How does cervical cancer manifest in women?

Uterine oncologies occur quite often in gynecological practice. One of the most common lesions is cervical cancer, cervical carcinoma or cervical cancer.

Uterine carcinoma - what is it?

Most often, cervical carcinoma occurs among patients aged 35-50 years, as well as in women prone to frequent changes of sexual partners.

CC is a malignant tumor process that develops on cervical tissues from the cellular structures covering the uterine cervix. Such an oncological process is characterized by slow development, which can take a decade.

Photo shows what cervical cancer looks like during colposcopy

Even before the development of cancer cells, the structures of the uterine cervix undergo dramatic changes, and epithelial dysplasia develops. If treatment is not carried out, the changes progress further, gradually turning first into non-invasive and then into invasive cancer.

All changes can be traced during histological studies.

Statistics in Russia

Non-invasive forms of cervical cancer are found four times more often among patients than invasive varieties. Cervical cancer has begun to be detected much more often, and there is a tendency for cases of this to become more frequent.

Thanks to screening tests, in recent years the number of patients in whom cervical cancer was detected in the early stages of development has increased. This factor has led to a significant reduction in female mortality from this type of disease.

On average, cervical cancer is found in 11 out of 100 thousand women. Unfortunately, cervical cancer has become increasingly detected in young women, which experts associate with the early onset of regular sexual relationships.

In general, mortality from the pathology has decreased threefold, however, with too late detection, the survival rate remains at a rather low level.

The disease most often affects Russian women of average age 35-50 years, however, about 5-6% of cases of this oncology occur in relatively young patients (about 20-30 years old), and 20% are women 65 years old and older.

Risk factors and causes

The fundamental key factor provoking the occurrence of cervical carcinoma is human.

Almost all patients with cervical cancer have traces of this virus in their bodies. 8 and 16 are considered the most; it is these varieties that most often provoke malignant tumor processes in the cervical tissues.

This virus is transmitted through sexual contact, and often even barrier contraception is unable to prevent this.

In addition to HPV, the causes of cancer in the cervix can be:

Frequent change of sexual partners or their large number;
Early start of “adult” life with regular sexual relations;
Erosive lesions of cervical tissues;
Weak immune status;
The presence of infectious pathologies transmitted through sexual intercourse;
Availability ;
Constant contact with carcinogenic substances;
Long-term use of oral contraceptives;
Heredity. Women who have relatives with similar cancer pathology significantly increase the risk of developing cervical carcinoma.

How does cervical cancer manifest in women?

In the initial stages, cervical cancer proceeds covertly and does not manifest itself in any way. This fact is considered very unfavorable, because a malignant tumor of the cervical tissue detected in the early stages has every chance of a final cure.

Signs of the disease at an early stage

Some patients may experience symptoms such as:

Spotting discharge, minor bleeding between periods;
Slight hyperthermia (37-37.7°C);
Unusual and uncharacteristic discharge after sexual intercourse, representing a bloody substance from dirty brown to pinkish;
Menstrual disorders;
Pain in the lower abdomen.

Painful symptoms can occur from time to time, especially often such a symptom appears after sexual intercourse.

Symptoms of carcinoma in later stages

At stages of later development, the above symptoms are supplemented by more striking manifestations such as:

Bloody impurities in the urine;
Chronic urge to urinate;
Painless rectal bleeding;
Hypersweating;
Intestinal disorders;
Swelling of the legs;
Heavy uterine bleeding not associated with menstruation;
At the terminal stage of cervical cancer, hydronephrosis may occur (kidney damage caused by impaired urinary outflow and manifested by atrophy of the kidney parenchyma).

Classification

In accordance with the type of epithelium from which the tumor process is formed, gynecological oncologists distinguish:

(84-96%);
(4-16%).

Depending on the intensity and direction of growth, as well as on the nature of the development of the tumor process, cervical cancer is distinguished:

Pre-invasive– this is grade 0 oncology, which is intraepithelial in nature;
Non-invasive– this form of oncology is considered the first stage of development, when cancer is characterized by the slow growth of oncological structures that do not spread beyond the boundaries of the mucous cervical tissues;
Microinvasive– such cancer is superficial in nature and does not grow into the underlying tissue deeper than 5 mm. The likelihood of metastasis with such a tumor is minimal;
Exophytic– the tumor grows in the shape of a cauliflower, is considered the most common form and is better diagnosed than others in the early stages, grows into the vaginal lumen;
Endophytic– such a tumor forms inside the cervical canal and looks like an ulcer that bleeds at the slightest touch. The tumor grows into the uterine body.

How quickly does cancer develop?

Cervical cancer can take decades to develop. Even before the formation of true cancer, dysplastic changes begin on the surface of the mucous cervical tissues, which last for years.

The picture shows the stages of development of cervical cancer

If dysplasia is not treated on time, it progresses and at the third stage develops to the initial stages of intraepithelial cancer, the treatment of which should already be carried out along the oncological line.

Zero

At stage zero of cervical cancer, abnormal cellular structures are located on the surface of the mucous membranes of the cervical canal. During this period, processes occur that precede abnormal mutations of normal cells into cancer cells.

At this stage, there is 100% cure and survival rate.

Initial

At stage 1 of the process, localization of the tumor focus is observed in the superficial epithelial mucous layers of the cervical tissues. Abnormal cells do not spread to nearby organs, and the tumor is strictly limited in nature.

The prognosis for this stage of cancer is very positive, survival rates reach 98-100%. A professionally performed operation gives a woman the opportunity to give birth to a child on her own in the future.

Second

At stage 2 of the oncological process in the cervical tissues, the tumor becomes larger, however, it does not affect the neighboring and underlying tissues. The formation can grow into lymph node structures of regional importance or into the uterine walls.

Typically, this stage is characterized by the appearance of the first signs of oncology in the uterine cervix.

At this stage, the tumor often grows into the body of the uterus and is localized inside the organ. Prognostic data deteriorates markedly, and survival rates also decrease.

Third

At stage 3 of the cancer process in the cervix, patients experience a deterioration in their general health. Oncology continuously progresses, inhibiting the activity of the renal, ureteric and urinary systems.

Cancer metastasizes to the uterine walls, spreads throughout the pelvic area, penetrating the organs located there. Even if the therapeutic tactics are chosen as correctly as possible, the prognosis is extremely unfavorable, the mortality rate of patients is about 70%.

Fourth

The fourth stage of cervical cancer is considered a terminal stage, when the question is no longer about cure, but about the maximum possible extension of the patient’s life.

Since the treatment is ineffective, palliative therapy is used to make the patient’s life easier.

The tumor at this stage has already penetrated into the bladder, intestinal, and bone tissues. The disease in this case is incurable, so the prognosis is unfavorable.

The five-year life expectancy for cervical cancer rarely reaches 10%.

Metastasis

Cervical carcinoma can metastasize to the uterine body, parametrium, and vagina.

Metastasis occurs predominantly by the lymphogenous route through lymph node structures located near the uterine body, cervix, through the hypogastric and iliac, presacral, etc.

There is also a possibility of hematogenous metastasis, when tumor processes reach widespread distribution and penetrate through the blood into the bone, liver or pulmonary system.

Such spread of cancer cells usually occurs at stages 3-4 of oncology.

The role of HPV

It has been scientifically proven that certain types of papillomavirus play a significant role in the formation of cervical carcinoma.

Carriage of such a virus increases the likelihood of developing CC by 10 and even 100 times. However, carriage of this virus does not guarantee the occurrence of cancer.

If a woman’s immune status is strong enough and can resist the papillomavirus, then cancer will not develop.

CC and pregnancy

Sometimes there are clinical situations when cervical cancer is combined with pregnancy (1 case in 2500 pregnancies).

There is a 30% chance of getting pregnant with cervical cancer. The average age of cancer patients and pregnant patients is about 27-29 years.

Treatment measures are planned in accordance with the duration of pregnancy, the stage of development of cervical cancer, the nature of the tumor formation, etc.

At stage 0, pregnancy, as a rule, continues, and the operation is performed after childbirth. If invasive cervical cancer is detected in the 1st-2nd trimester, then surgical intervention is performed through extended extirpation.

If the tumor process is at the advanced stage, then the fertilized egg is removed, and then a course of radiation therapy is carried out.

If invasive cervical cancer is detected against the background of a viable fetus, the patient undergoes a cesarean section, and then an extended extirpation is performed.

If, after treatment of cervical carcinoma, the uterine body was completely preserved, then with a favorable response to restorative therapy, the woman may well hope for pregnancy and childbirth.

Why is the disease dangerous?

The danger of cervical cancer lies in its very difficult consequences:

Risk of removal of the uterine body, cervix, vagina, bowel and bladder. In this case, the woman is guaranteed disability, and the main task of doctors is to preserve and prolong her life as much as possible;
If only the reproductive organs are affected, then removal threatens only the uterus, cervix, ovaries and vagina. In this case, the woman will never be able to give birth to a child;
They can only remove the uterus, leaving the appendages. Then hormonal disorders will not be as obvious as when the ovaries are removed;
It is believed that the outcome of treatment is favorable if the removal affected only the cervical canal;
If a woman has her vagina removed, she will have to forget about having sex;
If the uterus is removed, but the ovaries remain, then the woman will certainly not be able to give birth, but her sexual desire and sex life are fully preserved.

Diagnostics

The diagnostic process is divided into several stages.

At the first stage, the patient undergoes a gynecological examination on a chair using mirrors.
Then the gynecologist prescribes laboratory tests such as general and biochemical, Pap test, examination of vaginal discharge of a bacteriological and bacterioscopic nature.
Diagnostic studies of an instrumental nature, which include procedures such as colposcopy, X-ray, tissue biopsy of the uterine cervix, renal urography, ultrasound examination of the pelvic organs, MRI, etc.

Treatment

Treatment is most effective in the early stages of cervical carcinoma. Various techniques are used, but surgical intervention is considered the most effective.

In general, treatment can be carried out:

Operational;
Chemotherapy;
Laser;
Radiotherapy;
Hyperthermic method.

Often, to increase efficiency, complex therapy is carried out using several methods.

Surgical treatment can be carried out in several ways, such as laser therapy, ultrasound, cryodestruction, hyperthermia.

Radiotherapy can be carried out intracavitary or remotely. This technique involves the destruction of cancer cell structures through irradiation.

Chemotherapy uses antitumor drugs that are administered intravenously.

Such therapy is usually carried out on postmenopausal patients, because the drugs used have a detrimental effect not only on cancer cells, but also on healthy cellular structures, which adversely affects the condition of the entire body.

Survival prognosis

If the oncological process was detected at the zero or first stage, then the prognosis in almost all cases is favorable. To avoid the neglect of such a disease, it is recommended to undergo a gynecological examination at least once every six months.

When cervical carcinoma is detected at stages 2-3 of the oncological process, survival rate drops to 30-50%, and this is also provided that adequate antitumor therapy is provided. At the last 4th stage of cervical cancer, survival rates do not exceed 8%.