Early stage cervical cancer

Cervical cancer (CC) is the most common problem compared to other female diseases. Every year, according to WHO, 500 thousand women are diagnosed with malignant neoplasms of the cervix. The early stage of cervical cancer is often accidentally detected at a gynecologist's appointment, to which women usually turn with other symptoms not associated with this pathology.

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Causes early-stage cervical cancer

The most influential factor for the development of cervical cancer is officially recognized as infection with the human papilloma virus. There are a great many of them, but only some of them are considered oncogenic. The most dangerous HPV types are 16 and 18, intermediate risk is recognized for types 33, 35 and 39, and minimal risk is recognized for types 6 and 11.

Early stage cervical cancer can be caused by:

• beginning of sexual activity before the age of 16;
• sexual life with a large number of partners (more than 3 per year) or such a male partner;
• long-term hormonal contraception;
• multiple abortions;
• first birth at a very young age;
• trauma and ruptures of the cervix due to childbirth;
• genetic predisposition;
• lack of intimate hygiene;
• smoking;
• sexually transmitted infections (STIs), both bacterial and viral.
• genital herpes or other external genital herpes disease.

The human body is so amazing that when studying the causes of a particular disease, one cannot rely only on physiological reasons. There are many proven scientific studies that claim a connection between cancer of the female genital organs and the lifestyle, social status, and way of thinking of women. In particular, the risk of such diseases is increased by women's tendency to hold grudges, inability to forgive, frequent stressful situations, and prolonged depression, which reduce immunity and the body's ability to self-heal. Low social status and unfavorable economic conditions are also indicated as predisposing factors.

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Pathogenesis

The cervix of a woman is covered on the outside with a smooth multilayered epithelium, which has a shiny surface and a pale pink color. It consists of basal, intermediate and superficial layers. Inside the cervix there is a cervical canal, the walls of which are lined with cylindrical epithelium, where pathological processes most often develop.

Long-term diseases can lead to complications such as precancer and cervical cancer. Precancerous diseases are all types of cervical dysplasia - mild, moderate, severe. Visually, dysplasia is a red spot on the pale pink tissue of the cervix.

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Symptoms early-stage cervical cancer

For a unified diagnosis of diseases, the ICD-10 code (International Statistical Classification of Diseases and Conditions, developed by WHO) is used - class 2, section C53 "Malignant neoplasm of the cervix", includes the following headings:

• 0 - ZNSHM of the internal part (cervical canal, practically inaccessible for examination and internal os);
• 1 - ZNSCM of the external part (the tumor affects the surface of the cervix and the external os);
• 8 - Lesions of the cervix that extend beyond the above-mentioned locations;
• 9 - ZNShM of unspecified part.

Cervical cancer proceeds asymptomatically in the body for a long time, therefore the early stage of cervical cancer is rarely diagnosed and may manifest itself only in the form of difficult to determine discomfort. The absence of clear clinical signs and expressive complaints at the onset of the disease create difficulties for diagnosis, and irregular examinations by a gynecologist completely reduce the chances of timely diagnosis of the disease.

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First signs

At the initial stages, the first signs are vague and uncharacteristic, becoming more apparent as the tumor grows. This greatly reduces the possibility of early diagnosis. The early stage of cervical cancer can be accompanied by both single and systemic signs, for example:

• increasing weakness in the body, malaise, fatigue;
• sudden, unexplained weight loss;
• changes in the normal menstrual cycle;
• sensation of a voluminous formation in the vagina;
• pain during intercourse;
• profuse leucorrhoea, liquid, watery in nature;
• cloudy bloody discharge, which is of a contact nature.

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Stages

Cervical cancer itself, like any oncological process, is divided into 4 stages:

• 0 or early stage cervical cancer - with timely treatment the prognosis is favorable for 98-100%;
• For greater accuracy, stage 1 is divided into two subgroups: A - if the tumor penetrates the epithelium of the cervix no more than 3 mm, it is diagnosed only microscopically, B - is characterized by tumor penetration into the tissue more than 3 mm, it is already clinically determined;
• Stage 2 is characterized by tumor penetration into the uterus;
• at stage 3, the tumor grows to the walls of the pelvis, also disrupting the functioning of the kidneys, as a result of compression of the ureter by the tumor;
• Stage 4 is characterized by the spread of the tumor to neighboring organs, lymph nodes and the formation of distant metastases.

Without proper treatment and in the presence of minimal carcinogenic factors, early stage cervical cancer progresses quite quickly to an invasive form.

Complications and consequences

At the invasive stage, in the absence of the necessary treatment, cancer cells grow into the lymph nodes and blood vessels and pass through them into neighboring organs, giving rise to new tumors - metastases. Due to inflammatory processes, there is an increase in body temperature, disruption of the intestines and urinary system. The late stages are characterized by the following symptoms:

• purulent discharge - with large tumors, foul-smelling discharge appears from the genital tract.
• enlarged lymph nodes, swelling of the legs.
• pain in the back, lumbar region, perineum and pelvis. Since there are almost no nerve points on the cervix, pain appears when the tumor grows further.
• difficult or painful urination, as a result of damage to the bladder and ureter. If kidney inflammation is added to this, frequent urination is observed, possibly with blood.
• difficulty with bowel movements, presence of blood in the stool.

From the outlined symptomatic map, it can be noted that cervical cancer, in the absence of necessary treatment, brings complications in the form of compression of the lymph nodes, inflammation of the kidneys, purulent infection of the urinary tract, anuria, hydronephrosis, formation of fistulas, etc.

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Diagnostics early-stage cervical cancer

Modern healthcare requirements are aimed at ensuring an effective diagnostic process and early detection of cervical cancer for subsequent successful treatment. Primary diagnostics of the disease does not require preparation on the part of the patient. When visiting a gynecologist, a woman is examined in mirrors, where various cervical diseases are first detected. In order to clarify the nature of the disease, it is necessary to conduct a cytological examination of smears to exclude oncological pathologies. If questionable or negative results arise, diagnostics are carried out in combination with related specialists.

Cancer diagnostics can be divided into several groups:

1. General examination by a gynecologist
   • General examination of the external genitalia on a gynecological chair;
   • Examination with mirrors, as well as manual examination of the condition of the mucous membrane of the cervix.
2. Tests
   • general and biochemical analysis of blood and urine;
   • Lugol's solution staining;
   • Pap smears. Women should have these smears done annually, they help detect the early stages of cervical cancer;
   • analysis to detect HPV types 16 and 18;
   • bacterioscopic and bacteriological analysis of secretions.
3. Instrumental diagnostics
   • Colposcopy is a special method of examining the cervix, using an optical system that allows for a 10-40x magnification of the image, allowing for a more detailed examination. With the help of colposcopy, early stages of cervical cancer can be diagnosed in a timely manner.
   • If ambiguous areas on the cervix are detected during colposcopy, additional examination is required. Then a cervical biopsy is performed, during which a small section of the mucous membrane is taken from the cervix for detailed examination in laboratory conditions. After the biopsy, the final analysis can be determined.
   • chest x-ray;
   • intravenous urography of the kidneys;
   • X-ray of the rectum and bladder;
   • Ultrasound of the pelvic organs is a mandatory diagnostic step in preparation for surgical intervention;
   • If there are indications, a CT scan of the pelvis is performed to assess the possibility of tumor growth into neighboring organs;
   • MRI.

All of the above diagnostic procedures are prescribed in an individual volume and order.

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Differential diagnosis

Differential diagnosis of early stage cervical cancer is carried out with such gynecological diseases as:

• cervical polyps;
• RE with distribution to SM;
• metastatic lesions.

Treatment early-stage cervical cancer

Treatment of cervical cancer is divided into two types: radical, aimed at complete recovery, and palliative, when the probability of a successful outcome is no longer there, and treatment is aimed at alleviating symptoms and relieving pain with the help of narcotic analgesics.

Surgical treatment of cervical cancer begins immediately after diagnosis. Early stage cervical cancer can still be completely cured. When the tumor is not invasive, that is, has not penetrated deep into the epithelial cells, organ-preserving surgery is used, the scale of which depends mainly on the age and condition of the patient's body. Young patients of childbearing age undergo surgery only on the cervix so that they can have children in the future. The following surgical operations are used: removal of the cancerous area with a scalpel, laser evaporation, cryodestruction, ultrasound surgery. Women after menopause undergo removal of the uterus.

At all stages, radiation therapy is strongly recommended – irradiation of the cancer source using radioactive applicators, and chemotherapy, since surgical manipulations, as is known, are not capable of completely eliminating malignant cellular structures.

Also, drug treatment with several groups of drugs is mandatory:

• Antitumor agents: vinblastine or vincristine – drip, 1 time per week.
• Antitumor antibiotics: mitomycin – intravenously, dosage is individual.
• Antimetabolites: hydroxycarbamide - as monotherapy 20-30 mg/kg daily for 3 weeks,

All medications should be taken under the supervision of specialists, with caution prescribed to elderly people, patients with liver failure, lung disease, cardiovascular diseases.
In each individual case of cervical cancer, treatment is prescribed strictly individually, since there are many influencing factors: stage, extent of tumor spread to neighboring organs, concomitant diseases and the state of the body as a whole.

Folk remedies for the treatment of cervical cancer

Very often, folk treatment of early stage cervical cancer complements traditional treatment, but always with the consent and under the supervision of the attending physician. Early stage cervical cancer in most cases allows, as an additional therapy, after surgical intervention or a course of chemotherapy to use folk treatment.

There are many herbal preparations made from a properly selected mixture of medicinal herbs that help relieve pain, have cleansing and anti-inflammatory properties. However, patients often completely refuse traditional treatment, due to their mistrust of doctors or other reasons, and let the situation reach a critical stage, when surgical intervention loses all meaning. Therefore, the main condition for using herbal treatment is to notify your doctor in advance of this intention. He will help you choose the correct dosage for ready-made herbal preparations or herbal infusions, taking into account their compatibility with medications and the state of the body, and will also prevent the consequences of possible allergic reactions in time in case of individual intolerance to certain components.

The most famous for its healing, antitumor properties is the tincture of common barberry: 1 teaspoon of finely chopped dry barberry roots, pour 2 cups of boiling water, boil for 5 minutes, strain and take ½ cup 3 times a day for 3-4 weeks.

Homeopathy, as a method of treatment in oncology, is based on taking medicines from those plants that are natural poisons, and due to this, the early stage of cervical cancer is cured.

Celandine tincture: take 1 tbsp. dry crushed stems of the plant (sold in pharmacies), pour 0.5 liters of boiling water, leave to brew for 1 hour, strain. Take 1 tablespoon 3-4 times a day before meals, every day. The course is 4 weeks.

Hemlock tincture in 40% alcohol: drink 1 drop, diluted in 100 mg of water. Increase the dose every day by 1 drop, but take into account the symptoms of intoxication - at the slightest dizziness, reduce the dose by 3 drops. Take for 10-15 days.

There are also several schemes for the simultaneous use of two poisons - hemlock and dead bees (cleanses the blood, removes chemicals, increases immunity), however, each organism has its own tolerance to poisons, so you should check with your doctor about the possibility of such a method.

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Prevention

The most important task of prevention is to protect the woman's body from HPV. This requires a set of precautions. Personal hygiene of the genitals and prevention of sexually transmitted diseases are very important, which means choosing the safest method of contraception and reducing the number of sexual partners.

Quitting smoking and drinking alcohol is of great importance. Nicotine and ethanol penetrate the mucous tissues of the cervix and provoke mutations in cells. Also, children of smoking mothers are 4-5 times more likely to suffer from various types of cancer.

But the most important thing is that regular examinations after the start of sexual activity by a gynecologist will allow to recognize and stop diseases in time, when the first signs that a woman may have early stage cervical cancer appear. If the patient has high-risk factors, the necessary examinations are carried out every year.

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Forecast

With cervical cancer, the prognosis depends primarily on the stage of the disease, and, naturally, with each subsequent stage, the prognosis for the patient worsens. The early stage of cervical cancer is completely curable in 98-100% of cases. Since cancer can be surgically cured at the first and sometimes second stage of the disease, the prognosis for women at these stages is favorable, and sometimes after treatment at the beginning of the process, such a woman can become pregnant, carry and give birth to a child. For the third stage, the prognosis for patient survival is about 30%, for the fourth - less than 10%. The prognosis worsens even more with a combination of late-detected cervical cancer and pregnancy.

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