All of the cervical cancer was removed. Life after cervical cancer. Consequences of surgical treatment

The main way to deal with various malignant neoplasms is surgical excision of the focus. This also applies to cervical cancer. In most cases, this tactic allows you to save a woman's life, albeit at such a cost as the loss of reproductive functions. Surgery for cervical cancer, as a rule, involves the removal of not only the organ itself, but also the nearby lymph nodes, which makes it possible to stop the further spread of the tumor as much as possible.

What are the indications for surgery

The decision on the need for surgical intervention in the cervical region by a specialist is made individually. As a rule, this is preceded by a comprehensive examination of the woman and differential diagnosis. The information obtained makes it possible to distinguish between benign and malignant neoplasms.

The main indications for removal of the cervix:

• an early stage of the oncological process - surgery for cervical cancer can greatly increase the chances of recovery, improve the prognosis of survival;
• if the cancer focus is localized only in the area of ​​the neck of the organ, on the surface and the woman subsequently plans to become a mother, it is quite possible to carry out the most organ-preserving operation - trachelectomy;
• certain forms of cervical hypertrophy - a similar condition is provoked by various pathological processes, for example, prolapse of the uterus, malfunction of the cervical canal, chronic inflammatory processes of the mucous membrane, myoma with localization in the cervical region;
• severe course of endocervicitis, with recurrence of cervical polyps;
• the consequences of cervical ruptures in severe childbirth or late abortions - against the background of eversion of the cervix into the vaginal cavity, ulcerations are formed that can become malignant;
• congenital or acquired deformities of the cervix;
• not amenable to conservative therapy of leuko- and erythroplakia.

As can be seen from the above, there are many indications for surgery in addition to cervical cancer. However, most of these grounds mean the prevention of the formation of an atypical focus in the organ.

Types of cancer interventions performed in citu

In a situation where a woman has received a dubious result of a cytological smear or when diagnosing an early stage of tumor formation in the cervical region, a specialist in order to prevent further progression of the pathology makes a decision on conization.

The procedure is the removal of a malignant lesion. In this case, the remote area of ​​the cervix and cervical canal resembles a cone, which is the name of the procedure. The resulting biomaterial is necessarily carefully examined in the laboratory - to identify the presence of atypical cells, or, upon confirmation of cancer, to assess the depth of its penetration. Therefore, conization is both a diagnostic procedure and a therapeutic one.

In many ways, it resembles the above-described conization of the cervix, but loop electroconization has its own characteristics. Instead of a scalpel, the specialist uses a wide metal loop through which during manipulations is passed electricity... Coagulation of tissues in contact with a loop heated to the maximum temperature has a cutting effect. This allows you to safely and almost painlessly remove the area of ​​malignancy.

Minimally invasive treatment methods

In the formation of tumor lesions within the boundaries of the cell membrane of the epithelium, as well as in precancerous changes in the mucous membrane of the cervix, the latest minimally invasive treatment methods are currently successfully used. They consist in the local application of various physical factors capable of destroying atypical cells.

For example, one of such successful techniques based on liquid nitrogen, which freezes and completely destroys a limited area of ​​the epithelium in the area of ​​cervical malignancy, is cryodestruction. After the complete removal of the superficial form of the cancer focus, the need for surgical intervention no longer arises. The duration of the rehabilitation period is minimal.

In addition to this technique, you can resort to laser surgery. Its essence boils down to the directed effect of a medical laser, which causes coagulation of tissues affected by atypia.

In most cases, such minimally invasive methods of getting rid of cervical cancer do not affect a woman's reproductive capacity - she may well become a mother after some time. In addition, cryodestruction and laser surgery do not increase the risk of cervical insufficiency at the time of carrying a baby.

Tactics for the treatment of progressive forms of neoplasms of the cervix

Aggravating the situation - the movement of cancer cells to neighboring tissues and organs, most often the pelvic lymph nodes, requires more radical measures from oncologists. The treatment tactics are necessarily complex, in which, in addition to excision of the primary and secondary focus, radiation and chemotherapy are also used.

Surgical interventions used for metastasis of atypical elements from the cervical region will be of the following types:

1. Removal of the uterus by vaginal access, without making incisions in the area abdominal cavity- vaginal gastrectomy.
2. Removal of not only the uterus itself and its cervix, but also the appendages and nearby lymph nodes - radical hysterectomy.
3. Modified hysterectomy differs in less extensiveness of intervention from the above-described radical technique. Appendages or lymph nodes may remain intact - at the discretion of a specialist, in each case making a decision individually.
4. Bilateral elimination of uterine appendages - bilateral salpingo-oophorectomy, is performed both by an open technique and using a laparoscopic technique.

Achievements modern medicine allow saving the lives of women using the above methods of surgical intervention in situations that were previously considered inoperable. However, even a radical hysterectomy, when in addition to the uterus, the appendages and lymph nodes are also given, necessarily requires exposure to chemotherapy, as well as biological and targeted medications. This tactic greatly improves the prognosis of survival.

Consequences of surgical treatment

In each case of diagnosing cervical cancer, specialists choose the most the best option surgical intervention - the most organ-preserving. However, with metastasis, secondary foci may require removal of not only the cervix, but the entire organ, as well as lymph nodes, part of the bladder, intestines, and vagina.

In the second stage of a malignant neoplasm, only the uterine part of the tumor is subject to removal, the ovaries are trying to save so that a hormonal disruption in the woman does not occur.

A successful option is recognized if the cancer focus is detected in citu, when the atypia has not yet managed to go beyond the epithelial layer. In this case, it is possible to perform only conization - removal of a part of the neck, while the reproductive function is preserved. Sexual relations after excision of cervical cancer are possible if the vagina was preserved, or it was restored with the help of intimate plastic surgery.

In the early postoperative period, of the possible complications, the following should be indicated:

• inflammatory lesions in the area of ​​intervention;
• vaginal bleeding of varying intensity and duration;
• infection of the urethra, bladder;
• thromboembolism, which poses a threat not only to ischemia in any organ, but also to death.

In the late postoperative period, a woman may be disturbed by discomfort and soreness in the region of the perineum of the vagina and ovaries. In addition, itching and numbness in the seam area, periodic spotting.
In any case, it is not worth losing optimism - at the moment, cancer of the cervix is ​​not a sentence at all.

Women who have undergone surgery for neoplasms of the gynecological sphere are quite active. sex life, think about pregnancy and become mothers.

What are the prognosis after surgery

Surgical excision of the primary tumor, formed in the cervical region, at stages 1–2 of its appearance, has a favorable prognosis. The recovery of patients reaches 85–90%. In this case, the ovaries and the vagina are rarely removed, so the hormonal background practically does not suffer - the woman feels full.

Sometimes it is completely dispensed with only by removing the cervix. The situation is viewed as a great success, since in the future it is even possible to carry a pregnancy.

With the most negative prognosis, when metastasis is diagnosed not only to neighboring tissues and organs, but also to distant parts of the body, and then you should not give up - after surgical removal of everything that is possible, specialists then carry out long-term rehabilitation, cosmetic and plastic restorations. Of course, it is impossible to regain former health, but life will continue, albeit with limitations.

With late treatment of the patient, when metastases from the primary focus have managed to affect many organs, the prognosis is most unfavorable.

All activities are palliative - to maximize the quality of life of a cancer patient, to relieve pain. In many ways, everything depends on the woman herself - her mood for recovery, goals in life, financial security and, of course, the support of relatives and friends.

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

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

Recurrence of cervical cancer after radiation therapy

Cervical cancer may relapse after radiation surgery. This usually occurs in the second or third stage of the disease with complications. Such cases are not uncommon and they entail serious health complications.

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

It is imperative to pay attention to the main symptoms that may indicate the development of repeated tumor growth in the cervical region:

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

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

After a relapse is confirmed, the following treatments may be prescribed:

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

After radiation therapy, various unpleasant manifestations can occur during cervical cancer treatment. Mild side effects are general and local.

Common symptoms include the following:

• manifestation of nausea;
• vomiting;
• dizziness;
• headache;
• signs of fatigue;
• symptoms of digestive disorders;
• frailty.

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

• The manifestation of the inflammatory process of the suprapubic skin area;
• A burning sensation while urinating;
• Frequent urge to urinate
• Narrowing of the vagina;
• Serous and bloody discharge may appear from the vagina.

Note! If the above unpleasant sensations appear, you should immediately inform your doctor about them. The specialist will conduct an examination and, if necessary, prescribe an effective therapeutic therapy. But usually all side effects go away on their own in 1-6 weeks.

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

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

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

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

Oppression of the hematopoietic system in bone marrow after radiation therapy requires special treatment. It is important that it is correct and comprehensive. In this case, it is imperative to fulfill the following important conditions:

• taking vitamins and minerals;
• compliance with regular rest;
• full night sleep;
• enhanced balanced nutrition;
• additional transfusion of blood or leukocytes, erythrocytes may be required;
• application is assigned medicines that provoke increased production of leukocytes;
• taking drugs that cause the release of red blood cells.

During oncological pathologies Special attention should be given to nutrition. It is this that helps to strengthen the immune system and speeds up the recovery process after radiation therapy for cervical cancer.

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

When eating after radiation therapy, the following important guidelines should be followed:

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

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

• semi-finished products;
• fried and fatty foods;
• salty food;
• highly spicy and smoked dishes;
• cocoa;
• chocolate;
• tea with high strength;
• sweets, pastries with a high cream content;
• alcohol.

Important! You should not give up sugar and salt completely. Be sure to control the content of these ingredients in cooked food. It is worth adding them in limited quantities.

Intimate life after cervical cancer

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

A full intimate life is possible under the following conditions:

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

Folk remedies help a quick recovery from radiation therapy. For cervical cancer, recipes can be used:

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

Prophylaxis

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

• Compliance with a healthy lifestyle;
• Regular hygiene procedures;
• Vaccination against cervical cancer;
• It is imperative to do cervical screening, which allows you to detect cervical cancer;
• In order to quickly bring the organs of the reproductive system back to normal, it is worth using special suppositories, which must be prescribed by a doctor.

It is imperative to closely monitor the health of the organs of the reproductive system. It is better to go to a gynecologist's appointment twice a year, this will allow you to timely determine the presence of dangerous diseases. At the very beginning, the disease can be eliminated drugs, proper nutrition and prevention without negatively affecting health. It is worth remembering that radiation therapy can provoke many complications that will last a lifetime.

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Video: radiation therapy for gynecological cancer

They can be both local and general. They can appear both at an early stage, even during treatment, and months or even a year after its completion.

The early stage of the reaction to therapy is manifested by the following symptoms - nausea, impaired appetite, vomiting, a decrease in the number of thrombotic, leuko- and lymphocytes in the blood. You can cope with these complications with the help of a gentle diet, high-calorie foods, blood transfusions, and taking vitamins. But if these measures do not work, you have to stop the course of radiation therapy.

Some of the patients may experience problems in life after cervical radiation therapy due to the suppression of the hematopoietic organs. To prevent this problem, you need to take a blood test every 3 months in the first few years, and then do the same procedure at least 2 times / year. If leukopenia or anemia occurs, the analysis may be done more often if indicated.

Inhibition of hematopoietic activity in the bone marrow after therapy will require special treatment, which must be systematically correct and comprehensive. Life after cervical cancer then takes place in such general strengthening measures as improving working and resting conditions, enhanced nutrition, and taking vitamins. The following procedures are also performed:

• additional transfusion of blood or red blood cells or leukocytes;
• taking medications that stimulate the appearance of leukocytes;
• taking funds that improve the reproduction of erythrocytes.

Nutrition

With oncology, it is recommended to eat more vegetables, berries, fruit products, as well as cereals. They contain antioxidants that help cleanse the body of free radicals. Products must also be fresh and of good quality.

Medical research shows that for prophylactic purposes or with an already active illness, it is necessary to eat up to 5 servings of herbal products every day. Food should be eaten fresh, without going through heat treatment (the maximum that can be allowed is steam cooking).

Sport

Through constant physical exercise, you can not only improve your physical shape, but also speed up the process of treatment and recovery from cancer. Studies show that regular exercise can improve mood, sleep well, strengthen immunity, and relieve depression.

For those who have just completed an intensive course of treatment, it is not recommended to immediately start serious stress. It is best to start rehabilitation with brisk walking and walking in the street. In bad weather, you can exercise on an exercise bike or treadmill. You can increase the load only after consulting your doctor. Optimal mode- classes by brisk walking for 30-40 minutes. 4-5 times / week.

Life after cervical cancer must be active physical exercise should please, not strain, so you should not play sports if you feel unwell or fatigued. Adjust the load according to your capabilities.

Majority scientific research demonstrates that due to constant sports activities, the risk of getting a relapse of the disease becomes much lower, and most body systems become stronger and more resilient.

Intimate life after cervical cancer

For the most part, after a successful course of treatment, patients undergo rehabilitation rather quickly and continue to live a full-fledged intimate life after cervical cancer. Although there are also many patients who, because of this, experience serious problems and do not know how to cope with them.

Having an intimate life after cervical cancer is quite possible. There are various options for doctors to allow patients to continue having sex:

• If the uterus persists. In this case, after restorative therapy, sometimes even the opportunity to become pregnant and give birth to a child returns;
• If the patient's uterus is removed. Under these conditions, libido will depend on whether the ovaries are removed - if not removed, the ability to have sex can be restored;
• If all organs are removed. It is possible to restore hormonal levels and women's sexual health with the help of hormonal procedures and intimate plastic surgery.

In any case, women who are forced to undergo surgery due to cervical cancer should not lose faith in themselves and optimism. The return to a full-fledged rhythm of life will depend only on you, you just need to find the desire and strength in yourself in order to recover.

Rehabilitation period

What life will be like after cervical cancer and a woman's well-being depends on several factors. This is the method of treatment, the stage at which the disease was diagnosed, and the patient's age. After completing medical therapy, it is important to go through the correct rehabilitation period, consisting of several recovery procedures that can increase performance and improve health. There are such methods:

• Eating light and natural products, changing the diet;
• Hiking every day;
• Daily sports activities;
• Maintaining optimal weight and maintaining well-being;
• Regular medical examinations;
• If necessary, go to a psychologist.

Since you will need to lead healthy image life, you will have to forget about bad habits - smoking and alcohol will be unacceptable for you. Even being near smokers can cause relapse, which can worsen the patient's condition.

It is also very important to be constantly examined by an oncologist for several years so that any problems or relapse will be identified on time. Timely detection of the disease will allow for surgical treatment, preventing the occurrence of complications.

Sick leave

During the treatment of cervical cancer, a biopsy may be necessary. In this case, a small piece is taken for examination under a high power microscope. Based on the results of the biopsy, the correct diagnosis is established and selected optimal method treatment. The diagnosis made after the biopsy becomes final, the accuracy is no longer in dispute.

When a biopsy is performed on an outpatient basis, a woman receives a sick leave for 2 days, and if this procedure is performed in a hospital, the sheet can be extended up to 10 days.

If an abdominal operation is performed, the patient needs to stay in the hospital for about 2 weeks. The staples are removed from the suture 7 days after the operation, and the speed of wound healing depends only on the woman's body.

With the global removal of all lymph nodes and ligaments in the small pelvis, serious changes occur, due to which the recovery period becomes longer.

Postoperative therapy helps to restore fluid and electrolyte balance and prevent inflammation.

In general, the term of a sick leave after surgery to remove the uterus can be 25-45 days.

This is an oncological disease in which a malignant degeneration of the mucous membrane of the cervix is ​​diagnosed. In terms of the frequency of clinically diagnosed cases, cervical cancer is superior only to breast and endometrial cancer.

The main risk areas for cervical cancer are women between the ages of 40 and 55. But for Lately the disease is dramatically younger. Increasingly, cervical cancer (cervical cancer) is diagnosed in patients under 30 years of age. There is one more problem - late diagnosis. Although the disease is easy to detect, in more than half of cases, cervical cancer is found at an advanced stage. If you suspect a disease, you should urgently consult a gynecologist.

Types of cervical cancer

The main classification of cervical cancer arises from the type of tissue affected by the tumor. The topmost and most protective layer is squamous epithelium. In this case, we can talk about the following forms:

• Dysplasia (it may have 3 degrees) is a precancerous condition;
• Cancer in situ. This is the name of the degree of the tumor with minimal invasion into other layers;
• Squamous cell carcinoma of the uterus.

Directly in squamous cell carcinoma of the cervix, the following types can appear:

• Papillary;
• Warty;
• Keratinizing;
• Non-keratinizing;
• Lymphoepithelioma-like;
• Basaloid;
• Squamous transitional.

Tumors that invade the secreting epithelium are called adenocarcinomas. They can be:

• Endometrioid;
• Serous;
• Clear-celled;
• Mesonephral;
• Mucinous.

Often, the process is accompanied by the formation of concomitant tumors of other etiologies:

• Neuroendocrine and large cell carcinomas;
• Carcinoids;
• Sarcomas;
• Small cell cancer of the cervix.

Classification of forms of cancer

Distinguish cancer by location (vaginal part of the cervix and the inner part). In addition, there are several forms of growth:

• Pre-invasive. In this case, stage zero is assigned. The malignant process develops strictly within the epithelium;
• Microinvasive. The depth of the lesion does not exceed 0.5 cm, without metastases;
• Non-invasive (stage 1). Cervical cancer cells are not widespread, progresses very slowly;
• Exophytic. The most common type in which the tumor grows in the lumen of the vagina. Outwardly resembles cauliflower forks. This is stage 3 (with damage to the tissues of the vagina). At stage 4, metastases to various organs can be observed;
• Endophytic. The tumor grows secretly in the cervical canal. It becomes noticeable only in the late stages of tumor decay, leading to looseness and unevenness of the cervix. Outwardly defined as a bleeding ulcer that grows deep into the tissues of the uterus;
• Mixed. This is a rather rare option, since it involves the presence of several tumors of various types at once.

Causes

The main threat of cervical cancer in women is viruses that lead to mutations and degeneration of healthy tissue cells into malignant tumors. Risk factor # 1 is human papilloma virus (HPV). But this virus has more than 100 varieties with varying degrees of risk of developing oncology. It is because of this feature that over 90% of cases of cervical cancer develop. After entering the body, the HPV virus can proceed in 3 forms:

• Asymptomatic form;
• Subclinical form;
• Clinical form. In the genital area, there are multiple or single growths (condylomas and papillomas).

The most dangerous and with high level oncogenic risk are HPV strains bearing markers 16, 18, 45 and 46. The average level of risk of developing cervical cancer is type 31, 33, 51, 52 and 58 strains.

Other causes of cervical cancer include:

• Predisposition. If women among relatives had cases of cervical cancer, then you should be extremely careful about your health and be regularly examined;
• Viruses - genital herpes, HIV, chlamydia, cytomegalovirus;
• Untreated or untreated genital infections;
• Diseases of the cervix, accompanied by changes in tissues (erosion, dysplasia, leukoplakia);
• The presence of benign tumors (fibroids, fibroids), which, under long-term adverse conditions, can degenerate into malignant, other neoplasms;
• Strong weakening of the immune system;
• Uncontrolled human exposure to radiation, chemical toxins;
• Frequent abortion or curettage, as well as complications associated with these and other surgical procedures;
• Frequent pregnancy and childbirth;
• Microtrauma of the cervix or the uterus itself, as well as the cervical canal;
• Early onset of sexual activity;
• Change of partners more often 2 - 3 times a year;
• Long term stress;
• Uncontrolled use of oral combined contraceptives;
• Long-term smoking or alcohol addiction;
• Availability chronic inflammation in the pelvic area without proper treatment. Other chronic diseases associated with inflammation.

Symptoms

The main and most alarming symptoms are:

• Unforeseen and frequent bleeding (after a visit to the gynecologist, after intercourse, between normal periods, during menopause);
• Menstrual bleeding lasts more than a week in duration;
• Discharge with blood, they can have an unpleasant odor and signal the onset of tumor decay;
• Purulent discharge with a pungent and unpleasant odor;
• Prolonged cuts (lower abdomen and uterine region);
• Pain that is spasmodic. In this case, part of the pain can be given to the lower back;
• Excessive vaginal dryness and pain during intercourse;
• Sudden weight loss (10 to 15 kg in a few weeks). This symptom is unconditional and requires a quick visit to a doctor;
• Persistent constipation and pain during bowel movements. Other diseases associated with the intestines;
• A sharp increase in frequency, or vice versa, severe delay in urination. This is due to the growth of a tumor that compresses the bladder. There may be blood in the urine;
• Constant severe weakness;
• Excessively fast fatigability;
• Too much sweating for no apparent reason;
• A slight increase in temperature without signs of a cold (from 37 ° C to 37.8 ° C);
• Constant swelling of the limbs. This is especially true for the legs and feet;

The symptoms listed above are not a prerequisite, but their presence may indicate others. serious illnesses, including gynecological or venereal. Therefore, do not postpone a visit to a gynecologist.

Diagnostics

Diagnosis of cervical cancer consists of several stages:

• Examination by a gynecologist to identify oncology. It is necessary to pass it 2 times a year;
• Scraping from the surface of the cervix for cytological examination (Pap smear);
• Colposcopy. Examination using a special device that helps to enlarge and bring closer the image of the cervical tissue;
• Biopsy - with the help of this microinvasive method, a biomaterial is taken for histological examination;
• The procedure for curettage of the cervical canal. It is necessary and carried out only when cytology shows oncology or dysplasia, and colposcopy does not reveal anything;
• Schiller test samples (with vinegar or iodine);
• Examination of the pelvic organs using ultrasound. Allows you to fairly accurately identify the presence or absence of tumor formations. If ultrasound is not enough to determine the exact location and quality of the tumor, then pelvic MRI may be prescribed.

If there are several symptoms at once and serious suspicions of cervical cancer, the gynecologist may also prescribe related examinations related to other organs for the detection of metastases:

• Ultrasound of the liver and kidneys;
• Ultrasound examination of the bladder;
• Radiography of the lungs. This is how distant metastases to the chest are revealed;
• Colon X-ray (irrigoscopy);
• Appointment of cystoscopy and rectoscopy. Examination data of the bladder and rectum make it possible to find out the presence of metastases or tumors that have penetrated their walls;
• Intravenous urography. Cervical cancer is often accompanied by squeezing of the ureters and leads to serious impairment of the kidneys. Up to the development of atrophy of the renal tissues or ureters. This method allows you to identify such violations.

Which doctors to contact

The main doctor conducting examinations and prescribing treatment is a gynecologist. If cancer is found in the process, then an oncologist will additionally need to be observed. Doctors of another profile (therapist, endocrinologist) are visited as needed or in cases of detection or development of other diseases.

Treatment

Treatment methods largely depend on the degree of development of the disease. It should be remembered here that although there are only 5 stages of cancer (including zero), each of them has 2-3 degrees of difficulty (categories A or B). The designation depends on the size and location of the tumor:

• Stage 1A1. (invasive stage). The tumor is detected only by microscopic examination. Only the area of ​​the cervix is ​​affected (without metastases). The dimensions do not exceed 7 mm in volume and 3 mm of the lesion in the depth of the epithelium. Treatment is conization (excision of diseased tissue) in young patients or traditional hysterectomy (removal) of the uterus in postmenopausal women. With concomitant damage to the lymph nodes or blood vessels a lymphadenectomy is prescribed (lymph nodes are removed) of the pelvic region. After the operation, radiation therapy is prescribed (with or without chemotherapy);
• Stage 1A2 (invasive stage with complications). The tumor also cannot be detected visually, but upon detection it turns out that its dimensions exceed 7 mm in width of the lesion and 3 mm in depth. The treatment for patients of childbearing age is the excision of the neck or its conization, and for the elderly, a hysterectomy is prescribed. Pelvic lymphadenectomy is mandatory. If metastases are detected, chemotherapy and radiation therapy are performed;
• Stage 1B The tumor is visible visually, and its size does not exceed 4 cm. There can be 2 methods of treatment: surgical intervention with external radiation. In the first case, a radical hysterectomy is performed (removal of the uterus completely with appendages and tubes) and bilateral oophorectomy. Pelvic lymphadenectomy is prescribed and performed. In especially favorable cases, surgical treatment is carried out with the preservation of all organs. In the second case, the problem is solved by a radiosurgical method. First, brachytherapy is performed, and after 1.5 - 2 months - the operation itself;
• Stages 1B2 - 5A. the tumor is detected visually, and its dimensions are equal to or slightly exceed 4 cm.In such a situation, tumor lesions of the vagina, rectum with bladder... The most optimal treatments are radiation therapy and chemotherapy. ;
• Stage 5B. The area of ​​the lesion and the overall size of the tumor can be any. Distant metastases are also present at this stage. At this stage, palliative treatment is carried out.

Follow-up after treatment

All patients who were diagnosed with cervical cancer and received appropriate treatment should regularly visit a gynecologist and undergo the necessary instrumental and laboratory diagnostics.

Within 2 years after treatment, a cytogram analysis must be performed every 3 months. For another 3 years after that, a smear is taken every six months. For the rest of his life, the cytogram is handed over annually. This is necessary in order to avoid relapses of the disease.

To control the appearance or development of metastases, as well as for their early detection, MRI, CT and PET of the abdominal and pelvic organs are used.

Prophylaxis

The most effective prevention is recognized as vaccination against the papilloma virus (HPV), as the main primary source of cancer development. It can be done from 9 to 11 years old, since the drugs are most effective if the vaccine is given before the onset of sexual activity. This means before contracting a sexually transmitted virus. It also makes sense to vaccinate against this virus for all women under 45 years old.

The most studied and effective remedy immunization is the Gardasil vaccine. The drug effectively protects against the virus for 4 years after vaccination. Then the procedure must be repeated.