Early stage uterine cancer is treated. Uterine cancer: the first signs and symptoms, treatment at an early stage

This ailment considered very common at the present time. The most common early signs and symptoms of cervical cancer found in women aged 30 to 55 years(per last years this disease is much "rejuvenated"). Despite the fact that this pathology is easily diagnosed, unfortunately, in almost half of the patients it is detected already in the later stages. modern medicine offers several ways to solve the problem, up to a complete recovery and restoration of the body. Practice shows that when timely treatment diseases in the early stages (without removal of the organ) in the future, a woman can have healthy offspring.

In most cases, the disease develops against the background of precancerous conditions. The risk group for such a disease includes women who neglect the treatment of sexually transmitted infections, patients who do not follow the rules of personal hygiene.

Girls who begin to have sex in early age(up to 16 years), when the cervical epithelium contains immature cells that easily degenerate into cancerous ones. Cicatricial changes on the mucous membrane of the organ, hormonal imbalance, smoking, alcohol intake, exposure to radiation - all this significantly increases the risk of occurrence. Every year, this diagnosis is detected in 600,000 women worldwide.

The reasons

Regardless of what symptoms a woman experiences with cervical cancer, the source of the tumor is healthy cells that cover this organ.

The main reasons are:

• papillomavirus infection;
• infection with genital herpes, HIV, cytomegalovirus, chlamydia;
• diseases of the cervix (dysplasia, leukoplakia, erosion);
• lack of vitamin A and C in the body;
• weakened immunity;
• exposure to the body of radiation and chemical toxins;
• early abortions, curettage;
• scarring of the tissues of the uterus;
• organ injury;
• disorderly, unprotected sex life if the change of partners occurs more often than 2-3 times a year;
• stress.

The main threat is viruses that cause mutations, and provoke the degeneration of healthy cells into cancerous ones. During the course of the disease, tumor cells can be transported with lymph to nearby The lymph nodes thus forming metastases. Despite the development and spread of the disease, the symptoms of cervical cancer in women at this stage may be absent or mild.

Kinds

Depending on the type of affected epithelium, there are:

• squamous cell carcinoma(most common, the tumor is formed from squamous epithelium cells covering the vaginal part of the organ; due to a failure in the DNA structure, immature cancer cells are formed during division, capable of dynamic reproduction);
• adenocarcinoma(the tumor affects the deep layers of the endocervix).

Squamous cell carcinoma is divided into 3 groups:

• keratinized (the tumor is distinguished by its density, keratinous structure);
• poorly differentiated (the tumor grows rapidly, has a soft texture);
• non-keratinized (considered an intermediate stage between keratinized and poorly differentiated cancer).

Main stages

• stage 0 - a precancerous condition, when pathogenic cells do not form a tumor, do not penetrate into the tissues, but are located on the surface of the cervical canal;
• stage I (cancer cells penetrate deep into the tissues, the pathology does not affect the lymph nodes, the average tumor size is 3-5 mm (IA) or up to 5 mm (IB));
• stage II (sprouts into the uterus, goes beyond its borders, does not affect the lower part of the vagina and the walls of the small pelvis);
• stage III (tumor extends beyond the cervix, up to the pelvic walls and lower third vagina, observed);
• stage IV (the tumor is characterized by large sizes, spreads from all sides of the neck, affects the lymph nodes and neighboring organs).

Symptoms of cervical cancer

It is impossible to say exactly what is the first symptom of cervical cancer, since all manifestations of the disease are usually mild. In the early stages, they may not be present at all. As the tumor grows, warning signs and symptoms may occur. But at this point, the lesion can reach neighboring organs. That's why women should have regular check-ups with a gynecologist with mandatory colposcopy (microscopic examination of the state of the cervix).

What are the symptoms and early signs of cervical cancer? The main ones include:

• bleeding after intercourse, between periods, after menopause, immediately after examination by a gynecologist;
• abundant whitish curdled discharge from the vagina with blood impurities;
• purulent discharge from the vagina with an unpleasant odor;
• increase in the duration of menstruation (more than 7 days);
• sharp pains in the lower abdomen;
• spasms radiating to the lower back;
• discomfort in the vagina during intercourse;
• weight loss (up to 10-15 kg in a few weeks);
• problems with bowel movements;
• frequent urination or with delays;
• general weakness of the body;
• increased fatigue;
• swelling of the legs;
• temperature rise.

When examining the condition of the cervix in cancer, ulcerations are diagnosed, as well as a change in the color of the cervix.

The signs and symptoms of cervical cancer listed above are not exact and mandatory. They can also signal the presence of other gynecological diseases, so it is very important to complex diagnostics from an experienced gynecologist.

Diagnostics

Any manifestation of symptoms in women should alert and to confirm or refute the diagnosis, it is necessary to conduct the following types of studies:

• oncoprophylactic examination by a gynecologist (at least once every 6 months);
• cytological examination scraping from the surface of the neck;
• PAP test (study for the presence of atypical cells);
• colposcopy;
• biopsy of cervical tissue;
• Schiller test (test with or acetic acid);
• Ultrasound of the pelvic organs - such a study allows you to determine the spread of the tumor in the pelvis, thus establishing the stage of the disease.

If signs and symptoms of cervical cancer are observed and the presence of the disease is suspected, gynecologist prescribes related diagnostic procedures to exclude or confirm the germination of a malignant neoplasm to neighboring organs.

• MRI of the pelvic organs - is performed in cases where the results of ultrasound do not accurately determine the spread of the disease;
• ultrasound of the kidneys;
• Ultrasound of the liver;
• ultrasound procedure Bladder;
• X-ray of the lungs - performed to exclude or confirm the presence of distant metastases;
• irrigoscopy - a study of the colon using an x-ray, allowing you to determine the area of ​​\u200b\u200bdistribution of the neoplasm;
• rectoscopy and cystoscopy - an examination of the rectum and bladder, which allows you to determine whether these organs are affected by the tumor;
• intravenous urography is necessary to determine the "performance" of this organ, since cervical cancer often causes compression of the ureters, with further impairment of kidney function.

Treatment

Treatment of cervical cancer involves the following types of therapy:

• conization of the cervix (conical amputation), which involves the removal of the cone-shaped part of the cervix and the mucous membrane of the cervical canal;
• electrosurgical loop excision, when pathological tissues are removed with an electric knife, the pathogenic area is cauterized, healthy tissues are formed in its place;
• high amputation, when the surgeon performs a radical removal of the cervix; the operation may involve the removal of part of the vagina, pelvic lymph nodes;
• extirpation of the uterus with complete or partial removal ovaries;
• radical hysterectomy, which involves the removal of the uterus, fallopian tubes, vagina, ovaries, lymph nodes;
• radiation and chemotherapy;
• drug therapy;
• hormone therapy.

Radiation and chemotherapy, as a rule, are prescribed at the preoperative stage in order to reduce the size of the cancerous tumor. The most common treatment is complex, which combines surgical intervention, radiation and chemotherapy. For a long period of time, only the first two methods were used; recently it has been proven that the combination of all methods of treatment significantly increases the effectiveness of the course of treatment.

Irradiation is the leading method of treatment, it is especially often resorted to if the patient has a 3-4 stage of the disease and surgical removal of the tumor is impossible.

During the course, remote gamma therapy is used, which is supplemented by intracavitary irradiation of the cervix.

Chemotherapy is usually used as an adjunct to radiation. The results obtained are ambiguous: on the one hand, the efficiency increases and it becomes possible to reduce the radiation dose, and hence reduce the likelihood of the appearance of radioinduced formations. On the other hand, such combined treatment poorly tolerated by patients and leads to side effects.

Complications

Such a disease can develop rapidly or have a sluggish character, but in each of these cases, a number of complications may occur:

• compression of the ureters;
• stasis of urine;
• development of hydronephrosis;
• the appearance of a purulent infection of the urinary tract;
• the occurrence of bleeding from a tumor or genital tract;
• the formation of fistulas, peculiar unnatural channels connecting the bladder or intestines with the vagina.

Prevention

In order not to understand what symptoms may be evidence of cervical cancer and look for what is the first sign of such a disease, one should timely preventive maintenance. To this end, the following actions are taken:

• regular examinations at the gynecologist - visual and bimanual (manual);
• colposcopy (at least once a year) - examination of the organ with a magnification of 7.5-40 times, allows you to see precancerous processes;
• passing a PAP test to detect atypical cells;
• timely treatment of sexually transmitted diseases;
• protected sexual intercourse;
• vaccination against cervical cancer with a quadripartite vaccine. (vaccination gives immunity for 3 years, is performed in several stages, is given to girls aged 9 to 12 years (before sexual activity, when infection with the virus has not yet occurred), as well as older girls (from 13 to 26 years old); the cost of vaccination - from $ 400 per course).

Treatment of the disease should take place under the supervision of a gynecologist with a surgical profile, as well as an oncologist.

Forecast

Cervical cancer is serious illness which leads to serious complications. The main threat is metastasis to the lymph nodes, other organs (kidneys, lungs, liver), removal of the uterus and, as a result, infertility. Chemotherapy, which is used in the treatment of cancer, has a toxic effect on organs and systems. human body. The development of cancer can be prevented by undergoing preventive examinations by a gynecologist at least once every six months., as well as paying attention to the emerging characteristic symptoms cervical cancer in women.

The success of the treatment of the disease depends on the age of the patient, general condition health, the therapy chosen by the gynecologist and oncologist, the stage and form of cancer. If cancer is diagnosed early stage, forecast - favorable disease can be cured surgical techniques, a woman may have healthy offspring in the future (pregnancy can be planned after 3 years, given the absence of relapses).

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Cancer of the female reproductive system in modern oncology is far from a common malignant disease. In the first place is noted, in the second - a tumor of the ovaries and in the third place - a malignant neoplasm of the body of the uterus.

The causes of the occurrence and spread of cancer in the internal genital organs of women are varied, but rather they can be called predisposing factors. More often, postmenopausal women suffer from cancer of the ovaries, cervix and body of the uterus, but the manifestation of this pathology is also observed in the reproductive age of the fair sex.

Etiology and risk factors of oncological diseases of the internal female genitalia

Cancer of the uterine body is especially evident in postmenopausal women, that is, during the period when hypothalamic dysfunction is determined and ovarian function completely fades. Postmenopause occurs from sixty to seventy years of a woman's life, while menstruation is not observed for more than a year. If symptoms appear during the postmenopausal period spotting from the genital tract, then such a woman is in the background with suspected uterine cancer.

The main precancerous conditions of the body of the uterus, which can be more or less pronounced, are:

1. Focal adenomatosis of the endometrium;
2. Adenomatous polyp of the inner layer of the uterus;
3. Atypical endometrial hyperplasia.

Symptoms of precancer, both in postmenopausal women and in the reproductive period of a woman, are bleeding from the vagina, which can occur without cyclicity.

The occurrence of cancer of the body of the uterus is often observed in the area of ​​​​its corners and bottom. The endometrium in these departments is reborn in the form of a polyp. Such a tumor of the uterus is called limited. In the case of damage to the entire endometrial layer by a malignant process, they speak of diffuse form uterine cancer. Proliferation of the neoplasm occurs from the cells of the glandular-coelendric epithelium of the surface layer of the endometrium. According to the histological structure of atypical cells, three degrees of uterine cancer are determined:

1. Mature glandular cancer;
2. Glandular - solid tumor;
3. Poorly differentiated cancer (solid).

Clinical signs in uterine cancer

The specific symptoms of oncology of the uterus and ovaries are mild, therefore, women may not go to the gynecologist for years, which leads to the neglect of the malignant process. According to patient reviews, an early symptom of uterine and ovarian cancer is a liquid whitish discharge from the genital tract. With the development of a tumor, bloody streaks are added to the whites, and if an infection joins the process, the discharge becomes yellow or green color with an unpleasant odor and cause itching in the area of ​​the perineum and large lips.

In almost all patients with uterine cancer, the main symptom is uterine bleeding. If a woman is of childbearing age, then this can manifest itself in the form of prolonged uterine bleeding (metrorrhagia). During menopause - bleeding occurs as a daub with an acyclic course. In postmenopause, the discharge becomes the color of meat slops with a putrid odor.

The symptom of pain is not present in all cancer patients with uterine and ovarian cancer. With infiltrative tumor growth, the affected endometrium fills the uterine cavity, and it begins to contract. This process is accompanied by a symptom of cramping pain in the lower abdomen, which radiates to the sacrum and perineum. Pain relief occurs after emptying the uterus. Dull and constant pain in the lower abdomen appears when squeezed by a tumor or metastatic lymph nodes nerve trunks, and also, with the germination of oncological formation of the walls of the uterus.

As a rule, with cancer in the uterus, the tubes and ovaries are affected, which greatly increase in size. Metastases during infiltration of the tumor into the uterus, spread by the method of implantation, through the blood and lymphatic channels. In invasive mature uterine cancer, metastases are more likely to progress through the lymphogenous route. When the tumor is localized in the lower segment of the uterine organ, then metastatic lymph nodes are noted in the iliac region, and para-aortic nodes are affected by metastases. lymphatic system, observed in cancer of the upper meters. The bloodstream of metastases can be directed to the bone, lung and liver tissue.

Since the female genitalia are considered visual organs, the diagnosis of possible pathologies is not particularly difficult. Gynecological examination of the genital organs consists in examination, palpation of the reproductive organs, as well as in the use of hardware and surgical research. Diagnosis of the inner layer of the uterus can be carried out using hysterography, ultrasound and curettage of the uterine cavity, followed by cytology. If we consider the morphological structure of the endometrium with uterine tumors in different phases menstrual cycle, the following changes can be noted:

In the first phase - a thin and even, without visible blood vessels, endometrium is determined;

In the second phase - the inner layer of the uterus becomes red, edematous and thickened with folds (endometrial hyperplasia).

A histological examination of the contents of the uterine cavity during curettage or after a biopsy of a section of the endometrium, a polyp, for example, in 90% of cases determines the cause of the pathological symptoms that have arisen.

The uterine organ consists in introducing a hardware instrument into the uterus, which performs the role of diagnostics and biopsy of the internal cavity of the organ.

When malignant cells are detected in histological analysis, the diagnosis of a woman is supplemented by an X-ray of the lungs and an ultrasound examination of the liver to track metastases of uterine cancer.

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Stages of development and treatment of endometrial tumors

Classify a malignant tumor of the uterus according to its shape, invasion and metastasis. There are international systems for determining the stage of endometrial carcinoma:

• Stage 1 - a pronounced solid cancer or poorly differentiated carcinoma, limited to the endometrium or capturing half of the myometrial layer, an increase in the uterus of more than eight centimeters;
• stage 2 - damage to the body and cervix with invasion of the endocervical glands and cervical stroma;
• Stage 3 - the malignant process is transferred to the tubes and ovaries, to the parametric tissue of the small pelvis. Determination of metastases in the para-aortic nodes of the lymphatic system and in the vagina;
• Stage 4 - tumor germination in nearby organs and tissues: intestines, bladder, and also outside the small pelvis. The presence of affected lymph nodes in the groin and peritoneum.

The tactics of treating endometrial carcinoma depends on the age of the patient, the stage of pathology and the sensitivity of the organism to therapy.

In most cases, the treatment of uterine cancer is carried out surgically and in combination therapy. Radical intervention is expressed by complete amputation of the reproductive organ. According to diagnostic and prognostic data, choose the appropriate methods for removing the tumor:

• Removal of the uterine organ without a neck (subtotal amputation);
• Removal of the uterus with the cervix (total amputation);
• Amputation of the uterus along with tubes, ovaries (radical extirpation);
• Removal of the uterus along with the tubes, ovaries, lymph nodes and the upper part of the vagina (hysterosalpingo-oophorectomy).

Radiation therapy is almost always given after surgery, and sometimes radiation is given before surgery to stop and reduce the proliferation of cancer cells. Radiation treatment is also used by the intracavitary method when tracking the spread of cancer from the uterus to the cervix. In the presence of contraindications and inoperability of the tumor, irradiation is carried out as an independent treatment.

Ray exposure improves hormonal drugs, namely progestins, which are taken by long-term regimens.

Rehabilitation measures for uterine cancer are carried out in stages. First, a woman is checked for the presence of complex endocrine, nervous and other pathologies, which can serve as both an obstacle in the treatment process and a complication in postoperative period. Therefore, such states of the body need to be controlled in postoperative life. Depending on the stage and histological structure of uterine carcinoma, after treatment, a further prognosis for vital and professional activity a woman who should be registered with the oncology center, with a check every six months.

Preventive measures for the occurrence of a malignant process in the reproductive organs should be aimed at observing healthy lifestyle life, especially postmenopausal women with annual preventive medical examinations and timely referral to specialists in case of pathological conditions. Modern diagnostics allows you to quickly and informatively identify possible pathology, the main thing is to do it on time.

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Content

Uterine cancer is one of the most common cancers. According to various data, in terms of prevalence, it is in second place after a malignant tumor localized in the mammary gland.

Uterine cancer often affects older patients. However, like other oncological pathologies, uterine cancer is rapidly getting younger. In modern gynecology, the first symptoms and signs of cancer of the uterine body can be diagnosed in young women. According to statistics, signs of uterine cancer are found in women before menopause in 40% of cases.

Usually, in the later stages, uterine cancer is detected in age-related representatives. Early stages of detection are more typical for women of reproductive age. However, in order to identify the disease at an early stage, it is necessary to consult a specialist in time and undergo an examination. The gynecologist determines the first symptoms and signs, prescribes the appropriate treatment.

As you know, the uterine wall is not uniform. In the structure of the uterine body, three interconnected layers can be distinguished.

1. The parametrium, or serosa, is the outer layer of the uterus.
2. Myometrium is a muscular layer, which is considered the middle uterine layer.
3. Endometrium or mucous membrane, called the inner layer of the uterus.

Myometrium in the structure of the uterine body performs several important functions. Due to the muscular layer, the uterus increases in size during pregnancy, shrinks during menstruation and childbirth.

The first signs of cervical cancer affect the lining of the uterus. The endometrium includes a functional and basal layer. The superficial functional layer during each cycle grows under the influence of sex hormones, thus preparing for a possible conception. If pregnancy does not occur, the overgrown layer is rejected, which is accompanied by the onset of critical days. The reserves of the basal layer allow you to restore the mucous membrane.

With the progression of cervical cancer at an early stage, all layers are gradually involved in the malignant process. Then the tumor moves to the cervix and surrounding tissues. Over time, distant organs can be affected due to the occurrence of metastases.

The reasons

Cervical cancer can have many causes and predisposing factors. Often the occurrence of signs and symptoms of pathology becomes a complex various reasons and the way of life that a woman leads.

A variety of factors can predispose to the development of uterine cancer. Uterine cancer can be both hormone-dependent and autonomous. Gynecologists note that in most cases, the onset of the first signs and symptoms of cancer is associated with hormonal imbalance and the causes that lead to it.

The entire reproductive system of a woman is dependent on the normal ratio of sex hormones. Due to the optimal ratio of sex steroids, a woman has a regular two-phase cycle with the presence of ovulation, which allows conception to occur. The endometrium also grows and is rejected under the influence of the necessary sex hormones.

However, under the influence of some unfavorable factors, this balance is disturbed. There are functional, and then structural disorders. The endometrium may overgrow. Over time, the first signs and symptoms of atypia often occur.

For proper functioning reproductive system The correct ratio of progesterone and estrogen is important. In many pathologies, an excess amount of estrogen is observed with a consistently low progesterone.

Gynecologists distinguish the following factors that lead to hormonal disorders and the appearance of early stages of the oncological process:

• early onset of the first menstruation and puberty in general;
• the appearance of signs of menopause after 55 years;
• prolonged absence of ovulation;
• endocrine disorders;
• PCOS;
• excess body weight, contributing to excessive production of estrogens;
• diabetes;
• the use of estrogen-containing drugs for a long time;
• treatment with breast cancer drugs, such as Tamoxifen;
• irregular nature of sexual life;
• absence of pregnancies and subsequent childbirth;
• hereditary predisposition;
• pathology of the liver, which utilizes estrogens;
• hypertension.

Hormone-dependent uterine cancer is often detected with signs of a malignant tumor of the intestine, breast. Usually such a neoplasm progresses slowly and is sensitive to progestogens. If the tumor is detected at an early stage, the course can be considered favorable.

There are the following signs that increase the risk of symptoms of uterine cancer:

• infertility;
• anovulatory bleeding;
• late onset of menopause;
• follicular cysts on the ovaries and tecomatosis;
• excess body weight;
• incorrect estrogen therapy;
• adrenal adenoma;
• cirrhosis of the liver.

Autonomous uterine cancer is often diagnosed in older women and develops against the background of pathologies such as ovarian or endometrial atrophy. Such a tumor is rarely detected in the early stages, as it progresses rapidly and has a poor prognosis.

Some scholars hold points of view, according to which the transformation of cells is embedded in DNA. This is the so-called genetic theory of the development of uterine cancer.

The development of uterine cancer occurs in accordance with the following stages.

1. Anovulation and estrogen rise.
2. The occurrence of background pathological processes, for example, polyposis and endometrial hyperplasia.
3. The appearance of precancerous conditions, in particular, hyperplasia with signs of atypia.
4. The development of preinvasive cancer, which is an early stage of uterine cancer.
5. The first signs of a slight penetration of malignant cells into the myometrium.
6. Expressed cancer of the uterine body.

Women who are at risk should systematically visit a gynecologist and undergo an examination.

Stages and types

Specialists classify the severity of the course of uterine body carcinoma by determining the stage. In general, the stages show the size of the neoplasm, the depth of penetration into the myometrium and the nature of the spread of the oncological process to the surrounding tissues, the presence of metastases.

Early stage uterine cancer is called preinvasive cancer. In another way, such a pathology is defined as cancer of the zero stage. As a rule, there are no signs and symptoms at this early stage of the cancer process. It is possible to identify the disease through the use of laboratory and instrumental methods diagnostics.

Gynecologists distinguish four stages of uterine cancer.

• Stage 1 is characterized by damage to the endometrium (A). As part of the early first stage, the myometrium may be affected up to half of the layer (B) or the entire muscular layer (C).
• Stage 2 is characterized by involvement in the pathological process of the cervix. If the tumor is present exclusively in the glandular layer - A, with the penetration of the neoplasm into the deep layers - B.
• Stage 3 includes the penetration of malignant cells into the serosa and appendages (A). Sometimes there is a lesion of the vagina (B). In the most severe cases, metastasis occurs to surrounding lymph nodes (C).
• Stage 4 means the appearance of metastases. If metastases develop only in the bladder and intestine - A. If metastases occur in the lungs, liver and bones - B.

It is known that in the early stages, for example, pre-invasive and first, the prognosis is more favorable. However, the first symptoms and signs often appear in the third and fourth stages.

The prognosis of the disease depends not only on the stage. Early appearance of the first signs and symptoms depends on the degree of cellular differentiation:

• high;
• average;
• low.

The neoplasm grows more slowly with a highly differentiated neoplasm of the uterine body. The likelihood of a cure with such cancer is much higher. Poorly differentiated tumors have the first signs and symptoms already at an early stage. It is quite difficult to cure such a pathology.

There are the following morphological varieties of uterine cancer:

• squamous;
• adenocarcinoma;
• clear cell;
• glandular squamous;
• musical;
• serous;
• undifferentiated.

The most common tumor is adenocarcinoma. Education can be localized in the fundus of the uterus, as well as in its lower segment.

Symptoms and signs

Often, women go to the doctor about the first signs of pathology. This may be acyclic bleeding or an increase in menstrual flow. After examination, in some cases, uterine cancer is detected.

Many of the first signs and symptoms of uterine body cancer, especially in the early stages, coincide with other gynecological pathologies:

• profuse leucorrhoea associated with damage to the lymphatic capillaries;
• increased bleeding during menstruation;
• bleeding;
• highlighting the color of meat slops due to the decay of tumor tissue;
• pain in the lower back and abdomen;
• frequent painful urination;
• constipation;
• bleeding during bowel movements, which may be accompanied by pain;
• swelling of the legs;
• an increase in the circumference of the abdomen.

Early first signs usually include abnormal discharge, which can be observed in the second or third stage. Early stages, such as pre-invasive and first, are usually asymptomatic. The appearance of the first signs is associated with the spread of cancer and tumor growth.

In advanced stages, the first signs are:

• pain of varying intensity;
• puffiness;
• deterioration in general well-being, which can be manifested by weakness, dizziness, subfebrile temperature.

Usually the first signs of a deterioration in the general well-being of a woman associated with poisoning of the body by the waste products of the tumor. One of early symptoms is also anemia.

Methods of diagnosis and treatment

Diagnosis of uterine cancer in the early stages is somewhat difficult. In order to identify the first signs of a malignant process, the following studies are carried out.

1. Aspiration biopsy in the early stages is not informative enough, however, with the progression of the neoplasm, its symptoms can be detected in 90% of cases. The procedure is performed on an outpatient basis.
2. Ultrasound of the pelvic organs is a simple and reliable way to identify various gynecological diseases. In the early stages, such a sign as endometrial hyperplasia in patients should alert. As a rule, in such cases, additional research is carried out.
3. Hysteroscopy is a method instrumental diagnostics, which allows you to diagnose and treat some formations. The hysteroscope is inserted into the uterus through the cervical canal. The method allows for curettage and biopsy for further histological analysis.

To detect metastases, it is necessary to perform MRI, CT and X-ray of the lungs. Evaluation of the functions of the bladder and intestines, which are often affected in uterine cancer, is carried out through cystoscopy and rectoscopy.

Treatment involves a combination of several methods:

• surgical intervention;
• radiotherapy;
• chemotherapy.

The main method of treatment, which is used at any stage of the disease, is the removal of the uterus and appendages. The amount of intervention depends on the degree of spread of the oncological process. Organ-preserving operations can be performed at an early stage - preinvasive cancer.

Irradiation is more often performed after surgery to remove the remaining malignant cells. As an independent method, it is practically not used.

Chemotherapy is used to treat the signs and symptoms of a tumor. As the main method of treatment, this tactic is not recommended. In hormone-dependent forms of the malignant process, doctors also prescribe hormone therapy.

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. Surgical method leads to 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 hormonal therapy are used. 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.

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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.

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Uterine cancer

What is uterine cancer

Uterine cancer It is very common, currently ranking fourth in women after breast, skin and gastrointestinal cancers. This form of malignant tumors is usually observed between the ages of 40 and 60 years.

What provokes / Causes of Uterine Cancer:

Risk factors for uterine cancer- diabetes, hypertension, smoking, human papillomavirus infection, HIV, early onset of sexual activity, late menopause and menstrual irregularities, infertility, a large number of sexual partners, early first birth, sexually transmitted diseases, oral contraceptives.

One of the risk factors is obesity: in women with a body weight exceeding the norm by 10-25 kg, the risk of developing endometrial cancer is 3 times greater than with normal body weight, and in women with an excess body weight of more than 25 kg, the risk of the disease 9 times higher.

Widely known precancerous conditions that play a significant role in the occurrence of cancer. These are erosions, ulcers, scars after a birth injury, proliferation of the epithelium (warts, polyps) and leukoplakia, as well as chronic inflammatory processes- endocervicitis and endometritis.

Pathogenesis (what happens?) during Uterine Cancer:

According to the nature of the epithelium of various parts of the uterus, squamous cell carcinoma of the cervix and glandular cancer (adenocarcinoma) of the cervical canal and uterine cavity are distinguished. Adenocarcinoma is the main morphological variant (up to 70%). It should be pointed out that a relatively rare tumor affecting the uterus is a sarcoma. There are three degrees of tumor differentiation (highly differentiated, moderately differentiated and undifferentiated).

With uterine cancer, 4 stages of its development are distinguished: stage 1 - the location of the tumor in the body of the uterus, stage II - damage to the body and cervix, stage III - spread to the parametric fiber or metastases in the vagina, stage IV - spread beyond the pelvis, germination of the bladder or rectum.

Symptoms of uterine cancer:

Clinical symptoms of uterine cancer consists of complaints of leucorrhea, bleeding and pain. However, all these three symptoms occur already during the decay of the tumor and the time of their appearance depends on the time of onset of ulceration. Therefore, in some cases, uterine cancer may not give any symptoms for a long period.

The early stages of uterine cancer are usually accompanied by a mucopurulent discharge that causes itching and irritation, which may appear after physical activity, shaking, defecation, and spotting, which can be scanty or heavy, constant or intermittent. Signs of the disease can be a violation of the menstrual cycle, an increase or decrease in the duration of menstruation, frequent urination and pain when urinating (this means that the tumor has begun to grow into the bladder).

Leucorrhea is of a different nature: watery, mucous, stained with blood, odorless and fetid. The admixture of blood gives the whites the appearance of meat slops. The retention of discharge in the vagina and the joining infection leads to the appearance of purulent leucorrhea with a smell. In stage III and IV cancer, discharge from the genital tract is putrefactive. Bleeding can be in the nature of small spotting, as well as single or multiple heavy blood loss. For cervical cancer, so-called contact bleeding is very typical (during sexual intercourse, douching, vaginal examination, or after heavy lifting). If a woman has already stopped menstruating, then the appearance of bloody discharge from the vagina in most cases is a sign of a malignant tumor.

Pain is a late symptom, indicating the involvement of the lymph nodes and pelvic tissue in the cancerous process with the formation of infiltrates that compress the nerve trunks and plexuses. General symptoms and, in particular, cachexia (weight loss) occurs extremely late, in very advanced stages, and usually women suffering from uterine cancer retain a blooming, healthy appearance.

Diagnosis of uterine cancer:

Recognition of uterine cancer begin with the study of the patient's complaints and the course of the disease. In all suspicious cases according to the anamnesis, patients are subject to immediate examination by a gynecologist. It is absolutely unacceptable to prescribe any treatment for such patients without a detailed examination.

The examination includes a vaginal two-handed examination, a rectal two-handed examination, and examination with speculums.

At vaginal examination in cases of a sufficiently pronounced tumor process, it is possible to determine certain changes in the neck, depending on the type of tumor growth (exophytic, endophytic and mixed). As a rule, the study is accompanied by bleeding as a result of trauma to the tumor with the examining finger. With advanced uterine cancer, an additional study is performed through the rectum to clarify the transition of the tumor to the pelvic walls and sacro-uterine ligaments.

To detect the initial stages of cervical cancer, one should not be limited only to a vaginal examination; mandatory inspection with mirrors. To detect early forms of cancer in all cases of certain changes in the cervix, they take swabs for cytology or biopsy. If cancer of the cervical canal or uterine cavity is suspected, diagnostic separate curettage of the cervical canal and uterine cavity is performed and subsequent histological examination.

All these studies can be carried out already in the clinic if you have the necessary tools and follow the rules of asepsis. To illustrate the importance of a comprehensive examination, it is sufficient to point out that cervical cancer remains unrecognized in more than half of the patients whose examination consisted only of a two-handed vaginal examination. At the same time, when viewed with the help of mirrors, the number of errors in the diagnosis decreases by almost 5 times, and when using a biopsy, they are observed only in isolated cases.

Recently, widespread and great importance acquired ultrasound diagnostics(ultrasound), which allows to detect changes in the uterus that are inaccessible to other research methods and has become a mandatory research method in case of suspicion of any benign and malignant formations in the uterus.

To establish the defeat of the lymph nodes and metastases, which very often accompanies cervical cancer, they resort to radiological methods- lymphography and ileocavagraphy. For the same purpose, radiography of organs chest , intravenous pyelography, irrigography, cystoscopy and sigmoidoscopy. It is possible to perform CT, MRI, lymphangiography, biopsy of the tumor with a thin needle.

These studies are very important for uterine cancer to develop a plan for radiation or combined treatment.

Treatment for uterine cancer:

Uterine cancer treatment tactics depends on the patient's age, general condition and clinical stage of cancer. Treatment is mainly surgical (extirpation of the uterus with appendages and sometimes removal of the pelvic lymph nodes). Combined treatment is possible - surgery, and then remote irradiation on the vaginal stump area, intracavitary gamma therapy. Preoperative radiation therapy is also carried out, mainly in stage III. Radiation therapy as an independent method is used for local spread of the tumor process, with contraindications to surgery. Anticancer drugs effective in highly differentiated tumors, in III and IV stages of the disease.

In cervical cancer, treatment is carried out with equal success as a method of combined radiotherapy, and surgical (extended extirpation of the uterus with appendages). Treatment depends on the stage of the disease. At stage Ia (microinvasive cancer), the uterus is extirpated with appendages. At stage Ib (cancer is limited to the cervix), remote or intracavitary irradiation is indicated, followed by extended extirpation of the uterus with appendages, or, conversely, an operation is performed first, and then remote gamma therapy. In stage II (involvement of the upper part of the vagina, it is possible to pass to the body of the uterus and infiltration of the parametrium without passing to the pelvic walls), the main method of treatment is radiation, surgical intervention is rarely used. At stage III (transition to the lower part of the vagina, parametrial infiltration with the transition to the pelvic bones) is shown radiation treatment. Finally, in stage IV (transition to the bladder, rectum or distant metastasis), only palliative radiation is used. In the later stages, symptomatic treatment is carried out, it is possible to use chemotherapeutic treatment.

After treatment, periodic visits to the doctor are required to examine the pelvic organs and take a smear. Investigations also include chest x-ray, ultrasound, and intravenous pyelography. During the first year of visiting a doctor every 3 months, then for 5 years - every 6 months. After 5 years, control is carried out annually.

In case of relapses, if the process is localized, a partial or total pelvic exenteration is performed (removal of the uterus, cervix, vagina, parametrium, bladder and rectum as a single block). In the presence of distant metastases, patients usually receive chemotherapy. Radiation therapy can be used to palliatively treat painful metastases.

Metastasis.
Most often, uterine cancer metastasizes to the pelvic lymph nodes, less often to the inguinal. Distant metastases are more often in the kidneys, liver, lungs, have a poor prognosis.

Prognosis for uterine cancer.
In uterine cancer, the 5-year survival after surgical treatment is from 84 to 45%, depending on the stage of the disease. With relapses, 25% of patients who initially underwent surgical treatment, can be spared from the recurrence of the disease with the help of radiation therapy of the pelvic organs. With metastatic recurrences, cases of cure are extremely rare, and healing effect individual and short-lived. In stage IV of the disease, the 5-year survival rate is up to 9%.

Prevention of uterine cancer:

Early diagnosis and prevention of uterine cancer only possible through systematic preventive examinations all women over 30 years old (at least 2 times a year). It is advisable to start regular examinations with the onset of sexual activity. Regular examinations, ultrasound tomography and cytological examination (once every 2 years) contribute to the detection of precancerous diseases, and their treatment - cancer prevention.

Not less than importance has timely and proper treatment precancerous lesions of the cervix. There are no especially characteristic signs inherent only in precancerous diseases of the cervix, they proceed as usual. inflammatory diseases. Common signs of precancerous diseases are long-term chronic course, constancy of symptoms, and most importantly, the lack of effect from conservative (anti-inflammatory) treatment. Treatment of precancerous diseases of the cervix should be radical and consists of electroexcision, electrocoagulation of the affected areas, or even amputation of the cervix. They also resort to the radiation method of treatment in the form of application radium therapy. Among patients radically treated for various precancerous lesions, mortality from cervical cancer decreased by 6 times.

Which doctors should you contact if you have Uterine Cancer:

Are you worried about something? Do you want to know more detailed information about Uterine Cancer, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can book an appointment with a doctor– clinic Eurolaboratory always at your service! The best doctors examine you, study external signs and help identify the disease by symptoms, advise you and provide needed help and make a diagnosis. you also can call a doctor at home. Clinic Eurolaboratory open for you around the clock.

How to contact the clinic:
Phone of our clinic in Kyiv: (+38 044) 206-20-00 (multichannel). The secretary of the clinic will select a convenient day and hour for you to visit the doctor. Our coordinates and directions are indicated. Look in more detail about all the services of the clinic on her.

(+38 044) 206-20-00

If you have previously performed any research, be sure to take their results to a consultation with a doctor. If the studies have not been completed, we will do everything necessary in our clinic or with our colleagues in other clinics.

You? You need to be very careful about your overall health. People don't pay enough attention disease symptoms and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called disease symptoms. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to several times a year be examined by a doctor not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the body as a whole.

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