Cancer of a neck of uterus

Description:

Cancer of a neck of uterus in structure of cancer cases among women takes the second place. On average in 90% of cases cancer is localized in a neck of uterus. Most often cancer of a neck of uterus strike women at the age of 40-60 years.

Reasons of Cancer of neck of uterus:

Now scientists precisely proved primary role of a viral infection in development of cancer of neck of uterus, first of all a papillomavirus of the person which is found in 95% of patients. In case of stratification and a gerpevirusny infection risk to ache raises several times. Communication between the number of sexual partners at the woman and probability to develop in the future cancer of a neck of uterus is also revealed.
The risk increases in the following situations: early sex life, repeated abortions in the anamnesis, early pregnancy and early childbirth, the accompanying venereal diseases, smoking and decrease in immunity.

Symptoms of Cancer of neck of uterus:

The beginning of development of a cancer tumor often is followed by emergence plentiful liquid, watery is more white, colourless or slightly yellowish, not having a smell and not having the irritating properties. Further character is more white changes: they become is purulent - serous with an unpleasant smell and cause irritation of integuments. Other symptom characteristic of cancer of a neck of uterus, - acyclicly the repeating bloody allocations from a vagina. They can be scanty or gain the nature of bleeding. Sometimes it is the first and only symptom of a disease. Most often bleeding at the beginning of a disease has character of contact and is shown after sexual intercourse, at a natuzhivaniye or a manual research of a neck of uterus. Cancer of a neck of uterus at some women can be shown also in the form of the disturbances of a menstrual cycle which are expressed in lengthening, strengthening and increase of periods. Especially suspiciously on cancer emergence of blood from generative organs of the woman in the period of a menopause. Pains at cancer of a neck of uterus generally demonstrate far started process. However and at limited defeat by cancer of a neck of uterus there can be pains in the bottom of a stomach and in inguinal areas owing to penetration of the infection promoting development or an exacerbation of inflammatory diseases in cellulose of a small pelvis or in appendages. In addition, colicy pains in the bottom of a stomach can confirm the developing cancer of the cervical channel when the tumor closes its gleam and allocations accumulating in a cavity of the uterus have no free outflow that leads to emergence of stupid colicy pains in the bottom of a stomach. With a further growth of a cancer tumor, its germination in the next fabrics and bodies and innidiation in lymph nodes there are pains caused by a prelum of nervous trunks and textures tumoral infiltrates or the increased lymph nodes at basin walls. Patients in such cases complain of severe pains in a waist, in the bottom of a stomach, in inguinal areas and the lower extremities. At spread of a tumor to prevesical cellulose appear the speeded-up urination with incomplete bladder emptying which in turn leads to congestive cystitis. Sdvaleniye a tumor of a rectum leads to difficulty of the act of defecation.

The clinical picture of early cancer of neck of uterus often specifically is not shown, but nevertheless the existing separate signs of an ozlokachestvleniye can be considered at survey of a neck of uterus in mirrors and palpatorny inspection. Defeat by cancer of a neck of uterus can have character of a small ulceration or the papillary growths having sharp borders  extending to the outside surface of a neck. Cancer of a neck of uterus can have an appearance of knotty education. This form of defeat as well as defeat by cancer of the cervical channel, as a rule is followed by consolidation and deformation of a neck of uterus. The type of diffusion infiltration by cancer (more often adenogenny), пр which the neck of uterus a long time keeps the configuration is especially difficult for recognition. For all forms of cancer in an initial stage existence of focal consolidations, loss of elasticity of fabric and easy bleeding at an injury is characteristic.

At simple forms of cancer of neck of uterus it is accepted to distinguish the exophytic, endophytic and mixed forms of tumoral growth. Exophytic cancer of a neck of uterus is characterized by excess of fabric and existence of easily bleeding and crumbling melkobugristy papillary tumor located on the wide basis. Such form of tumoral growth is called as the tumor reminding "cauliflower". At endophytic cancer the neck of uterus becomes dense, hilly, tenacious and can reach big size. Its cover at the same time often ulcerates.  Sometimes the ulceration gains the nature of the crateriform retraction with a dense bottom and the raised valikoobrazny edges.

Diagnosis:

In addition to carefully collected anamnesis for the purpose of identification of symptoms of cancer, obligatory survey of a neck of uterus and vagina in mirrors, vulval and vulval прямокишечное the research allowing to define the nature of changes of a mucous membrane of a neck of uterus, density and a hypotrophy of vulval and its supravaginal part is meant. In addition to these methods of clinical diagnosis auxiliary tests are applied to cancer detection of a neck of uterus in an initial stage of its development.
Test on "elasticity of fabric" consists in easy pressing by the pallet on the surface of a neck of uterus. The site of a uterus, cancer-stricken, very slowly fills a trace from impression of the pallet. At the same time at the researcher an impression about elasticity and density of fabric is made.
Color diagnostic test is based on ability of the changed mucous membrane of a neck of uterus is painted by solution of iodine and potassium iodide in dark-brown color. Sites of a neck of uterus, cancer-stricken, are not painted and look light against a dark background surrounding mucous. Test is not specific to cancer (the surface of an ectopia, the healing erosion, cicatricial fabric and a leukoplakia is not painted). Even at clinically expressed cancer of a neck of uterus final specification of the diagnosis requires a histologic research of a tumor. The biopsy at the expressed tumor can be made by a conchotome. In certain cases endophytic cancer of a neck of uterus without ulceration the diagnosis is established by means of a deep knife biopsy or after a diagnostic scraping of the cervical channel. The last action serves also for cancer detection of the cervical channel.
On cancer the following kolposkopichesky pictures are suspicious: 1) a leukoplakia – a reinforced white or gray plaque with cracks and ulcerations; 2) a leukoplakia basis – a melkososochkovy whitish surface with gyrose atypical vessels in the form of commas; 3) a mozayka, or a zone of formation of fields, - sites mucous with the strengthened keratinization, divided by red streaks.

Cancer therapy of a neck of uterus:

At cancer therapy of a neck of uterus the combined treatment and the combined radiation therapy are applied.
The combined method consisting of surgical and beam treatment is carried out in two options. The first consists of operation – an expanded hysterectomy with appendages – and the subsequent outside radiation. Operation is carried out in the form of an expanded hysterectomy with appendages, with an upper third of a vagina, with a surrounding parametric fat, and also with the cellulose located on the course of ileal and hypogastric vessels and a locking nerve.
The second option of the combined treatment consists of preliminary radiation and the subsequent expanded hysterectomy with appendages. Postoperative radiation therapy is generally carried out by method of outside radiation.
At cancer of a neck of uterus of 1 stage can both the combined beam, and combined treatment is carried out. The combined method is applied preferably at patients of young and middle age. In 2-3 stages of cancer of neck of uterus the combined beam treatment is applied. At the 4th stage the symptomatic treatment is recommended.