Squamous cell carcinoma of the cervix: causes, symptoms and treatment
One of the leading threat of malignant tumours in gynecological practice there squamous cell carcinoma of the cervix. Medical statistics annually records the increase in the number of patients with this pathology. Disease affects absolutely all age categories of women, but is most often observed in patients of childbearing age. The greatest danger is hidden symptoms in early stage of tumor development, which complicates the diagnosis.
The disease detected at an early stage of development, with competent approach and adequate therapy guarantees the most effective results.
The causes of disease
Among the main factors contributing to the development of this disease are as follows.
- Early sexual debut. Cervical mucous is completely formed by 22 years, which contributes to her vulnerability at an early age.
- Infectious-inflammatory processes of the reproductive organs, which passed into the chronic stage.
- Sexually transmitted diseases (trichomoniasis, chlamydia, gonorrhea, syphilis, and others).
- Promiscuous. The lack of local remedies increases the risk of infection with pathogenic flora.
- Infection with human papilloma virus (16 and 18) – the main cause of cervical cancer. The presence of HPV infection in the majority of cases with cervical neoplasia.
- The presence of erosions, polyps, papillomas, dysplasia in the cervix and cervical canal is the preceding stage of cancer.
- Genetic predisposition. If any of the relatives on the female line suffered oncological diseases of the reproductive system, the woman automatically gets to group of risk.
- Injury of the cervix as a result of ongoing surgical procedures (abortions, multiple pregnancies).
- Hormonal disturbance due to endocrine diseases (high level of estrogen triggers the development of cervical cancer). A similar phenomenon is observed with prolonged use of hormonal contraceptives for systemic effects.
Diagnosis of the disease
The presence in the cervix or the cervical canal of any neoplasm is a signal for immediate action (a thorough examination, appointment treatment). Erosive processes are also hidden symptoms. Women who leave the visits to the gynecologist, can go for years without suspecting the presence of pathological changes in tissues and cells at this time mutating involving inflammation healthy parts of the body. The sooner the disease is detected, the higher the chances of successful treatment.
Squamous cell carcinoma of the cervix (cervical cancer) is characterized by hidden symptoms in early stage disease. Only a thorough diagnosis using laboratory and instrumental methods of examination, regular visits to the gynecologist can help to detect the pathological process in the cervix and prevent the spread of the surrounding tissue.
- Examination on the gynecological chair with the help of mirrors the cervical canal and cervix. Additionally, the doctor will examine the uterus and ovaries.
- Swab of the vagina for microbiological (pathogenic flora) and a cytological examination (PAP-test) for the presence of atypical cells. Fence material for cytological study was carried out, a ovulation and menstruation. Transcript cytograms performed by the physician.
- Colposcopy. Study of structural changes of the epithelium under the microscope (a colposcope) may detect abnormalities at an early stage. In the process of diagnosis gynecologist uses iodine test. Painted iodine on the wound surface allows to detect the source of inflammation and its boundaries.
- Biopsy of the suspicious area with histological examination of the material. Allows you to set an accurate diagnosis and determine the severity.
- Ultrasound of the pelvic organs.
- Urography. Used radiographic study of the kidneys, ureter, bladder, uterus and spine to determine the level of destruction cancer cells and further treatment.
- Cervical conization under intravenous anesthesia. Shown in cases where fails to obtain tissue fragments for analysis.
- General analysis of blood. Determines the General state of the organism, the scale of the defeat.
- Analysis on HPV.
- A blood test for tumor markers: SCC.
In the absence of visible signs of the disease the degeneration of cells occurs within 12 years. If you do not take any methods, pathology will progress into a carcinoma.
Symptoms of the disease
The main symptoms of tumors of the cervix expressed as:
- pulling pain in the pelvis and lumbar;
- the appearance of vaginal bleeding scarlet provoked by sexual contact (the decay of the tumor);
- losing body mass on the background of the common signs of intoxication (lack of appetite, nausea);
- the increase in body temperature to subfebrile indicators;
- constant feelings of fatigue, apathy;
- increase of lymph nodes in the groin area;
- voiding, evacuation (late);
- swelling of the lower extremities due to the development of nefronekroz (late).
The severity of clinical manifestations depends on the stage of the disease, individual peculiarities of the organism. These symptoms common to many infectious diseases. That is why most women do not suspect the presence of dangerous diseases.
For each type of tumor characterized by specific symptoms that the scale of destruction and the speed of propagation of the inflammatory process. Careful diagnosis of pathology is an indispensable condition for future treatment.
The development of cancer is a multistep process, which is presented in the following sequence:
- Normal epithelial layer of the cervix without any structural damage.
- The presence of dysplasia (1, 2, 3 stages). Each stage has characteristic clinical manifestations that can be diagnosed by colposcopy.
- Non-invasive cancer. Implies severe stage of dysplasia, which are diagnosed with 100% certainty by using the colposcope.
- Micro-invasive cancer (microcarcinoma of the cervix uteri). This stage is characterized by the spread of inflammation in the underlying tissue up to 5 – 7 mm. It precedes the clinical stage of the malignancy.
- Invasive cancer. Characterized by lesions of the adipose tissue, lymph nodes around the uterus. The tumor metastasizes in the pelvis, squeezing the bladder, rectum, regional lymph nodes, blood vessels. At this stage, see an increase in the number of tumors due to rapid metastasis.
Squamous cell carcinoma is recognized as one of the most dangerous cancer.
Is one form of squamous cell carcinoma of the cervix keratinizing. The specificity of this disease manifests itself in the keratolytic properties of cancer cells. Their characteristic structure and density to create in the region of the cervix Horny layer. The lack of treatment exacerbates the disease process. Cells cease to perform their physiological functions and regenerate in malignant education.
For this form characterized by the presence of keratin “pearls” in the form of anomalous flat cells of large size, evolving throughout the development process.
Neorogovevayuschy squamous cancer of the cervix (carcinoma) is the second form of the disease, devoid of keratization in 95% of cases. It is characterized by infiltrative growth of epithelium in the spiny layer of the dermis. Neorogovevayuschy cells have a disorderly arrangement and a more pronounced atypical.
The degree of differentiation of the cells classified into the following types of carcinoma:
The most favorable prognosis is seen in high-grade form of the tumor.
The use of a certain type of treatment depends on the type of malignancy, place of the localization and scale of the defeat. Also important is the age of the patient, the General condition of the organism (immunity), individual physiological characteristics. Rationality of therapy, the doctor determines on the basis of anamnesis data.
In the early stages of the disease the classical scheme of treatment involves the following procedures:
- cone biopsy (a cone-shaped excision of the affected area of the cervix);
- electrosurgical loop excision (removal of the damaged layer of the epithelium);
- a trachelectomy (radical removal of the cervix, of the vagina and lymph nodes in the pelvis).
When cancer is in a later stage with a pronounced clinical manifestations, treatment more radical. It includes the following procedures:
- Hysterectomy involving the complete removal of the uterus. If involved in the pathological process in the ovaries, they also removed (oophorectomy). In advanced cases, remove all the affected organs.
- Chemotherapy, in which the body by infusion administered drugs that destroy cancer cells. This method is in most cases combined with surgical to improve the efficiency in the case of the involvement in cancer of the lymph nodes and other organs.
- Radiation therapy involves the exposure of affected areas, exposure with radiation of different frequencies (remote gamma-therapy), as well as intracavitary introduction of radioactive purpose micro containers, which allows aiming to influence the cancer cells without affecting healthy tissue. Remote and targeted therapy alternated with an interval not to exceed 55 days.
Special attention deserves the suspicion of cancer during pregnancy. Often bleeding is associated with temporary complications, characteristic of this period. Upon detection of dysplasia requires a PAP smear. Treatment transferred to the postnatal period. Regular consultations of the gynecologist in this case, it is a prerequisite.
Preventive measures can prevent squamous cell carcinoma of the cervix. These include:
- the lack of casual sex;
- regular visits to the gynecologist (even in the absence of complaints);
- the use of barrier protection;
- personal hygiene;
- the beginning of sexual life at full physiological maturity of the body;
- avoiding harmful habits;
- a strengthened immune system;
- rational use of hormonal contraceptives to avoid abortion;
- timely treatment of gynecological diseases;
- lack of stress.
Despite the real threat of this disease, modern methods of treatment of oncological processes using the latest equipment allow us to remove the abnormalities at an early stage of development. The sooner the disease is diagnosed, the higher the chances of success.