Early stage of cervical cancer

Cervical cancer (cervical cancer) is the most common problem, compared with other female diseases. Every year, according to WHO, 500,000 women diagnosed with malignant tumors of CMM. For the first time, the early stage of cervical cancer is often accidentally detected at a gynecologist's appointment, to which women usually treat other symptoms not associated with this pathology.

[1], [2], [3]

Causes of the early stage of cervical cancer

The most influential factor for the formation of cervical cancer is officially recognized as infection with the human papillomavirus. There are a very large number of them, but only some of them are considered to be oncogenic. The most dangerous types 16 and 18 are HPV, intermediate risk is recognized for types 33, 35 and 39, minimal - at 6 and 11.

The early stage of cervical cancer can be provoked by the following reasons:

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

The human body is so amazing that when investigating the causes of a particular disease, one can not be guided only by physiological causes. There are many scientifically proven studies that confirm the association of cancers of female genital organs with the way of life, social status, way of thinking of women. In particular, the risk of such diseases increases the inclination of women to hold resentment, inability to forgive, frequent stressful situations, protracted depression, which reduces immunity and the body's ability to self-repair. Also, predisposing factors indicate low social status and adverse economic conditions.

[4], [5], [6],

Pathogenesis

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

Long-term illnesses can lead to complications, such as pre-cancer and cervical cancer. Precancerous diseases are all kinds of cervical dysplasia - mild, moderate, severe. Visual dysplasia in the form of a red patch on the pale pink tissue of the cervix.

[7], [8], [9], [10], [11], [12],

Symptoms of the early stage of cervical cancer

For a single diagnosis of diseases, the ICD-10 code (International Statistical Classification of Diseases and Diseases, developed by WHO) - Class 2, Section C53 "Malignant neoplasm of the cervix uterus", includes the following headings:

• 0 - ZNSHM internal part (cervical canal, almost inaccessible for inspection and internal pharynx);
• 1 - ZNSHM of the external part (the tumor affects the surface of the cervix and the external pharynx);
• 8 - Cervical lesion that extends beyond the aforementioned localizations;
• 9 - ZNSHM, part unspecified.

The cervical cancer is asymptomatic for a long time in the body, therefore, the early stage of cervical cancer is rarely diagnosed, it can manifest only in the form of difficultly defined discomfort. Lack of clear clinical signs and expressive complaints at the beginning of the disease make it difficult to diagnose, and irregular examinations to the gynecologist and at all reduce the chances of timely diagnosis of the disease.

[13], [14]

First signs

At the initial stages, the first signs are indeterminate and uncharacteristic, more manifesting 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;
• sharp, causeless weight loss;
• changes in the normal state of menstruation;
• sensation of volumetric education in the vagina;
• pain during intercourse;
• abundant leucorrhoea, liquid, watery;
• murky spotting that is of a contact nature.

[15], [16]

Stages

Directly, cancer of the cervix, like any cancer process is divided into 4 stages:

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

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

Complications and consequences

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

• purulent discharge - with large tumors appear malodorous discharge from the genital tract.
• lymphadenopathy, swelling of the legs.
• pain in the back, waist, perineum and pelvis. Since there are almost no nerve points on the cervix, pain occurs when the tumor grows further.
• difficulty or painful urination, as a consequence of a lesion of the bladder and ureter. If this is accompanied by inflammation of the kidneys, there is frequent urination, possibly with blood.
• difficulty with bowel movement, presence of blood in stool.

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

[17], [18], [19], [20], [21]

Diagnostics of the early stage of cervical cancer

Modern healthcare requirements are aimed at an effective diagnostic process, and the early stage of cervical cancer was detected in time for subsequent successful treatment. Primary diagnosis of the disease does not require preparation by the patient. During the visit to the doctor the gynecologist the woman is examined in the mirrors, where for the first time various diseases of the cervix of the uterus are 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 there are doubtful or negative results, the diagnosis is carried out in complex with adjacent specialists.

Diagnosis of cancer can be divided into several groups:

1. General examination at the gynecologist
   • General examination on the gynecological chair of the external genital organs;
   • Examination with the help of mirrors, as well as manual examination of the mucous membrane of the cervix.
2. Analyzes
   • general and biochemical analysis of blood and urine;
   • staining with Lugol solution;
   • study of Pap smears. Such strokes of a woman should be done annually, with their help they reveal the initial stages of cervical cancer;
   • analysis for the detection of HPV types 16 and 18;
   • bacterioscopic and bacteriological analysis of secretions.
3. Instrumental diagnostics
   • Colposcopy is a special method for examining the cervix, using an optical system that allows you to magnify the image 10-40 times, which allows a more detailed examination. With the help of colposcopy, the early stage of cervical cancer can be diagnosed early.
   • If colposcopy reveals ambiguous areas on the cervix, additional research is required. Then a cervical biopsy is performed, at which a small cut of the mucosa from the cervix is made for detailed study in the laboratory. After the biopsy, you can already determine the final analysis.
   • chest X-ray;
   • intravenous urography of the kidneys;
   • X-rays of the rectum and bladder;
   • Ultrasound of the pelvic organs is a mandatory stage of diagnosis in preparation for surgery;
   • If there is evidence, do a computer tomography of the small pelvis, to assess the possibility of tumor germination in neighboring organs;
   • MRI.

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

[22], [23],

Differential diagnosis

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

• polyps of CMM;
• RE with distribution to CMM;
• metastatic lesions.

Treatment of the early stage of cervical cancer

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

Operative treatment of the cervical tumor begins immediately after diagnosis. The early stage of cervical cancer can be fully cured. When the tumor is not invasive, that is, it does not penetrate deep into the epithelial cells, use an organ-preserving surgical intervention, the scale of which depends mainly on the age and condition of the patient's body. Young, childbearing age, patients, operate only the cervix so that they can give birth to children in the future. The following surgical operations are applied: removal of the cancer site by a scalpel, laser evaporation, cryodestruction, ultrasound operation. Women after menopause carry out removal of the uterus.

Radiation therapy is strongly recommended at all stages - irradiation of a cancer source with the help of radioactive applicators, and chemotherapy, since surgical manipulations are known to be incapable of completely eliminating malignant cellular structures.

It is also necessary to medication several groups of drugs:

• Antineoplastic agents: vinblastine or vincristine - drip, 1p.v week.
• Antitumor antibiotics: mitomycin - intravenously, the dosage is individual.
• Antimetabolites: hydroxycarbamide - in the regime of monotherapy 20-30 mg / kg daily for 3 weeks,

All medicines must be taken under the supervision of specialists, with caution to appoint elderly people, patients with hepatic insufficiency, with lung disease, cardiovascular diseases.
In each case of cervical cancer, the treatment is strictly individual, because there are many influencing factors: the stage, the extent of the tumor spreading to neighboring organs, the concomitant diseases and the state of the organism as a whole.

Alternatives for the treatment of cervical cancer

Very often, alternative treatment for the early stage of cervical cancer supplements the traditional, but with the consent and supervision of the treating physician. The early stage of cervical cancer in most cases allows, as an additional therapy, after surgical intervention or a course of chemotherapy to use alternative treatment.

There are many phytopreparations made from the right mixture of medicinal herbs that help to remove pain, have clearing and anti-inflammatory properties. However, often patients completely abandon traditional treatment, due to their distrust of doctors or other reasons, and launch the situation to the critical stage, when already surgical intervention loses all meaning. Therefore, the main condition for the use of herbal medicine is the advance notification of this intention of its treating physician. It will help to choose the right dosage for ready phytopreparations or herbal preparations, taking into account their compatibility with medicines and the state of the organism, and also in time will prevent the consequences of possible allergic reactions in case of individual intolerance of certain components.

The most famous for its healing, antitumor properties is the tincture of barberry ordinary: 1 teaspoon. Finely chopped dry roots of barberry, 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 the intake of medicines from those plants that are natural poisons, and thereby cures the early stage of cervical cancer.

Tincture of celandine: take 1 tbsp. Dry shredded plant stems (sold in pharmacies), pour 0,5 l. Boiling water, leave to stand for 1 hour, drain. Take 1 tablespoon 3-4 times a day before meals, every day. Course 4 weeks.

Tincture hemlock on 40% alcohol: drink 1 drop, diluting in 100mg 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 10-15 days.

There are also several schemes of simultaneous reception of two poisons - hemlock and bee dodger (cleans blood, removes chemicals, increases immunity), but each organism has its own toxicity, therefore, it should be clarified the possibility of such a method in the doctor.

[24],

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 genital organs and prevention of sexually transmitted diseases are very important, which means choosing the most safe method of contraception and reducing the number of sexual partners.

Of great importance is the refusal to smoke and alcohol. Nicotine and ethanol penetrate the mucous tissues of the cervix and provoke mutations in the cells. Also, in smoking mothers, children are 4-5 times more likely to have different types of cancer.

But the most important thing is that regular examination after the beginning of a sexual life with a gynecologist will allow to recognize and stop the disease in time, when there were only the first signs that a woman could have an early stage of cervical cancer. If a patient has high-risk factors, the necessary examinations are carried out every year.

[25], [26], [27], [28],

Forecast

With cervical cancer, the prognosis depends, first of all, 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 fully cured in 98-100% of cases. Since the cancer can be surgically treated at the first and sometimes the second stage of the disease, at these stages the prognosis for women is favorable, and sometimes after treatment at the beginning of the process such a woman can become pregnant, bear and give birth to a child. For the third stage, the prognosis of patients' survival is about 30%, the fourth - less than 10%. The prognosis is further worsened by the combination of late-identified cervical cancer and pregnancy.

[29], [30], [31]