Can stage 1 uterine cancer be cured? Uterine cancer: symptoms and signs, prognosis of life at different stages

Article outline

Uterine cancer is one of the most common diseases in the structure of gynecological oncology. The pathological process develops in the endometrium, cells are involved in it different type, and then it begins to spread throughout the body, affecting other organs and systems. Most often detected in older women (after 40-45 years, the main risk group is 55-65 years), but in last years there is a tendency to "rejuvenation" - cases are recorded in patients under 30.

There are several reasons for the occurrence of this pathology, they will be described in detail. In gynecology, they are isolated into a separate group - which, in the absence of adequate treatment, lead to the degeneration of cells into atypical ones. This is how the primary tumor is formed. In the future, more and more tissues and organs are involved in the pathological process, metastases appear. Histologically, the disease is divided into different types. But the main way is the international classification, which is based on the size of the tumor and the degree of its spread.

It is important for women at any age to know what first signs and symptoms may indicate the onset of the pathological process. Since with uterine cancer, regardless of the type of pathology, development can be quite rapid, first of all, you need to pay attention to any bloody issues and bleeding. This symptom is a sign of a variety of gynecological problems and is dangerous in itself. In this case, it is typical for the period of transition of precancer to oncology, and can also be an independent signal for the development of the disease.

Patients already diagnosed are concerned about the prospects: how quickly the transition from mild stage in a more severe one, how to treat and whether it can be cured at all. Interested in what is the survival rate after surgery, the possibility of relapse, etc. Let's consider all these problems in detail. But before that, let us once again recall the importance of prevention and regular visits to the gynecologist. The disease rarely occurs spontaneously, usually it is preceded by other pathologies. Their timely detection and care for their health (including a scheduled visit to a gynecologist) is necessary to minimize the risk of cancer in the female reproductive system.

The concept of cancer, statistics

What is uterine cancer? This is a pathological process that develops in the cells of the inner epithelial layer (endometrium) and leads to their degeneration into atypical ones. And in the future - to the emergence and development of malignant neoplasms. Accordingly, the normal functioning of the organ is disrupted, since cancer cells replace healthy ones. All tumors are divided into groups (stages of the disease) according to the system generally accepted in oncology (according to the degree of development, the presence of metastases, etc.). In gynecology, it is also customary to distinguish and separately consider:

• cervical cancer: this pathology is isolated as a separate disease, the primary tumor develops directly on the cervix, and in the future it can grow both towards the vagina and towards the uterus itself.
• cancer of the body of the uterus: in this case we are talking about damage to the mucous or muscular membranes of the uterus. In accordance with what type of cells was initially involved in the pathological process, several types of malignant tumors are also distinguished.

In this article, we will consider in detail the oncology of the uterus itself, the pathology of the cervix will be discussed separately in the article cervical cancer.

Pathological proliferation of endometrial cells leads to the development of a cancerous tumor. Scientifically - uterine carcinoma, from lat. cancer uteri. In oncogynecology, tumors of the following types are distinguished (the classification is based on histology):

• endometrial cancer of the uterus (scientifically called)
• leiomysarcoma - the pathological process begins in the muscle tissue of the organ.
• sarcoma (degeneration of connective tissue);
• glandular squamous cell carcinoma;
• clear cell;
• musical;
• serous;
• undifferentiated.

In fact, cells of any type can be reborn. Depending on how differentiated the cellular structures are, low-, medium- and highly differentiated neoplasms are distinguished.

According to statistics, cancer is most often adenocarcinoma. It can be hormonal (more common) or autonomous type of development. In the first case, there is a connection between hormonal disorders, in the second, no obvious cause is revealed, the provoking factors are standard causes for oncology (for example, hereditary predisposition).

According to statistics, in the structure of all oncological diseases, uterine pathology occupies about 3%, if we take only the female population - up to 7.7% of the total. The hormonal type of tumors prevails over the autonomous type (approximately 70%:30% ratio). By age: most patients are over 40, more often detected at a later age (average - about 60 years).

Causes and risk factors

According to the gradation into an autonomous and hormone-dependent type of oncology, the causes of uterine cancer may be associated with hormonal imbalance or develop as a result of other provoking factors. It should be understood that they only increase the risk of developing pathology, but are not a direct cause of cell degeneration into atypical ones. As with other cancers, there is no single mechanism. What causes cancer in each patient is determined individually; in the diagnosis, all possible sources of influence on the cells are taken into account.

Risk factors for developing cancer are:

• Age changes. In this case, we are talking about processes that are somehow related to the function reproductive system: late menopause or too early maturation.
• Endocrine pathologies. Since the cause may be the degeneration of background and precancerous conditions of the uterus with hormone-dependent etiology, this reason considered one of the most important.
• Among the endocrine pathologies that provoke the development of oncological diseases, indicate: polycystic ovaries (more than 12 follicles). It develops as a result of an imbalance of male and female female hormones, as a result of which the menstrual cycle is disturbed, typical male secondary sexual characteristics appear (a rough voice, abnormal hair growth, body fat on the stomach, etc.). Obesity is an additional risk factor.
• Obesity against the background of hormonal disorders increases the risk of developing oncology by 2-3 times. The same result occurs when the diet is violated, if the diet is dominated by fatty food, as a result of which cancer can develop against the background of obesity resulting from malnutrition and overeating.
• Long-term use of certain hormonal drugs. Hormone therapy is not always considered a provoking factor. For example, when taking contraceptives with a large amount of progestins, the risk is reduced by an average of 2 times. But long-term hormone replacement therapy in women over 55 years old - on the contrary, increases by 2-3 times. Long-term use of drugs that block estrogen-sensitive receptors also negatively affects. Such drugs (for example, Tamoxifen) are prescribed in the treatment of breast cancer, but it is not recommended to use it for more than 2 years, otherwise the risk of damage to the body of the uterus increases significantly (according to some reports, from 2 to 7).
• Hereditary predisposition in women is formed as a tendency to obesity, disruption of the hormonal functions of the body, some have cancer in the form of primary multiple tumors.

These are the main influence factors that can increase the risk of a malignant tumor. What else can it develop from? There is information about the onset of the disease against the background of: diabetes mellitus, adenomas of the adrenal cortex. And also with severe liver disease, with irradiation of the pelvic organs. Women who have not given birth or who have one child are also included in the risk group.

At the moment, these are the main reasons associated with the development of oncology of the uterine body. Of all the above factors, background and precancerous conditions are unambiguously pathogenic, which sooner or later degenerate into oncology. The rest only contribute to the abnormal development of cells.

Classification

Cancer cells can not only replace healthy ones and form clearly localized tumors, but also spread to neighboring tissues and organs (metastases), involving them in the pathological process. There are several classification options: International, according to the TNM system and the FIGO system, adopted by the International Federation of Obstetricians and Gynecologists. Because the International classification, adopted back in 1971, is used most often, let's consider how it evaluates malignant tumor uterus.

There are different stages of oncology (four in total), there is also a zero one, which is not included in the clinical classification, but is diagnosed as a hyperplastic process with suspected malignancy and is evaluated according to histology. Consider all the stages, the definition of which is based on the degree of organ damage.

• Stage 1: the lesion is completely localized in the body of the uterus, the endometrium and myometrium are involved in the process, the size and degree of differentiation of the tumor are also important for classification;
• Stage 2: the tumor spreads not only to the body, but also to the cervix (into the glandular and / or deeper layers);
• Stage 3: further development leads to damage to the vagina, appendages and lymph nodes.
• at stage 4 uterine cancer: a common oncological process that affects both nearby organs (rectum, bladder), and located far from the primary tumor (liver, bones, lungs, distant lymph nodes).

As is clear from the description, the most dangerous are the last stages, especially uterine cancer of the 4th degree with metastases. When it comes to the defeat of lymph nodes distant from the primary tumor, the spread of oncology becomes unpredictable, treatment is as difficult as possible, and the prognosis is unfavorable.

The FIGO classification describes the scope of pathology in more detail. Uterine cancer of the 2nd degree is designated as IIA (with pathology of the glandular layer) and IIB (with the involvement of the deep layers of the cervix). At stage 1, the letters indicate the spread of cancer to the endometrium (A) or myometrium (B or C, depending on the depth of the lesion).

If grade 3 uterine cancer affects the serosa and / or appendages, we are talking about the onset of the disease at this level (A), if the vagina is involved (metastases), B is placed, and metastasis to nearby lymph nodes is classified as C.

If uterine cancer of the 4th degree affects the intestines and bladder, then it is indicated by the letter A, in other cases - B. An additional parameter for describing this period of development of oncology is the G indicator, which indicates the degree of non-squamous growth.

In fact, the entire gradation of the development and spread of a tumor indicates the degree of damage to the body, from the formation of a primary tumor to the distant spread of metastases.

Metastasis

The danger of oncological diseases is not only functional disorders in the functioning of organs and systems caused by the replacement of normal cells with atypical ones. The neoplasm spreads throughout the body, and it becomes too dangerous, as the disease becomes inoperable.

First, the tumor grows into closely located tissues (of the organ itself or in neighboring ones), i.e. it metastasizes. The mechanism of spread is as follows: modified cancer cells begin to separate from the primary tumor. These are the first metastases in uterine cancer, which is characterized by the onset of the pathological process in nearby organs (stage 3). The disease goes beyond the initially affected uterine body in 2 stages, moving to the neck, but rebirth occurs within one organ - in the uterus, albeit with the involvement of different types of tissues.

The transition from the third stage to the fourth means that already lymphatic system- the main "carrier" of atypical cells to distant organs. The defeat of the lymph nodes adjacent to the primary tumor indicates a real danger of spread throughout the body. If distant ones suffer, then metastases of uterine cancer can affect almost any organ (lungs, brain, etc.), the musculoskeletal system.

The initial stages of uterine cancer are relatively easy to surgical treatment, since the neoplasm has a relatively clear localization. In the future, the removal of the pathological focus is repeatedly difficult or even impossible, since in addition to the primary tumor, multiple metastases appear in the body, penetrating entire layers of tissues of various types. There are no clear contours, and the lymphatic system continues to spread cancer cells throughout the body. The hematogenous path (through the blood) of the movement of oncological cells throughout the body is connected to this process.

Diagnostics

At what stage can cancer be identified and diagnosed? This is already possible on the most early stages when the pathological process is just beginning. In women who are absolutely healthy in gynecological terms, regular check-ups help to identify almost any threat, even with a visual examination. If we are talking about patients with precancerous or background diseases, then they are assigned a scraping or a biopsy is taken for histological examination. In the future, they are under dispensary registration and are regularly checked.

Can cancer be seen on ultrasound? Yes, ultrasound helps to identify the pathological focus, as well as other diagnostic measures. Screening is rarely used to detect this pathology. Tumor markers help to detect pathology, in addition, they are often used to assess the effectiveness of already performed treatment and early detection relapses. Consider everything possible ways that help detect cancer even at the very beginning.

Diagnosis of the disease:

• Inspection: any, even the most minor violations that can be seen visually, serve as the basis for the appointment of a series of tests;
• Cytological examination of the collected material helps to obtain reliable data on the presence of oncology. For cytology, the contents are taken after aspiration. But the effectiveness of this technique in the early stages is only about 36%, the method gives accurate results only with the spread of oncology (90% detection rate).
• Ultrasound: cancer by this method is detected in patients at any stage of pathology development. Deciphering the results of a transvaginal examination allows you to notice a tumor up to 2 cm in size. A change in the size of the uterus (normally in women of reproductive age M-echo from 10 to 16 mm, with menopause - no more than 7, in postmenopause - no more than 4) is the reason for further examination. That is, the answer to the question: is it possible to clearly see cancer during an ultrasound examination, positive. This is a reliable and reliable method of examination.
• Histology: material sampling during hysteroscopy followed by histological examination allows you to get accurate results. Scrapings of the endometrium and cervical canal (diagnostic curettage) are also sent for research.
• Fluorescent diagnostics: endometrioid cancer at the earliest stages (lesion up to 1 mm) is well detected with the introduction of a contrast agent, followed by ultraviolet transillumination. Efficiency - up to 80%.
• MRI: the method is used to accurately assess the volume in advanced oncology, it reflects well clinical picture in the lymph nodes, it is recommended to examine the pelvic organs to obtain an accurate clinical picture.

How does it manifest

Symptoms of uterine cancer appear most often already in the later stages of development. It can be recognized at first only during a gynecological examination or with the help of modern methods diagnostics. This is the main danger: an asymptomatic course in patients who consider themselves healthy, in the absence of regular physical examinations, can lead to late detection when the disease is actively progressing.

Take a closer look at all the symptoms of endometrial cancer below.

Symptoms in oncology of the uterine body are directly related to the degree of development and spread of the pathological process. Therefore, we will consider what signs serve as the basis for an immediate visit to the gynecologist and a comprehensive examination.

Since cancer in the uterus at the earliest stages practically does not manifest itself, any bleeding that is not associated with normal menstruation, especially during menopause and postmenopause, can be a reason to suspect oncology. In 90% of cases, such bleeding is the first symptom of oncology. Therefore, let us consider in detail how spotting in cancer of the body of the uterus can serve as a signal of the beginning of the pathological process:

1. If young girls experience disruptions in the cycle, then most often these moments, signaling the possibility of developing uterine cancer, are ignored. This is due to two factors: there are many reasons for changing the cycle (starting from banal hypothermia, ending prolonged stress). In addition, up to 30 years this type of oncology is rare, patients of this age are not included in the risk group. However, any irregularities in the normal menstrual cycle should be a reason to visit a gynecologist.
2. In women over 40, a variety of bleeding can be considered as a clear symptom of uterine cancer, namely:
3. single or multiple;
4. scanty or plentiful;
5. breakthrough or intermittent;
6. any contact (during examination, sexual intercourse, douching, lifting weights).
7. In premenopausal women, menstrual irregularities are normal, so alarming symptoms can be missed and cancer is detected late. If instead of attenuation of menstruation, they intensify and become more frequent, you should consult a gynecologist.
8. AT menopause menstruation is already completely absent, so any bleeding will help to detect a tumor in the early stages of development.

It is necessary to monitor not only the nature of the menstrual menstrual bleeding. Dangerous signs are any discharge, with uterine cancer they most often have an unpleasant odor. Such a smell has a purulent compartment, characteristic of a late degree of uterine cancer, the third or fourth, when other pathological processes join the underlying disease.

Pain that begins with uterine cancer usually indicates the depth of the pathological process. As it develops, symptoms that are standard for oncology are added: digestive problems (lack of appetite, constipation or diarrhea, nausea and vomiting). A late symptom is also considered: a sharp weight loss, subfebrile temperature, fatigue, etc. They are typical for advanced oncology (common process, involvement of other organs and systems). If the last stage has come (how many live with it will be indicated separately), then the symptoms can be very different, since each affected organ can give its own clinical picture.

The asymptomatic initial stage, when the cancer practically does not manifest itself, is usually detected during a gynecological examination. At the slightest suspicious changes, the doctor prescribes a series of tests. That is why such attention is paid to the need for professional examinations.

What is the danger

If we consider possible consequences uterine cancer, it can be noted:

• good curability in the early stages (with preservation of reproductive function);
• identification of a more common process may threaten with an operation (organ-preserving or without preserving the genital organ);
• inoperable tumors with metastases are difficult to treat drug treatment and lead to death.

Analyzing these facts, we can conclude that the main danger of the initial stages of oncology is an asymptomatic course. The main danger of complications during treatment with a developed pathological process is infertility (as functional impairment or after removal of the uterus). The consequences of cancer of the last stages leads to a global spread in the body and death. Another danger is the risk of relapse, especially if the provoking factor (for example, hormonal imbalance) remains unchanged.

How to treat uterine cancer

Treatment of uterine cancer is directly related to the amount of pathology detected. When choosing a technique, the full clinical picture is taken into account: the size of the tumor, the degree of its spread, the presence or absence of a metastatic process, concomitant diseases. Only after complete examination a decision is made about the next course of action.

Can cancer be treated with therapeutic agents? Most often they are part of the overall comprehensive management plan for the patient. Separately, therapeutic methods are far from always effective, but are often used when it is impossible to perform a surgical intervention and as a palliative therapy.

Surgical method- the main one in this type of oncology. If necessary, it is combined with radiation and chemotherapy. Organ-preserving ablation surgery is possible if the cancer of the uterine body is in its early stages and the size of the neoplasm does not exceed 3 mm and has clear contours. But at the same time, there is a risk of incomplete removal, therefore, relapses are possible.

The uterus is removed even at the first stage, this method is considered the main one in cancer. As an alternative, other methods are chosen only if surgery is not possible due to concomitant diseases (only 10%). The outcome in this case is not very favorable, chemotherapy and other methods are not particularly effective in this type of oncology, the risk of further development is too high.

The operation to remove a malignant tumor is performed in different volumes:

• cancer in the initial stage (first): total hysterectomy and adnexectomy;
• with more severe pathologies: lymph nodes are additionally removed;

If metastases of uterine cancer are detected and surgery is not possible, courses of radiation and chemotherapy are prescribed.

Treatment of uterine cancer with therapeutic methods:

• hormone therapy: as an addition to other methods, provided that the malignant neoplasm is sensitive to such drugs;
• chemotherapy: in advanced stages and in combination with other agents;
• : is used actively after surgery, instead of it, if there are vital contraindications and for the treatment of organs and tissues located near the tumor;
• brachytherapy: radioactive substances are injected directly into the tumor;

Total hysterectomy in the early stages is considered the most effective, in such cases the risk of recurrence is minimal, especially when using additional therapeutic methods (adjuvant radiotherapy, hormones to normalize their metabolism, etc.).

How many people live with uterine cancer

The prognosis for uterine cancer is directly related to two factors: the degree of development of oncology and the age of the patient. If a tumor is detected in time and adequately treated in a woman under 50 years old, then the five-year survival rate is 91%, and after 70 years - only 61%. Now consider how many live with uterine cancer after surgery in accordance with the diagnosis.

Depending on the degree of differentiation of the tumor for 5 years without recurrence, the following are fixed:

• at low: 64%;
• with an average: 86%;
• at high: 92%.

What are the prospects if cancer with metastases? The patient can live 5 years without recurrence:

• in 90% of cases, if speech was diagnosed with stage 2 or with uterine cancer of stage 1, that is, there were no metastases to the lymph nodes;
• in 54% of cases, if the cancer is accompanied by a metastatic process (stage 3 and stage 4).

For hormone-dependent and autonomous tumors, the five-year prognosis for recurrence-free survival is 90% and 60%, respectively.

If uterine cancer of 4 or 3 degrees is detected, the prognosis is the least favorable. How long will a person live if uterine carcinoma was detected too late? The percentage of patients who survived for 5 years if an inoperable fourth stage was found is only 5%, with the third - about 30%.

If cancer of the uterine body was detected on time, how long the patients live depends on the characteristics of the tumor, the course of the disease, relapses after treatment, etc. The possibility of surgical intervention is directly related to how long the patients live in the future. This is due to the low effectiveness of conservative therapy (cancer is poorly amenable to it compared to other types of oncology).

After the operation, the prognosis is much better, this is evidenced by the average indicators: at grades 1 and 2 (operable stage): 98 and 70%, respectively. With an inoperable tumor, how long the patient will eventually live depends on many factors (risk of recurrence, type of tumor, prevalence of the pathological process, individual characteristics, concomitant diseases). The effectiveness of therapy and palliative care is also important.

How fast does uterine cancer develop?

Predicting how quickly cancer will develop is almost impossible. Like all cancers, this pathology can remain unchanged for years. And then begin to develop rapidly and rapidly.

Since the underlying disease or precancer is often first detected in patients, it is only possible to speak unambiguously about their long-term transition to oncology. Also, cases of a long stable state of the pathological focus in the zero stage were recorded.

A rather rapid spread of atypical cells in the body often occurs in the later stages, when the lymphatic and circulatory system. Especially if the medications taken are ineffective.

Help of folk remedies

Is it possible to cure cancer exclusively folk remedies? common opinion on this issue does not exist. But if we analyze the causes and risk factors, we can assume that plants will help:

• normalizing hormonal levels;
• helping to cope with diseases - predecessors (polyposis, polycystic, etc.);
• providing sanitation of the vagina (destruction of pathogenic microorganisms at the local level);
• containing vitamins of groups A and B;
• at an inoperable stage: all plants that can relieve symptoms or fully replace the drugs prescribed by the attending physician.

That is, folk remedies for uterine cancer can be divided into two groups: preventive and analogue herbal remedies. The use of non-traditional methods in the treatment of any oncological diseases has long been controversial. Traditional medicine usually considers herbal medicine as additional remedy. Since in the case of uterine cancer in the early stages, the most effective methods- surgical, then you should not risk replacing it with therapy using non-traditional methods.

Treatment of uterine cancer with folk remedies is possible only after consultation with a doctor who sees the true clinical picture. With this pathology, phytopreparations are often used based on:

• hemlock and celandine: both plants are poisonous, so the dosage regimen should be strictly observed. Hemlock is sold in a pharmacy (alcohol solution), an aqueous tincture of celandine can be made independently;
• inside in the form of infusions and decoctions, it is recommended to take shepherd's purse, bedstraw, horsetail grass, etc .;
• natural analogues of chemotherapy drugs: amygdalin is found in the kernels of bitter almonds and apricot kernels. Shark cartilage extracts, shark liver oil and melatonin show good results. They can be found in the form of dietary supplements;
• ASD is used as an immunomodulator in palliative treatment;
• soda dissolved in water stabilizes the level of acidity;
• various herbal remedies are used for douching: calendula, horse sorrel, propolis, etc.

The effectiveness of various non-traditional methods as an independent treatment of oncology is in doubt, therefore it is better to combine them with methods traditional medicine and after consultation with the attending physician.

Uterine cancer and pregnancy

During pregnancy, uterine cancer is found infrequently; women of reproductive age under 30 rarely suffer from this disease. Is it possible to get pregnant if the pathological process is already underway in the body? Availability malignant neoplasm at the first stage, it does not give symptoms, although there have been cases of detection of tumors after the woman became pregnant.

Therefore, we can conclude that the latent course of the disease does not interfere with conceiving a child with uterine cancer in the early stages of development. There are features of managing patients with pregnancy. Since we are not talking about surgical intervention in this case, large doses of progestins are prescribed to the pregnant woman. After reaching the goal - atrophy of the glands, the next stage begins. Hormone therapy is used to normalize the ovulatory cycle.

If oncology is detected in nulliparous women of reproductive age, the tactics of medical care will be directed, if possible, to the preservation of function (therapy or organ-preserving surgery).

Prevention

Measures aimed at eliminating risk factors are considered as preventive measures. Balanced nutrition, normalization of hormonal levels, treatment of obesity, etc. help avoid negative consequences.

Main prophylactic there will be regular medical examinations, uterine cancer rarely occurs suddenly. Identification of diseases - precursors in most cases helps to prevent their degeneration into a malignant tumor.

We observe proper nutrition

Nutrition for uterine cancer involves a balanced diet that does not contain fatty and spicy foods. Since such food is considered one of the risk factors, the same approach to nutrition is recommended in prevention. If obesity is fixed, then the diet should be aimed at weight loss.

Food must predominate plant origin. Nutritionists recommend vegetables and fruits for uterine cancer (saturation of the body with vitamins), including legumes, whole grains, herbs, onions, garlic, turmeric, cabbage. They have proven themselves well in oncology. Heat treatment should be minimal, fats and proteins of animal origin are used in doses.

Every day, almost 1500 women around the world find out that they have cervical cancer. Due to the fact that the symptoms appear too late, the chances of a cure become lower and life expectancy is reduced. This can be avoided if cervical cancer is diagnosed at stage 1.

Typical symptoms of this stage

Most cases of cervical cancer (CC) are detected when the woman's disease is already advanced. The main reason why early diagnosis is difficult is the absence or mild symptoms.

The first stage of cancer is the initial stage, during which epithelial cells are just beginning to rapidly divide. It is impossible to see it with the naked eye. If the patient has no complaints, the gynecologist will not be able to detect this disease during the examination.

Detection of cancer at the very beginning contributes to a favorable outcome of treatment in more than 90% of cases, so oncologists and gynecologists recommend that you carefully consider such symptoms:

Although these symptoms may also occur due to other, less serious illnesses, it is worth visiting a doctor if they appear.

Diagnostics

If a girl or woman has complaints characteristic of cervical cancer, or during an appointment with a gynecologist, they were identified, then a more thorough diagnosis is carried out.

First of all, a cytology smear is done. Thanks to a special brush, epithelial cells from the alleged focus of the disease on the cervix are transferred to a special glass, after which it is examined under a microscope. So you can detect cells that are evidence of a precancerous condition or cancer.

If the Pap test showed the presence of atypical cells, then a colposcopy or biopsy is additionally performed. The method chosen will depend on the number of cells and the nature of the changes present.

A cytological smear is a screening method for cervical cancer, i.e. performed on a regular basis for early cancer detection. This approach is the best for detecting pathologies and improves the outcome of treatment.

The detected changes in the epithelium do not always lead to the development of cancer, despite this, treatment is prescribed that affects the changed cells mechanically or thermally. In the future, this can lead to complications during childbearing, and also increases the risk of premature birth and death of the newborn. Therefore, it is recommended from 25-30 years.

If during the study there is every reason to diagnose cancer, then additional examinations are carried out to clarify the size of the tumor and the stage of the disease, because the cancer cells could already have spread and there may be more affected organs. The following methods can be used for this:

• CT scan;
• Magnetic resonance imaging;
• x-ray;
• cystoscopy;
• positron emission tomography.

At the first stage of cervical cancer, changes in the epithelium affect only the cervix, without spreading to other organs. This stage is divided into 2 sub-stages:

1. At this stage, the number of cancer cells is so small that they can only be seen with a microscope. The affected area does not exceed 7 mm in width and 5 mm in depth.
2. In the second substage, changes in the epithelium can be seen without the use of a microscope, but they do not exceed 4 cm in width.

Treatment Methods

If the cancer was detected at the initial stage, when the affected area is small and does not affect the uterus, vagina and adjacent tissues, then low-traumatic methods can be used. This can be electrocoagulation and laser cauterization. They only affect the tumor itself. During this procedure, local anesthesia the patient is conscious.

If the epithelium affected by cancer cells extends to the uterus or, then an operation may be required to completely remove the uterus, and in some cases, the fallopian tubes and ovaries. Often, a course of radiation therapy is given in order to increase the chances of a complete recovery and prevent the recurrence of cancer. It is also acceptable to use radiation in combination with chemotherapy. The need to use one or another method of treatment is determined by the doctor based on the results of the examination.

After the operation, it will take some time to recover. If methods were used without complete removal of the uterus, then the process takes no more than 2 weeks. After a hysterectomy, it takes 2-3 months to recover.

Possible Complications

Thanks to the treatment of cervical cancer of the 1st degree, a complete cure is possible, but as a result, complications may arise. The most common consequence of treatment is narrowing of the vagina. Because of this, intimate relationships with a partner become difficult, because during sex there are discomfort and even pain. In order to cope with this problem, the doctor may prescribe a special hormone-containing cream that will increase the elasticity of the walls and increase the amount of lubrication.

Another method in this case would be to use special vaginal dilators in the form of tubes. They come in different sizes, and using them helps stretch the vagina and make it more flexible.

Due to the removal of the ovaries or after exposure to radiation therapy, early onset of menopause and impossibility are possible. Early menopause may be accompanied by the following symptoms:

• dryness of the vagina;
• hot flashes;
• decreased interest in sex;
• urinary incontinence during sneezing or coughing;
• thinning of bone tissue, which in the future can lead to osteoporosis.

To make the symptoms less pronounced, prescribe hormonal drugs that make up for the lack of those hormones that were produced in the ovaries before.

If lymph nodes are removed during the treatment of cervical cancer, then in the future this may lead to a violation of the removal of fluid from the body, especially from the legs. As a result, large edema may appear. Massage and special compression clothing will help to cope with this problem.

A common consequence of cancer is a worsening of the emotional state, which increases the risk of depression several times over. Such patients are well helped by cognitive behavioral therapy and a course of antidepressants.

Prevention

Preventive measures are aimed at reducing the risks that lead to cervical cancer. They are treated as general recommendations, for example, maintaining healthy lifestyle life, physical education, changing eating habits and avoiding bad habits, especially from smoking, and narrowly focused, for example, vaccination.

The risk group includes women infected with the human papillomavirus (HPV), so vaccination against this infection can prevent the occurrence of a tumor.

For this, special vaccines are used that effectively protect the body from infection with oncogenic types of HPV. This method will be effective only if this virus is not yet in the patient's body. That's why best age in order to be vaccinated - from 10 to 26 years or before the onset of sexual activity.

Forecast

At the first stage, the prognosis is the highest due to the fact that cancer does not metastasize to other organs. The rates are based on a five-year period from the time of diagnosis and are 95-99% for the first substage and 80-90% for the second. Patients who have coped with oncological disease in the future need to undergo regular examinations by a gynecologist and attend consultations with an oncologist to prevent relapse.

23.10.2018

The main problem that cancerous neoplasms of the female reproductive organs are detected on later dates, is the problem of its early diagnosis.

It can be attributed to uterine cancer of the 1st degree, its development passes without the manifestation of any symptoms. If he was recognized and treatment started on time, then a positive outcome of therapy is guaranteed.

Uterine cancer is one of the oncological neoplasms on the cervix or endometrial lesion. This cancerous disease is diagnosed in the fair sex, after fifty years, but the disease began to "rejuvenate".

Symptoms of the disease

The doctors determined that the disease early dates development is not manifested by symptoms, but there are signs by which it can be recognized.

Stage 1 uterine cancer is recognized by five main symptoms:

1. Bleeding from the uterus. Doctors consider this the first sign of cancer. If this symptom occurs after the onset of menopause, it indicates the onset of cancer. The therapy started has been quite successful.
2. Mucus-like discharge. These discharges indicate that oncological education has reached a certain level of development. Sometimes you can observe the accumulation of such secretions in the uterine cavity. During this, a woman may feel pain similar to premenstrual.
3. Watery discharge. This symptom indicates that a cancerous tumor is developing. In the process of the development of the disease, such discharge becomes purulent, an unpleasant odor appears.
4. Discharges of a purulent nature. This is a symptom for uterine cancer, which indicates accumulated purulent discharge in the organ cavity.
5. Pain sensations. Some kind of pathology develops in the reproductive system. The nature of the pain is pulling and it appears mainly in the evening and at night. As the disease progresses, the pain becomes similar to kidney pain.

Disease diagnosis

Diagnosis of cancers is aimed at the stage of development of the neoplasm. It will help you choose the right treatment. If the disease was diagnosed at an early stage of development, then it will be possible to cure the disease.

To make an accurate diagnosis, it is necessary to apply a comprehensive diagnosis. Only with the help of this method it will be possible to establish the stage of the disease and the area of ​​the lesion.

The following methods are used as diagnostics:

• Patient's complaints. In other words, you need to collect an anamnesis. This means that the doctor conducts a survey, carefully studies the patient's medical history, her previous tests and palpation. After processing this information, the doctor assumes possible reasons development of cancer.
• Visual gynecological examination, this procedure is performed using a speculum. Thus, the doctor can see the presence or absence of pathology in the uterus. In addition, the fallopian tubes, ovaries and other pathological formations are examined. If, nevertheless, the pathology has been identified, then a biopsy is prescribed.
• Biopsy. This is a painless procedure that is carried out in an outpatient setting. As a result, a piece of the affected biological material is taken from the patient for research. With its help, it is possible to detect oncology until stage 1 has passed. Although as a result of the formation process it is possible to identify it in 40% of cases.
• Cytological study. It is performed when a doctor suspects the presence of a cancerous growth. To do this, it is necessary to examine a sample of the resulting affected tissue.
• ultrasound. It is considered the most effective, and therefore the most common method of diagnosis. Ultrasound examination will help to accurately determine:

1. Cancer in the uterine cavity.
2. Damage area.
3. The structure of the tumor.
4. Localization area.
5. The defeat of the appendages.
6. Possible metastases.

• MRI and CT. They are carried out as an additional study to the ultrasound. With their help, it will be possible to establish the defeat of lymph nodes and bones by metastases. Because ultrasound can't show it.
• Hysteroscopy. it modern way diagnosis, which is used to establish or refute a cancer diagnosis. The procedure is carried out using an endoscope, which is used to examine uterine cancer, make a selection of damaged tissue for examination. This method is 100% effective.

Treatment of the disease

There are many ways to treat oncological diseases that occur in the female genital area and they are all quite effective. All of them are used in parallel with traditional methods.

Having determined uterine cancer of the 1st degree, it is impossible to say how long they live. It depends on which treatment was chosen, but also on the development of the disease.

There are several types of therapy:

• Operational intervention. For cancer of the first degree, the presence of a cancer in the uterine cavity is characteristic, which did not have time to metastasize. During this period there will be surgical intervention. The result of such treatment is positive.

Removal is carried out in several ways:

• Radical removal, in which the uterus itself is removed, and the ovaries, tubes and cervix remain.
• Subtotal excision, in which only the cervix is ​​preserved.

Only this method has its own contraindications, for example, diabetes, hypertension, atherosclerosis. Then other treatments are needed:

1. Irradiation. It can be used as an independent method of therapy, and in combination. The patient is usually irradiated before surgery, so that the size of the tumor decreases slightly, or for prophylaxis after the surgical intervention, so that the disease does not recur. This method can be used if other methods are contraindicated. Irradiation can be carried out in two ways, it is internal and external. Internal, carried out only in a hospital, and external can be used in an outpatient setting. Quite often, to improve the effect, two methods are carried out simultaneously.
2. Hormonal treatment. It is believed that this method will help only in case of early diagnosis of the disease. It can be used as a separate therapeutic method, or in parallel with surgery.
3. Chemotherapy. This means that the tumor will be affected by various chemicals that can stop the development of cancer. It must be used in combination with therapeutic methods. Such treatment can be started when the stage of the disease is diagnosed, it has side effects. It has a detrimental effect on cancer cells, this method can also kill healthy ones, which negatively affects the patient's condition.

Disease prognosis

The prognosis, when grade 1 cancer is detected, is quite good with a five-year survival rate. How long the patient will live will depend on the timely diagnosed disease, the selected method of therapy, the age of the patient and the condition of her body.

If the disease is detected in time, then the five-year survival rate can reach 90%. We can say that this is a victory over cancer. Not every doctor can boast of results.

Preventive measures

Women who may be at risk for this disease are advised by doctors to undergo regular preventive examinations, apply special preparations, carry out replacement therapy during menopause. You need to take care of nutrition and weight loss.

Current scientists have developed a vaccine that helps prevent the development of cancer, this is the first drug - Gardasil. You can also use barrier contraception. This method will help reduce the risk of cancer, prevent the occurrence of sexually transmitted diseases, human papillomavirus.

Conducted preventive actions and examinations to help avoid uterine cancer.

Content

After the age of 45, women are at risk of getting uterine cancer due to hormonal changes Therefore, you should know the first signs and symptoms of the disease in order to prevent it. The initial stages of the disease are asymptomatic, but it is possible to suspect the development of oncology with regular examination by a gynecologist. The sooner a pathology is detected, the sooner it can be treated in order to avoid serious consequences.

What is uterine cancer

In medical terminology, uterine carcinoma is the development of a malignant tumor in the female genital organ. It is the main one for bearing a child and is responsible for the reproduction of a woman. By appearance the uterus resembles a hollow flattened bag with an angle, consisting of a body and a neck. Inside, it is lined with endometrium, which is rejected and released outside with each menstruation. Oncology of this organ is extremely dangerous, can lead to death.

The reasons

Doctors have established a number of causes that affect the occurrence of cancer inside the uterine cavity and cause fast growth cancer cells:

• lack of childbirth;
• obesity;
• diabetes;
• taking hormonal drugs due to a hormonal imbalance, but not birth control pills;
• infertility, menstrual irregularities;
• early menstruation and late menopause;
• polycystic ovaries, their tumors;
• breast cancer due to lack of breastfeeding;
• hereditary colon cancer without polyps:
• endometrial dysfunction in the past;
• age over 45;
• heavy pregnancies, miscarriages, abortions.

Classification

According to oncological data, several types of classifications of malignant neoplasms are distinguished:

1. According to the morphological form - adenocarcinoma, sarcoma, clear cell (mesonephroid) adenocarcinoma, squamous cell carcinoma, glandular squamous cell oncology, serous, mucinous, undifferentiated cancer.
2. According to the form of growth - with predominantly exo- or endophytic, mixed autonomous growth.
3. By localization - in the area of ​​the bottom, body, lower segment.
4. According to the degree of differentiation (the lower, the worse) - highly differentiated, moderately differentiated, low-differentiated cancer.
5. According to the ICD code, according to the FIGO classification, there are their own types with a digital and alphabetic code.

Forecast

In 90% of oncology of the cervix and ovaries is cured completely due to surgery and subsequent radiotherapy. If cancer is detected in time, it is possible to prevent the development of metastases and improve the prognosis of survival. Depending on the stage, the forecast will be as follows:

• in the first, 78% of patients survive the first five years;
• on the second - 57%;
• third - 31%;
• fourth - 7.8%.

Stages of uterine cancer

Oncology develops gradually, starting from the zero stage, when only the first rudiments of cancer cells can be detected. The main stages of development are:

• the first - the tumor affects the endometrium or grows into the muscle layer (myometrium);
• the second is the development of a tumor on the neck (collus of the uterus);
• the third - the exit of the cancer beyond the uterus, spread to the vagina, pelvic or lumbar lymph nodes;
• the fourth - germination in the bladder, rectum;
• metastasis - the appearance of metastases in the liver, lungs, inguinal lymph nodes.

endometrial cancer

A malignant tumor of the mucous membrane lining the cavity from the inside is the initial cancer of the endometrium of the uterus. It occurs after menopause, 72% of the detection falls on the first stage. The cause of development is estrogenization - due to an excess of the female sex hormone, endometrial hyperplasia begins. Types of endometrial cancer:

• simple hyperplasia without atypia;
• complex adenomatous without atypia;
• simple atypical - a precancerous condition of a malignant neoplasm (MN);
• complex atypical - degenerates into cancer with a probability of 80%.

Cancer of the body of the uterus

The next stage after the defeat of the endometrium is a tumor of the body of the uterus. Oncology of the uterus develops from the tissues of the mucous membrane (adenocarcinoma) or muscular (leiomyosarcoma) membrane. The growth of a malignant tumor falls on the bottom, isthmus, uterine cavity. Cells metastasize to adjacent tissues, to the cervix, fallopian tubes, ovaries, lymph nodes, and blood vessels.

Cervical cancer

A malignant tumor often found in women is cervical cancer. 85% of its cases are due to the occurrence of neoplasms from squamous cells of the epithelium, the remaining 15% is adenocarcinoma, which arises from cells that produce mucus. Allocate exo-, endophytic form, which affect the vagina or the body of the uterus. The papillary type is characterized by the growth of small papillae (looks like cauliflower), and the crater-like type is characterized by covering the tumor with ulcers and a gray coating. The cause of tumor growth is often the human papillomavirus (HPV).

Uterine and ovarian cancer

After the defeat of the cervix and in the absence of treatment, oncology gets to the ovaries, which serve to produce hormones. The disease is asymptomatic, but can be manifested in pain, constipation, squeezing of the bladder. Types of ovarian cancer:

• mucinous;
• serous;
• endometrioid;
• Brener's tumor;
• clear cell;
• mixed epithelial;
• carcinoma;
• stroma of the sex cord;
• lipoid-cellular;
• soft tissue damage;
• germinogenic;
• secondary;
• gonadoblastoma;
• cysts.

An ovarian tumor develops in one organ, quickly passes into the second, affects one of them completely. Education affects the fallopian tubes, body, abdominal cavity. The third stage is manifested by infection of the lymph nodes, inguinal, ends with metastases in the liver, lungs. 80% of patients in the first stage can be successfully cured of oncology, in the later stages this figure is only 10%.

Metastasis

Metastases are understood as secondary foci of growth of malignant tumors. An endometrial tumor manifests itself in three types of metastasis:

• implantation - the path of decay, involving the visceral peritoneum;
• lymphogenous - damage to the lymph nodes of the pelvis;
• hematogenous - damage to the lymph nodes and infection of the bones, liver, lungs.

Symptoms of uterine cancer

The first stages of oncology of the uterus are asymptomatic, only in postmenopausal women can be noted acyclic uterine bleeding or profuse prolonged menstruation. Early signs of uterine cancer are watery, blood-streaked vaginal discharge. A less common symptom is pain in the pelvis, abdomen, accompanied by a short duration. Older women may experience stenosis (infection) and accumulation of pus in the uterine cavity.

First signs

Doctors identify the following first signs of uterine cancer that characterize cancer, and in the presence of which you should immediately consult a doctor:

• bleeding from the genitals, reminiscent of menstruation, but occurring suddenly;
• pain.

Allocations

Depending on the stage of tumor development, the type, format and volume of secretions differ, both during menstruation and pathological:

• with oncology of the body of the uterus - serous leucorrhoea, pain, bleeding without reference to the cycle;
• at the first stage - light disposable uterine bleeding, watery discharge, odorless mucous membranes;
• in the last stages - fetid discharge, stained with blood, pus, fever.

Diagnosis and treatment of uterine cancer

If symptoms of oncology are detected, an urgent need to contact a gynecologist for examination and diagnosis. The doctor makes an examination, palpation of the uterus, scraping from the cervix. The smear is examined for the presence of cancer cells, with a positive result cleansing of the inner layer of the uterus under general anesthesia and a mucosal test is performed. To confirm a cervical tumor, a CT scan is done to determine exactly where the mass is. Biopsy, hysteroscopy, immunohistochemical study, cytological method, MRI help to establish the etiology.

Cancer treatment is carried out in several ways, depending on the stage of development and severity of the course:

1. The operation is the complete removal of the uterus and ovaries, if the tumor has also affected them. The fallopian tubes are removed. The surgical method leads to an early menopause, strikes at the psyche of a woman.
2. Radiation therapy- is prescribed for signs of illness after the removal of the uterus. The procedure reduces the risk of cervical lesions, metastases. Radiotherapy can be carried out remotely (irradiation of all organs of the small pelvis in several series) or internally (the introduction of radioactive emitters at the site of the pathology).
3. Hormone therapy - to exclude the recurrence of oncology. Progesterone, hormonal drugs that reduce estrogen production, is prescribed.
4. Chemotherapy - to reduce the volume of the tumor and in severe advanced cases.

Prevention of uterine cancer

To reduce the risk of oncology, the elimination of hyperestrogenism and therapy are used. hormonal drugs. In addition, prevention includes:

• regular examination at the gynecologist, delivery of smears;
• conducting an ultrasound;
• taking combined oral contraceptives;
• weight loss;
• HPV vaccination in the absence of contraindications.

Video

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment, based on individual characteristics specific patient.

Cervical cancer (cervical cancer, cervical cancer) is a merciless malignant tumor of the female genital area.

In Russia, about 20 women die every day from this oncological disease. Moreover, cervical cancer in recent years has been rapidly “getting younger” - the first peak of incidence is already at the age of 20-35 years (instead of the previously observed at 45-49 years).

In this article, we'll talk about symptoms, prognosis and treatment of stage 1 (first) cervical cancer. About the stage when it is really possible to achieve a complete recovery.

Adequately performed radical surgical treatment of precancer
and stage 1 cervical cancer in almost all cases provides a complete recovery.

At later, inoperable stages, the patient undergoes palliative radiation and chemoradiotherapy. Here the prognosis, although less favorable, is not hopeless.

Stages of cervical cancer

Practicing oncology uses two systems for describing the staging of a malignant process.

TNM clinical classification:

• T (tumor - malignant tumor) - the degree of prevalence of the tumor
• N - damage to regional lymph nodes (N0 - no; N1 - yes; Nx - little data)
• M - metastases to distant lymph nodes, lungs, liver, bones ... (M0 - no, M1 - yes, Mx - little data).

Classification by stages (FIGO)- describes the prevalence of the malignant process.

(according to two classifications)

Features of stage 1 cervical cancer

The first stage (I, T1) of the disease is divided into two main substages:

• Stage IA (T1a) - microinvasive* cervical cancer
• IB stage (T1v) - macroinvasive**, defined clinically invasive cervical cancer

Germination (invasion) of malignant cells under the basement membrane of the mucosa is so small that it can be detected only under a microscope, during histological examination of a sample of suspicious tissue.

IA1 is the preclinical stage of cervical cancer, an intermediate period between severe dysplasia/precancer and a clinically detectable tumor.

At this stage, the disease is almost asymptomatic. The scant manifestations of a developing tumor are lymphorrhea (liquid watery discharge). But this symptom is masked by background pathological processes (erosion, inflammation, dysplasia).

If cervical cancer is detected at stage 1A, then after the correct radical surgical treatment the prognosis for the patient is the most optimistic - a complete cure occurs in 99.9% of cases.

Substage 1B (T1c) stage 1 cervical cancer is the first clinical stage of NMC.

The tumor is still small. She still does not go beyond the cervix. But it can already be seen or suspected during colposcopy or when examining a patient on an armchair using a gynecological “mirror”.

It is still possible to carry out a radical operation during this period, which means that there are all chances for a full recovery.

Substages of the first stage of cervical cancer
(1a1, 1a2… cervical cancer stage)

All further findings obtained by MRI, PET-CT, laparoscopy do not change the previously established stage, but significantly affect the choice of treatment tactics and the prognosis of the disease.

• Thorough gynecological examination using a gynecological "mirror", rectovaginal examination
• Cervical smear for oncocytology, aka: Pap test, smear for atypical cells
• Extended colposcopy with biopsy of suspicious tissue
  or
  extended colposcopy with curettage of the mucous membrane of the cervical canal and (if necessary) of the uterine cavity
• Wedge biopsy or LEEP electrosurgical excision or cervical conization.

• Ultrasound of the pelvic organs and retroperitoneal space (relevant for a clinically detectable tumor of more than 4 cm) - performed after a histological examination
• MRI of the pelvis with intravenous contrast (if MRI is not possible, CT is performed)
• PET or PET-CT (to detect metastases in the lymph nodes or distant organs)

Careful histological and histoimmunochemical examination of the biopsy or surgically removed preparation should determine:

1. Histological type of tumor: squamous cell carcinoma, adenocarcinoma, etc.
2. Grade of tumor differentiation (G)*
3. Depth of tumor invasion into border tissues
4. Is there tumor invasion into the LVSI lymphovascular space (are there tumor emboli in lymphatic and/or blood vessels):
   (LVSI+) - the tumor has grown into the vessels - a poor prognostic sign;
   (LVSI-) - no traces of tumor invasion into the lymphatic bloodstream were found - a good prognostic sign.
5. Are there tumor cells in the resection margin (after cervical conization)
6. ...as well as a number of some specific histoimmunochemical parameters

G determines the degree of "similarity" of the structure of tumor cells to the structure of "normal" cells of the body.

The more tumor cells resemble cells of a particular tissue, the higher their differentiation, the more predictable their "behavior": the tumor progresses slowly, responds to treatment as expected ("responds" to treatment), rarely metastasizes, which gives an optimistic prognosis.

For cervical cancer, 3 degrees of tumor differentiation are determined:

G1 - highly differentiated (low-grade, least aggressive, the best forecast)

G2 - moderately differentiated (moderately aggressive)

G3 - undifferentiated or poorly differentiated tumor (the most aggressive, high degree of malignancy with an unpredictable course and a disappointing prognosis)

Gx - a situation when, for some reason, tumor differentiation could not be determined

Treatment of the disease at stage 1

The stage of cervical cancer is confirmed by a histological diagnosis, which means that treatment tactics are determined after conization and histological examination.

If histology has identified signs of dysplasia or atypical / malignant cells along the resection margin or in the scraping of the cervical canal, then:
- repeated (wide) conization of the cervix and repeated histological examination are carried out;
or
- an extended hysterectomy according to Wertheim is immediately performed: a radical modified hysterectomy (type 2 operation). During it, the uterus is completely removed (cervix and body, with or without), the ligamentous apparatus of the uterus, pelvic tissue with regional lymph nodes(pelvic lymphadenectomy or lymph node dissection), as well as 1-2 cm of the vaginal cuff.

After the operation, all removed tissues are sent for re-histological examination.

Surgical treatment of stage IA disease

/treatment of microinvasive cervical cancer/

Radiation therapy for stage IA CC

Radiation therapy:

• remote
• or intracavitary
• or combined (remote + intracavitary)

in the treatment of stage IA microinvasive cervical cancer held INSTEAD OF radical operation (if this operation is not possible):
- there are objective contraindications to surgical treatment;
- for some technical reasons it is impossible to carry out a radical operation;
The patient refuses surgical treatment.

"Chemistry" for cervical cancer of the 1st stage IA

Chemotherapy at the first (IA) stage is not carried out.

Treatment of the first (IB) stage of cervical cancer

There is no single tactic for the management of clinically pronounced invasive cervical cancer stage 1B1, 1B2.

Treatment options are selected individually, taking into account the age of the patient, technical equipment medical institution, vocational training medical staff, the wishes of the patient herself.

The main methods of treatment:

• Surgical
• Combined (radiation/chemoradiation/chemotherapy + surgery)
• Radiation/chemoradiation

Surgical treatment of the first IB stage of cervical cancer

Recommended
radical extended extirpation of the uterus according to Meigs (type 3 operation): the uterus with appendages, cardinal and sacro-uterine ligaments from the pelvic walls, the upper third of the vagina, periuterine tissue and pelvic lymph nodes are completely removed.

Postoperative supportive (adjuvant) treatment is prescribed after assessing the risk factors for tumor progression.

Factors of high risk of cervical cancer progression:
(poor prognostic factors)

• Histology revealed a metastatic lesion of the lymph nodes
• G3 tumor differentiation
• LVSI+
• Primary tumor >3 cm
• Endophytic tumor growth (barrel cervix)
• The operation was performed non-radically (inadequate volume of the operation)
• It is not possible to assess all histological parameters of the tumor

Low risk of tumor progression
postoperative treatment is not carried out, dynamic observation is prescribed.

At high risk of progression tumors:
after the operation, according to individual indications, it is prescribed:

• Complementary Radiation Therapy
• Auxiliary chemoradiotherapy (radiotherapy + Cisplatin, once a week for radiation treatment, up to 6 weeks)

As a treatment option for the first stage IB (instead of radical surgery), the following can be used:

• Radiation therapy according to the radical program
• Chemoradiation therapy (chemotherapeutic drugs are administered during the period of therapeutic exposure) according to a radical program

Indications for radiation y / chemoradiotherapy according to a radical program:
- the impossibility of a radical operation;
- refusal of the patient from the operation;
- tumor stage IB2 (according to individual indications)

If the cancerous tumor is limited to the cervix, but already more than 4 cm (first stage IB2 cervical cancer), then preoperative chemotherapy with platinum preparations (2-3 courses) may be prescribed before radical surgical treatment (type 3 surgery).

High mortality in cervical cancer necessitates individual approach and serious attitude to the treatment of the disease at any stage of its development