At the same time, type 16 occurs in squamous cell carcinoma of the cervix, and type 18 in adenocarcinoma and low-grade cancer.

Precancerous diseases (dangerous due to frequent transformation into cancer): cervical dysplasia (a change in the structure of the epithelium that does not exist normally), cervical erosion, leukoplakia. They require mandatory treatment, most often, laser evaporation of the affected area.

1- Polyp of the cervical canal; 2- erosion of the cervix.

Symptoms of cervical cancer

Symptoms of cervical cancer are divided into general and specific.

General symptoms: weakness, weight loss, loss of appetite, sweating, causeless rises in body temperature, dizziness, pallor and dryness of the skin.

Specific symptoms of cervical cancer may include:

1. Bloody discharge from the genital tract, not associated with menstruation, may be slight, spotting, or profuse, in rare cases, bleeding is observed. Often spotting occurs after sexual contact - "contact discharge". Manifestations are possible in the form of acyclic discharge or against the background of menopause. In the later stages, the discharge may acquire an unpleasant odor associated with the destruction of the tumor.

2. Pain in the lower abdomen: may accompany spotting, or occur with advanced forms of cancer as a result of infection or tumor growth of other pelvic organs or structures (nerve plexuses, pelvic walls).

3. Edema of the extremities, external genitalia occurs with the progression of the disease in advanced and advanced cases, occurs as a result of metastasis to nearby pelvic lymph nodes and blockage of large vessels that drain blood from the lower extremities.

4. Violation of the function of the intestines and bladder occurs when a tumor grows into these organs - the formation of fistulas (holes between organs that do not exist normally).

5. Urinary retention associated with mechanical compression of the metastatic lymph nodes of the ureters with subsequent shutdown of the kidney from work, the formation of hydronephrosis, a consequence of which is poisoning of the body with waste products (uremia) in the complete absence of urine - anuria.

In addition, the described changes lead to the penetration of a purulent infection through the urinary tract and the death of patients from severe infectious complications. Possible hematuria (blood in the urine).

6. Edema of the lower limb on the one hand - can occur in the later stages, in the presence of metastases in the lymph nodes of the pelvis and compression of large vessels of the limb by them.

Testing for suspected cervical cancer includes:

1. Examination in the mirrors and bimanual (manual) examination - a standard examination by a gynecologist, a visual examination allows you to identify or suspect a tumor pathology by the appearance of the mucous membrane of the cervix (growth, ulceration);

In the mirror view of the cervix

2. staining with Lugol's solution (iodine) and acetic acid: allows you to identify indirect signs of both initial and advanced cervical cancer - tortuosity of blood vessels, staining of pathological foci less intense than normal areas, and others;

Area of ​​altered epithelium (dark area, shown by arrow)

3. colposcopy - examination of the cervix with a magnification of 7.5-40 times, allows you to examine the cervix in more detail, identify precancerous processes (dysplasia, leukoplakia) and the initial form of cancer;

4. taking smears for cytological examination from the cervix and cervical canal - should be performed annually for every woman to detect microscopic, initial forms of cancer;

5. biopsy of the cervix and curettage of the cervical canal - taking a piece of the cervix for examination under a microscope, mandatory if cancer is suspected, can be performed with a scalpel or an electric knife.

6. ultrasound examination of the pelvic organs - allows you to assess the prevalence of the tumor process in the pelvis (stage), is necessary for planning the scope of the operation;

7. Computed tomography of the small pelvis - in unclear cases, with suspicion of tumor invasion of neighboring organs;

8. intravenous urography - is performed to determine the function of the kidneys, since in cervical cancer there is often a compression of the ureters by the tumor, followed by a violation of the kidney function and turning it off from work;

9. cystoscopy and rectoscopy (or irrigoscopy - X-ray contrast examination of the intestine) - examination of the bladder and rectum in order to identify their germination by a tumor;

10. chest x-ray and abdominal ultrasound - performed to exclude distant metastases.

Stages of cervical cancer:

Stage 0 - the initial stage - "cancer in place", the survival of patients after treatment is 98-100%;
Stage 1 (A, A1, A2-1B, B1, B2) - is divided into subgroups, stage A - the tumor grows into the tissue of the cervix no more than 5 mm, stage B - the tumor is up to 4 cm;
Stage 2 (A and B) - the tumor has spread to the uterus, but without involvement of the walls of the pelvis or the upper third of the vagina;
Stage 3 - the tumor sprouts the upper third of the vagina, the pelvic wall or causes hydronephrosis on one side (overlaps the ureter, the kidney is switched off from work);
Stage 4 - germination in the bladder, rectum or pelvic bones (sacrum), as well as the presence of distant metastases.

Metastases are screenings from the main tumor that have its structure and are able to grow, disrupting the function of those organs where they develop. The appearance of metastases is associated with the regular growth of the tumor: the tissue grows rapidly, not all of its elements have enough nutrition, some of the cells lose contact with the rest, break away from the tumor and enter the blood vessels, spread throughout the body and enter organs with a small and developed vascular network (liver , lungs, brain, bones), settle in them from the bloodstream and begin to grow, forming colonies-metastases. In some cases, metastases can reach enormous sizes (more than 10 cm) and lead to the death of patients from poisoning with the waste products of the tumor and disruption of the organ. Cervical cancer most often metastasizes to nearby lymph nodes - adipose tissue of the small pelvis, along the large vascular bundles (iliac); from distant organs: to the lungs and pleura (integumentary lining of the lungs), to the liver and other organs. If metastases are single, their removal is possible - this gives more chances for a cure. If they are multiple - only maintenance chemotherapy. Big problems are caused to patients by pleurisy - a metastatic lesion of the lining of the lungs, which leads to a violation of its permeability and accumulation of fluid in the chest cavity, leading to compression of the organs - lungs, heart, and causing shortness of breath, heaviness in the chest and exhaustion of patients.

A favorable prognosis is possible only with adequate treatment (surgery or radiation therapy or a combination of both) in the initial, 1-2 stages. Unfortunately, at 3-4 stages, the survival rate is extremely low, does not exceed 40%.

Treatment of cervical cancer

The best results of treatment were obtained with initial cervical cancer (“cancer in situ”), which does not grow into the surrounding tissues. In young patients of childbearing age who are planning childbearing, there are several options for organ-preserving treatment: excision of the affected area with a scalpel within healthy tissues or laser evaporation, cryodestruction (liquid nitrogen), ultrasonic removal of the cervix.

With microinvasive cancer - tumor ingrowth into the underlying tissues no more than 3 mm, as well as at all other stages of the tumor, surgery is required - extirpation of the uterus without appendages in women of childbearing age and removal with appendages in women in the postmenopausal period. At the same time, starting from stage 1b, the removal of nearby lymph nodes is added to the treatment.

In addition, the operation can be supplemented with radiation therapy (irradiation).

At stages 1-2, independent radiation therapy is possible, without surgery: intracavitary (through the vagina) and remote (outside).

The choice of treatment method depends on the age, general well-being, desire of the patient.

When the tumor grows into the surrounding organs, a combined operation is possible (removal of the uterus with part of these organs).

For large inoperable tumors, the treatment option is radiation therapy, provided that the tumor is reduced in size, the next step is surgery.

At large stages of the tumor process, palliative operations (symptom relief) are possible: removal of the colostomy on the stomach, formation of a bypass anastomosis.

The treatment option may be chemotherapy - surgery or chemo-radiation treatment without surgery.

In the presence of metastases in distant organs - only chemotherapy.

Complete recovery of the patient is possible as a result of the use of surgical or combined exposure.

After treatment, dynamic monitoring is mandatory: a visit to the gynecologist to perform colposcopy and take smears every 3 months.

In no case should you self-medicate, as the favorable period for treatment will be missed during this time.

Complications of cervical cancer:

compression of the ureters, urinary retention, hydronephrosis, purulent infection of the urinary tract, bleeding from the tumor and genital tract up to profuse (fatal), the formation of fistulas (messages between the bladder or intestines and the vagina).

Cervical Cancer Consultation:

Q: How often do women get cervical cancer?
Answer: This tumor occurs quite often, it occupies the 2nd place in frequency after breast cancer in Europe. In Russia, it ranks 6th among malignant tumors and 3rd among the organs of the reproductive system. Women of all ages are ill, but more often 50-55 years.

Question: Is it possible to have children after cervical cancer treatment?
Answer: Yes, it is possible, subject to the early stages of cancer and organ-preserving operations.

Question: What alternative to surgical treatment of cervical cancer is there?
Answer: There can be many treatment options, it all depends on the desire of the patient and the capabilities of the medical institution: excision with a scalpel (knife amputation) within healthy tissues or laser evaporation, cryodestruction (liquid nitrogen), ultrasonic removal of the cervix and others.

Oncologist Barinova Natalya Yurievna

Cervical cancer is a very serious cancer. It is characterized by the occurrence, rapid development of a malignant tumor on the uterine mucosa. It should be noted that this disease is one of the most common among all types of cancer that affects the female body.

The consequences of this oncological disease are extremely serious. In particular, detected in the later stages, it leads to the death of a woman. But in the early stages, cervical cancer is cured quite successfully. That is why, without exception, all doctors advise regularly visiting a gynecologist for a preventive examination.

We will talk about all this with you today:

How does cervical cancer develop? Phases of the disease

0 - Cervical intraepithelial neoplasia. At this stage, malignant cells are only being formed, they are located on the surface of the cervical canal, and do not penetrate into the inner layers of tissues.

I - At this stage, growth, active development of cells occurs, a tumor is formed, which gradually penetrates deep into the tissues of the neck. However, the tumor does not go beyond its limits, does not give metastases, does not affect the lymph nodes.

II - It is characterized by the active development of a tumor that grows into the tissue of the uterus, goes beyond the organ. However, it does not yet grow into the lower parts of the vagina, does not spread to the lymph nodes.

III - The tumor greatly increases in size, already spreads to the walls of the small pelvis, affects the lower part of the vagina, nearby lymph nodes. At the same time, it interferes with the outflow of urine. However, distant organs are not yet affected.

IV - The neoplasm reaches a significant size, completely surrounds the entire neck. Both nearby and distant organs, lymph nodes are affected.

How does cervical cancer manifest itself? Condition signs

The worst thing is that this type of cancer develops for a long time without severe symptoms. The cervical mucosa does not have a large number of nerve endings, therefore it almost does not have sensitivity. However, the early stages of tumor development may be accompanied by an exacerbation of chronic local infectious diseases. Or the frequent appearance of new ones. Most often, the possible appearance of a tumor is indicated by persistent vaginal candidiasis.

Oncology of the cervix is ​​easily established during a gynecological examination. During colposcopy, altered epithelial cells are clearly visible. However, it is possible to diagnose cancer only after their detailed study. For this, a smear is taken, scraping of the cervical mucosa. After that, a cytological diagnosis is carried out. It detects the disease at an early stage.

With the development of the disease, with the active development of the tumor, pathological vaginal discharge may be observed. Often there is bleeding during intercourse. Menopausal women experience bleeding. Also, patients complain of soreness, negative sensations in the lower abdomen. Although these symptoms do not necessarily indicate oncology, nevertheless, they are an important reason for an urgent visit to the gynecologist.

What threatens cervical cancer? The consequences of a developing tumor

Oncological disease of the cervix has serious consequences: Due to the compression of the growing tumor of the ureters, persistent urinary retention occurs. A purulent infectious process develops in the urinary tract. Hydronephrosis develops, heavy bleeding may occur, fistulas form between the intestines, vagina, and bladder. Severe consequences threaten the life of the patient.

How is cervical cancer corrected? Condition Therapy

Surgery. Most often, surgical treatment is performed. Depending on the stage, course of the disease, a classic abdominal operation is performed, or a laparoscopic method is used. Modern technologies allow the surgeon to use a conventional scalpel or an electric scalpel. Often, the operation is performed using laser technology.

Radiation therapy. With the help of irradiation, cancer cells are suppressed, tumor growth stops. According to indications, intracavitary or external irradiation is carried out. These varieties are carried out by different technological methods, have their own characteristics. Often, both methods are used at the same time in the treatment.

Chemotherapy. This technique involves the use of strong drugs. Of course, they cause serious damage to the body, but they are extremely effective in fighting malignant cells, preventing the spread of cancer cells throughout the body.

Combined method. Very often, a combination of several effective methods is used. This certainly helps to reduce the severity of the effects of the treatment and also makes the treatment more effective.

What threatens cervical cancer? Disease prognosis

With timely treatment, almost 90% of patients with stage I cervical cancer live more than 5 years after diagnosis. In patients with stage II, this percentage is slightly less - 50-65%. 25-35% of patients with stage III survive for 5 years. With stage IV - about 15%. There are opinions that survival is increased when radiation therapy is combined with chemotherapy, using drugs based on cisplatin.

How to prevent cervical cancer? Condition prevention

It is known that most malignant tumors of the cervix begin their development from precancerous diseases. Therefore, it is so important to diagnose and treat gynecological pathologies in time before they provoke the development of cancer. Therefore, take care of yourself, regularly visit a gynecologist for the purpose of prevention. Be healthy!

Cervical cancer is one of those tumors in which the possibilities of additional use of chemotherapeutic drugs are very limited due to their low effectiveness. Chemotherapy as an independent method is used for relapses and initially neglected tumors. One of the important limiting points in the use of cytotoxic drugs is the presence of toxic side effects associated with the introduction of these drugs.

Each drug has its own set of complications that are specific to it. Whether there will be complications and what degree of severity, only a course of chemotherapy will show. Moreover, there are no courses that are the same in terms of tolerability, even in the same patient. And it is not at all necessary that each subsequent cycle will be worse than the previous one. A lot of factors affect tolerance, and not only purely physiological ones - this is the emotional state on the eve of treatment, and previous nutrition and atmospheric pressure.

Almost all combinations for cervical cancer include platinum drugs that cause kidney damage and vomiting. Diarrhea is common with irinotecan regimens, optional but possible with xeloda or fluorouracil, methotrexate. Vinorelbine temporarily suppresses hematopoiesis. Known ways to reduce the damaging effects of cytostatics, and they are necessarily used by oncologists. Most drugs are included in the Standards of Care.

The main method of treatment for advanced cervical cancer is radiation therapy as an independent method and as a component of combined treatment that complements surgery. The undeniable advantage of the combination of radiation treatment with chemotherapy has been proven.

Post-radiation complications often significantly complicate the subsequent life. Their frequency is from 7 to 60% according to different studies, and this is due to the lack of uniform evaluation criteria. Some researchers take into account only very serious damage to adjacent organs, others - everything, regardless of duration and severity. The probability of occurrence of radiation complications depends on many factors: this is the value of the total absorbed dose, and the mode of fractionation, and the volume of irradiated tissues, and the presence of concomitant diseases of neighboring organs.

The likelihood of complications increases with an increase in the dose of radiation, with a decrease in the intervals between sessions of radiation therapy. Concomitant anemia increases the radiosensitivity of tissues and, accordingly, their damage. In diabetes mellitus, trophism suffers, which makes it impossible for a full restoration of tissues, as well as in chronic inflammation of the intestinal mucosa or bladder.

To prevent complications, special methods of radiation therapy have been developed, the complex of preventive measures should include the treatment of chronic somatic diseases, increasing the body's resistance, sanitation of the bladder and regulation of bowel function.

What are the most typical complications of treatment? Are the side effects of chemotherapy and radiation therapy mandatory: diarrhea, post-radiation cystitis?

How dangerous is a particular disease?

The most important thing is life. So life expectancy and its quality are determined by the prevalence of the process at the time of cancer detection. With microinvasive cervical cancer, determined only by microscopic examination, the 5-year survival rate approaches 100%. At stage 1 without damage to the lymph nodes - from 87 to 95%, of course, only after adequate treatment. The presence of metastases in the lymph nodes significantly worsens the prognosis due to an increase in the likelihood of tumor recurrence.

How difficult it will be to recover after the operation, first of all, depends on the volume of the operation itself and the state of health of the woman. And here it is necessary to minimize the possible consequences by treating all foci of acute or chronic infection before surgery. Preliminary preparation of the gastrointestinal tract provides the necessary conditions for performing an extensive surgical intervention and a calm postoperative period. Prevention of thrombotic complications, if necessary, can be started before surgery.

A major operation cannot go unnoticed. Early complications that develop in the immediate postoperative period include: pulmonary embolism (As a rule, thrombophlebitis of the superficial veins of the upper extremities occurs due to their use for infusion of drugs. It is not dangerous and after local treatment with compresses and heparin ointment passes without a trace. Superficial thrombophlebitis of the lower extremities can cause deep phlebitis and threaten pulmonary embolism.

In these cases, limbs are bandaged, measures are taken to combat anemia, reduced levels of plasma proteins and dehydration, and normalize arterial and venous circulation. Women at higher risk may be given anticoagulants to prevent blood clots after surgery. In no case should you stay in bed, the movement will not allow the blood to stagnate.

The consequences of the operation are purely individual, due to the presence of concomitant diseases and the biological characteristics of tissues, which significantly affects the degree of development of the adhesive process. Simply put, if you are destined to have an adhesive process, then this cannot be avoided.

Obviously, a postoperative infection never occurs by chance, and its development depends not only on the presence of pathogenic microflora, but also on the state of the patient's immune defense mechanisms. Any surgical intervention has an adverse effect on the immune system and causes the development of secondary immunodeficiency. The duration of immunodeficiency can vary from 7 to 28 days and is determined by the nature of the surgical intervention and the initial state of immunity.

The specificity of oncological operations is their extensiveness, high trauma, frequent violation of the outflow of lymph due to the removal of lymph nodes, which creates additional conditions for the development and spread of infection. Quite often, after gynecological interventions, atony of the bladder occurs (10%) with the development of an ascending urinary tract infection (30-50%). Prophylactic antibiotic therapy reduces the likelihood of infection many times over. Therefore, the appointment of antibiotics after surgery is a canonical measure.

With a favorable course of the postoperative period, the body temperature in the first 2-3 days can be increased, but not higher than 38 °, and the difference between the evening and morning temperature is about 0.5-0.6 °. The pulse rate in the first 2-3 days remains within 80-90 beats. Moderate intestinal paresis (decreased peristalsis) is resolved on the 3-4th day on its own or after stimulation, cleansing enema. The pain gradually subsides by the third day. After operations under endotracheal anesthesia, a small amount of mucous sputum is coughed up the next day, but this is not necessary.

The percentage of delayed postoperative complications is variable: especially unpleasant and very difficult and long-term treatment fistulas (ureterovesical and vulval-vesical) are very rare - 1-2%. For operations during which lymph nodes are removed, the formation of retroperitoneal lymphocysts is specific in 25-30% of patients. Unfortunately, it is almost impossible to prevent this complication.

There have been several cases of cervical cancer during pregnancy. Is it possible to inform the child and is it dangerous for him?

Unfortunately, CC is one of the tumors associated with pregnancy. There is 1 case of cancer per 1-2.5 thousand births. In every 50th patient with cervical cancer, the tumor was associated with pregnancy. The choice of tactics is determined by the prevalence of the process and the duration of pregnancy, but the woman's desire to continue the pregnancy is also taken into account, although it should not be decisive. Wanting to keep the pregnancy, a woman should know that the likelihood of a miscarriage, as a reaction to diagnostic measures or tumor intoxication, is quite high.

To date, there is no single standard for the treatment of cervical cancer in pregnant women. The adverse effect of pregnancy on the course of cancer is known, the negative effect of the tumor on the condition of the fetus is possible, and a delay in treatment can be fatal for a woman. In the first trimester, abortion is definitely necessary for any extent of the tumor. In late pregnancy and a viable fetus - caesarean section, and then full treatment. With a far advanced and widespread process, the delay will have an extremely negative impact on the prognosis for the mother's life, so treatment must be started immediately.

The detection of cancer during pregnancy is an extremely tragic situation that confronts both a woman and her family. The joy of future motherhood comes into severe conflict with the same natural sense of self-preservation. It is very difficult to make a decision, knowing that nothing can be changed later.