Symptoms of early stage cancer in women. Cancer as a woman is the first signs of Cancer of the female genital organs

Oncological diseases are quite an urgent problem today. A lot of cases of citizens appealing to the oncological center for help and diagnosis of such a disease have been recorded.

Oncology, unfortunately, can spread to any organs in the human body. Tumors arise in various places and can start growing anywhere.

Cancer of the uterus occurs in women quite often today and according to statistics, this type of oncology is one of the most common.

What is uterine cancer?

This type of tumor is a neoplasm. As you know, neoplasms are malignant and benign.

A tumor such as cancer of the uterus can be classified as a malignant tumor.

The formation of such a neoplasm arises, first of all, from the tissues in the uterus, capable of spreading to all parts of the body.

Cancer is one of the most common diseases and ranks fourth after cancers of the breast, skin and gastrointestinal tract.

Incidence statistics

In order to talk about any kind of oncological disease, of course, one cannot fail to note about the statistical data on the basis of which appropriate conclusions can be drawn.

As mentioned earlier, uterine cancer is one of the ten most common cancers and ranks fifth among them.

Of course, it should be noted that the occurrence of this disease, as well as mortality for this pathology, has significantly decreased in recent years.

Statistics show that this pathology is observed more often in development in women over 50 years of age. However, according to doctors, young girls are also susceptible to this disease.

Previously, it was believed that uterine cancer is one of the main causes of death from a malignant tumor. The incidence of the formation of such a pathology has decreased to 70%.

Types of uterine cancer

There are several morphological types of uterine cancer:

1. Adenocarcinoma;
2. Squamous cell neoplasm;
3. Cancer of the glandular squamous type;
4. Adenocarcinoma of the clear cell type;
5. Serous cancer;
6. Mucinous cancer;
7. Cancer of the undifferentiated type.

Causes of uterine cancer

Certainly, certain causes and factors contribute to the formation of uterine cancer, which can aggravate the degree of this serious disease.

As such, the exact reason due to which the development and growth of a neoplasm on the uterus begins in the modern world has not been established and studied.

Research has made it clear that there are a number of reasons for the factors contributing to the growth of cancer:

One of the most basic and, perhaps, dangerous factors contributing to the formation of cancer is increased body weight.

If a woman-patient's body weight exceeds the usual established norm by more than 10-25 kilograms, then the risk of developing a tumor will be three times increased.

Some facts also play a very important role in the occurrence of a malignant tumor:

• ulcerative processes
• uterus
• cicatricial formations after childbirth;
• inflammatory processes.

Methods for diagnosing the disease

Diagnostics- a very important stage in any type of cancer. It is very important to diagnose the disease and this process must be organized correctly.

Diagnostics includes:

Symptoms of uterine cancer in women

Of course, symptomatology plays an important role in determining this disease.

A symptom is something that should be paid utmost attention if the patient feels that something is wrong. It is extremely important to pay special attention to their health for women over the age of forty.

Unfortunately, cancer is one of the diseases, the symptoms of which appear in the late stages.

Symptoms can be conditionally divided into several types:

Based on the age category and the period of menopause, symptoms may appear:

• opening of bleeding;
• pain in the perineal region;
• pain in the lumbar region and lower abdomen;
• rapid fatigue and sudden weight loss.

If you have one of the symptoms, you must immediately visit a doctor to correct this problem.

Definition of uterine cancer before menopause

As noted earlier, there are symptoms that make it clear about the presence of the appearance of a neoplasm before the onset of menopause.

Most often, during such a period, vaginal discharge is already irregular and every month it appears less frequently.

It is during such a period that symptoms of cancer of the uterus can be all discharge with blood from the vagina.

Uterine cancer can be suspected only if the menstrual cycle gradually stopped, and then a large volume of discharge began again.

Manifestation during menopause

At a time when a woman has already begun, namely menopause, symptoms may also occur that need to be given special attention.

As a rule, a woman has had no monthly periods for several months; symptoms of cancer can be bloody discharge, regardless of how often they appear, how long and in what volume.

Description of the stages of uterine cancer and life expectancy

There are only four stages of uterine cancer:

1. The first is a tumor that affects only the body of the uterus. The tumor is able to penetrate in the primary stages to the endometrium, myometrium to half the depth and to more than half the depth of the myometrium.
2. The second type is malignant cells that are found directly in the cervix. This type of neoplasm can penetrate the body of the uterus and penetrate into the deep layers of the cervix.
3. The third tumor is capable of transferring to the vagina and to the appendages, as well as to the lymph nodes. This type of tumor can give rise to the serous layer of the uterus of the external type or adjacent appendages, begin to grow in the vagina, and in case of metastases, go to the pelvic lymph nodes.
4. The fourth type of cancer of the uterus with the spread of metastases manifests itself in the bladder or in the rectal area, and also begins to spread to the lungs, liver, bones and distant lymph nodes.

In addition, the degrees of cell differentiation in the neoplasm differ.

Distinguish between a sufficiently high degree of cell existence, as well as a poorly differentiated degree. The whole point is that the more differentiation is expressed, the slower the growth process of the neoplasm is.

Accordingly, the likelihood of metastases decreases. If the cancer is poorly differentiated, then the prognosis in such a situation becomes worse.

Patient Life Expectancy:

• At the primary stage when a neoplasm is just forming and begins to settle in the uterine body, the patient's chance of recovery is about 80 - 90%.
• At the second stage, cancer begins its penetration beyond the border of the very body of the uterus itself and then contributes to the involvement of the cervix. In such a situation, the organs located nearby are not subject to defeat. Recovery is noted in 3 out of 4 of all cases.
• In the third stage When the oncology process begins to spread to the appendages and directly to the vaginal area, about 40% can get out of this situation.
• At the fourth stage when the tumor grows beyond the pelvic region, the formation begins to penetrate the intestines and the vesicular tissues in the uterus. The survival rate is not more than 15%.

Development of uterine cancer by stages (photo)

Metastasis

Metastases begin to grow and, usually, they penetrate the lymphatic vessels and nodes.

While at the terminal stage, the influence is also exerted on the human venous system.

Initially, the lesion begins to grow in the area of ​​the lymph nodes and its structure. As a rule, it happens in the iliac and hypogastric regions.

It is extremely rare that the lesions cover other organs.

Also, metastases grow to the canal of the cervical type and, as mentioned earlier, beyond the aisles of the uterine body.

With the method of the hemotogenic type, from which metastases usually begin to penetrate into the area directly into the area of ​​the epididymis.

In addition, the vaginal area is also affected, and in some cases the kidneys and liver, bone tissue.

The rate of development of the disease

The rate of growth and development is primarily due to the histological type of occurrence. In addition, it is necessary to take into account the pathology, the ability of the body to fight, competent treatment and the age category of the patient, the psychological and spiritual mood of the patient.

As such, it will not be possible to get an exact answer and to find out over what period of time the cancer will develop to the end.

Treatment for uterine cancer

Of course, the basis of competent treatment is surgical intervention, namely surgery.

The operation involves the removal of the uterine body in combination with the ovaries.

Very often, doctors prescribe such a treatment methodology even after surgery, radio exposure.

Radiation or radiation therapy can reduce the risk of recurrence. However, this method of treatment does not affect the rate of recovery.

Chemotherapy is also used. This method is in demand in the therapy of oncology.

In addition, good results have been noted with hormone therapy.

It is necessary to determine the appropriate method of therapy, taking into account certain factors. Prevention is the most effective measure to prevent diseases such as uterine cancer.

Methods and methods of treatment

As noted earlier, treatment is possible comprehensive and complex.

Very often, doctors are forced to agree to the surgical method of removing the tumor, to radiation, chemotherapy and hormone therapy.

Surgical intervention

Intervention with surgery is a common cancer treatment.

This type of treatment involves an operation that involves the removal of the uterine body and ovaries.

Radiotherapy

Radiation exposure is also a popular cancer treatment method. However, this method allows you to get rid of only relapses of oncology.

Unfortunately, this type of radiation does not affect patient survival rates.

Hormone therapy

As you already know, hormones are a pretty strong component that helps to cure many diseases and can also prolong people's lives.

For such treatment, drugs are used Depostat, Farlugal other.

If metastases are active, progestogen treatment is ineffective.

In this situation, appoint Zoladek.

Very often, hormone treatment will combine chemotherapy to achieve the best effect.

Chemotherapy

Chemotherapy is a fairly common technique that allows, in certain cases, to get rid of cancer.

Quite often, this methodology of treatment is used with an extensive spread of tumor growth.

Also, with the autonomous nature of the neoplasm, if the metastases are in an active position and have begun to spread, chemistry is used.

Consequences of uterine cancer

It should be noted right away that uterine cancer is the most dangerous pathological condition. If there is no therapy as such, which is necessary during the period of cancer treatment, then the consequences of an increase in education are most likely to be fatal.

Often, oncologists offer together with the appendages, with some part of the vagina and the cervix.

Typically, uterine cancer is found in women who are between 45 and 60 years old.

Differences between uterine cancer and fibroids

- This is a process, which is an increase and growth of uterine tissues, which are subsequently formed by some traumatic factors.

This can be facilitated by frequent abortions, curettage, inflammation of the genitourinary system and much more.

It is worth noting that uterine cancer and fibroids have nothing to do with each other. These two pathologies are completely different and myoma, in no situation, is not capable of developing into cancer.

It is also worth noting that oncology is formed in the epithelial layer, the benign one finds itself in the muscle layer.

That is why, any patient should visit a gynecologist for examination.

Prevention of uterine cancer

To prevent such a disease, it is necessary to avoid diagnoses such as diabetes, obesity and infertility.

In other words, you need to control your body weight, treat reproductive functions, if necessary, and get rid of diabetes, if any.

In modern medicine, there is another measure for the prevention of cervical cancer - this is vaccination.

Vaccination against cervical cancer Is a vaccine that prevents infection with the dangerous human papillomavirus. The emergence of a malignant tumor is provoked by about 15 types of HPV, of which the 16th and 18th types are the most oncogenic.

By itself, it cannot cause the development of the disease or provoke its exacerbation, however, it forms a stable immunity to all oncogenic HPV types.

It should be noted the importance of such a means of prevention, because often even the use of the most innovative methods of treating a malignant tumor does not give the desired result, which leads to a lethal outcome.

Therefore, it is better to prevent the disease with vaccinations that prevent infection, which doctors recommend for girls aged 12 years and older.

There is also secondary prevention, which offers women over 40 years of age to be examined with ultrasound from year to year. This type of procedure helps to detect cancer in its initial state and increase the chances of successful treatment.

Patient survival prognosis

As noted earlier, the percentage of survival primarily depends on the factor at what stage the cancer was found.

The sooner there is a reason and the patient visits a doctor and is able to diagnose cancer, the more chances are to live long and defeat cancer.

This means, first of all, that it is necessary to regularly visit a gynecologist and take the required tests and examinations.

The health of the reproductive system of women is given great attention by medical workers. However, the statistics are relentless - cancer of the female genital organs is detected more often every year. Tumors have different localization and structure, as well as clinical manifestations. In order to prevent serious complications, it is recommended to be attentive to the slightest deviations in your well-being - with early diagnosis, cancer is completely defeated.

Warning signs of cancer

At the first stages of its formation, the signs of cancer in women are so minimal that they can be confused with manifestations of other pathologies of the reproductive system. There are no specific symptoms in cancer in citu, but the following deterioration in well-being should be alarming for every woman:

• often bloating - flatulence is characteristic of many diseases, but often indicates an ovarian tumor;
• abdominal pain - discomfort and discomfort below the navel, which have no relationship with known pathologies or menstruation, should be alarming in relation to cancer in a woman's way;
• pain in the lumbar region - in addition to osteochondrosis, unpleasant discomfort in the sacral or lumbar spine may be related to ovarian or uterine cancer;
• an increase in temperature - subfebrile condition for a long time can be a hidden sign of a formed malignant tumor;
• abundant, prolonged vaginal discharge, previously unusual for a woman - a common sign of a tumor in the reproductive system, which must be notified to the doctor;
• disorders in the digestive system - frequent problems with the intestines, for example, constipation, diarrhea, nausea, may indicate not a peptic ulcer or pancreatitis, but be signs of cancer in the small pelvis.

In addition to all of the above, a chronic feeling of fatigue, as well as a deterioration in appetite and weight loss, will speak about the possibility of the formation of a focus of cancer in the genitals in women. It is better to inform the doctor about any negative change in the state of health in order to avoid serious complications of cancer.

Early symptoms of cervical and uterine cancer

Malignant tumors of the female genital organs occupy a leading position among the causes of death among women of reproductive age. The causes of the onset of a tumor can be both viral diseases, for example, the papilloma virus, and injuries of the cervix.

The clinical picture at the initial stage of the appearance of the tumor is low-symptom - the woman does not notice any pronounced changes in her well-being. Leads his usual life. Plentiful leucorrhoea flowing from the vagina, or spotting spotting outside the menstrual cycle can be alarming.

In some cases, discomfort and discomfort during sexual intercourse are forced to seek medical help - the cervix can be affected by cancer. A gynecological examination does not always reliably identify a tumor, therefore, specialists must take a sample of cells from the cervical canal to identify cancer cells.

A tumor of the body of the uterus at an early stage is also almost asymptomatic. As it grows, it will make itself felt with aching sensations in the groin, sacral region, acyclic uterine bleeding, or purulent vaginal discharge with an unpleasant odor.

Early symptoms of ovarian cancer

For cancer of the female reproductive organs, the appearance of a tumor on the ovaries is one of the frequent localizations of neoplasms. The reason is a negative family predisposition - the detection of cancer in representatives of the family for several generations, or previous inflammatory processes in the small pelvis.

The early symptoms of an ovarian tumor can be disguised as pathological disorders in other parts of the woman's body. So, cancer at the first stage of the formation of the focus disrupts the activity of the nearest organs - in the intestine, pancreas, kidneys. Therefore, warning signs include:

• an increased tendency to flatulence, previously unusual for a woman and not associated with pancreatic dysfunction;
• dyspeptic disorders - the urge to nausea, vomiting, for no apparent reason;
• problems with bowel movement - frequently recurring constipation, diarrhea without relationship with food intake;
• unpleasant aching constant pain in the lower abdomen;
• an increase in body temperature to subfebrile numbers - more often in the evening, but can be observed throughout the day;
• deterioration in appetite - its decrease, aversion to certain dishes;
• losing weight - for no reason, without any effort by a woman.

In some cases, ovarian cancer is an unpleasant result of preventive medical examinations - an ultrasound scan of the pelvis. A biopsy of the tumor tissue will serve as confirmation.

Symptoms of cancer of the vagina and labia

A tumor of the external genital organs of women can be detected in the early stages due to specific changes in the tissues - the appearance of seals, nodes, ulcerative defects in them. They are clearly visible during gynecological examinations or are detected by women during hygiene procedures.

With growth, the focus of cancer affects both superficial and deep layers of tissues, affects the nearest lymph nodes. Symptoms in the early stages may resemble signs of inflammatory processes - burning, itching, as well as discomfort and soreness directly in the genitals.

Somewhat later, with the collapse of the primary focus of the tumor, purulent-bloody discharge with a repulsive odor, weight loss of a woman, and swelling of the lower extremities will be observed. The process of urination begins to suffer - severe pain, blood clots in the urine, fluctuations in body temperature. Sexual intercourse becomes painful, almost impossible. Bleeding from the vagina becomes more frequent, becomes acyclic, profuse.

It is possible to defeat cancer in the female reproductive system - modern advances in oncology suggest that tumors of the genital organs are completely curable. The main condition is the timely appeal of a woman for medical help.

Malignant tumors can occur in any organ of the female reproductive system - the vulva (external genital organs), vagina, cervix, uterus, fallopian tubes, or ovaries.

Uterine cancer

Although this cancer is commonly called uterine cancer, it is more accurately called endometrial carcinoma because the tumor initially occurs in the lining of the uterus (endometrium). In women, it is the fourth most common cancer and the most common malignant tumor of the female genital organs. Cancer of the uterus usually develops after menopause, usually in women between 50 and 60 years of age. Tumor cells can spread (metastasize) both to adjacent tissues and to many other organs - down to the cervix, from the uterus into the fallopian tubes and ovaries, into the tissues surrounding the uterus, into the lymphatic vessels, which transport lymph to all organs, lymphatic nodes, into the blood, then through the bloodstream to distant organs.

Symptoms and Diagnosis

Abnormal uterine bleeding is the most common early symptom of uterine cancer. Bleeding can occur after menopause, repeated, irregular, or profuse in women who continue to have their periods. One in every three women with uterine bleeding after menopause will develop this form of cancer. In case of pathological uterine bleeding after menopause, you should immediately consult a doctor, as it may be caused by a malignant tumor.

Several methods are used to diagnose this malignant tumor. The Pap test can detect cervical cancer cells, but when performed, tumor cells are not detected in about one third of cases. Therefore, the doctor also performs an endometrial biopsy or fractional curettage (separate curettage of the cervical canal and the uterine cavity), in which the tissue of the uterine lining is removed for examination under a microscope.

If biopsy or fractional curettage results confirm the presence of a malignant tumor in the lining of the uterus, more testing is needed to determine if the cancer has spread outside the uterus. Ultrasound (ultrasound), computed tomography (CT), cystoscopy (examination of the bladder with a fiber optic system), intestinal x-ray using barium sulfate, x-ray of the chest, intravenous urography (x-ray of the kidneys and ureters), bone scans, and liver, sigmoidoscopy (examination of the rectum with a flexible fiber-optic instrument) and lymphoangiography (x-ray examination of the lymphatic system) provide the necessary information and help in prescribing optimal treatment. In each case, for specific indications, only some of the above studies are carried out.

Treatment

Extirpation, that is, the surgical removal of the uterus, is the mainstay of treatment for this type of malignant tumor. If the cancer has not metastasized outside the uterus, then extirpation of the uterus almost always leads to a cure. During the operation, the surgeon usually also removes the fallopian tubes, ovaries (that is, performs salpingo-oophorectomy) and nearby (regional) lymph nodes. They are examined by a morphologist to determine the stage of cancer development and to establish the need for postoperative radiation therapy.

Even when the cancer has not metastasized, the doctor may prescribe postoperative drug therapy (chemotherapy) in case some of the cancer cells go undetected. Usually hormones are used that suppress the growth of malignant tumors. Progestins (progesterone, a female hormone that blocks the effects of estrogens) and similar hormonal drugs are often effective.

If the cancer has spread outside the uterus, higher doses of progestins are usually given. In 40% of women with metastases of a malignant tumor, it decreases in size and its growth is suppressed by progestins for 2-3 years. If the treatment is effective, it can continue indefinitely. Side effects of progestins include weight gain due to water retention and, in some cases, depression.

If the cancer is widespread or if hormone therapy is not working, other chemotherapy drugs such as cyclophosphamide, doxorubicin, and cisplatin may be added. These drugs are much more toxic than progestins and cause many side effects. Before starting treatment, the risks and expected benefits of chemotherapy must be carefully weighed.

In general, almost two-thirds of women who have this type of cancer survive and do not have recurrence (reappearance) of a malignant tumor within 5 years after diagnosis, less than a third die from this disease and almost 10% survive, although cancer does not healed. If this malignant tumor is detected at an early stage of development, almost 90% of women live at least 5 years and usually recover. The chances are better in younger women, women with cancer that has not metastasized outside the uterus, and women with a slow-growing type of cancer.

Factors that increase the likelihood of uterine cancer

• Exposure to high doses of estrogens (the main female hormones) from hormone-producing tumors or when taking drugs containing high doses of estrogens, including estrogen replacement therapy without progesterone after menopause
• Menopause after 52 years
• Menstrual irregularities (eg, excessive bleeding, bleeding between periods, or long intervals between periods)
• Obesity
• Lack of childbirth
• High blood pressure
• Diabetes
• Tamoxifen therapy

Cervical cancer

The cervix is ​​the lower part of the uterus that goes into the vagina. Of the malignant tumors of the female genital organs, cervical cancer (cervical carcinoma) is the second most common tumor among women of all ages and the most common among younger ones. Cervical cancer is usually found in women between the ages of 35 and 55. The development of this malignant tumor may be associated with a virus (human papillomavirus), which can be transmitted during intercourse.

The lower the woman's age during the first intercourse, and also the more sexual partners she has in the future, the greater the risk of cervical cancer.

In about 85% of cases, cervical cancer is squamous, that is, it develops from stratified squamous epithelial cells, resembling skin cells, that cover the outside of the cervix. Most other types of cervical cancer develop from the cells of the columnar epithelium of the glands in the cervical canal (adenocarcinoma) or both.

Cervical cancer cells can penetrate deep under the mucous membrane, enter the vast network of small blood and lymphatic vessels in the deeper layers of the cervix, and then enter other organs. In this way, a malignant tumor metastases both to distant organs and to tissues located near the cervix.

Symptoms and Diagnosis

Symptoms include bleeding between periods or after intercourse. The woman may not be in pain and other symptoms may not develop until the later stages of the disease, but routine Pap tests (Pap smears) detect cervical cancer early enough. This disease begins with slow changes in normal cells and often takes several years to develop. Changes are usually detected by examination under a microscope of the cells of the mucous membrane of the cervix, which are taken for a Pap smear. Physicians-morphologists have described these changes as stages ranging from normal (no pathology) to invasive cancer.

The Pap test is inexpensive and can accurately detect cervical cancer in 90% of cases, even before symptoms appear. As a result, with the introduction of this research method, the number of deaths from cervical cancer has decreased by more than 50%. Doctors usually recommend that the first Pap test be performed when a woman is sexually active or reaches the age of 18, and then this test should be carried out annually. If normal results have been obtained within 3 consecutive years, such a woman can then have a Pap smear only every 2 or 3 years until her lifestyle changes. If this cytological study was carried out regularly in all women, then mortality from cervical cancer could be reduced to zero. However, almost 40% of patients do not receive regular check-ups.

If, during a gynecological examination, a neoplasm, ulcer or other suspicious area is found on the cervix, as well as suspicious changes in relation to a malignant tumor when a Pap smear is detected, the doctor performs a biopsy (takes tissue of the cervix for examination under a microscope). A tissue sample for this examination is usually obtained during a colposcopy, for which the doctor uses a fiber optic system with a magnifying lens (colposcope) to carefully examine the cervix and select the most suspicious biopsy site. Two types of biopsy are used - targeted biopsy, in which a small piece of cervical tissue is taken under the control of a colposcope, and endocervical curettage, in which the mucous membrane of the cervical canal is scraped without visual control. Both biopsies are painful and bleeding. Both methods usually produce enough tissue for the morphologist to make a diagnosis. If the diagnosis is unclear, the doctor will do a tapered biopsy, which removes more tissue. Typically, this type of biopsy is performed using loop electrosurgical excision (excision) techniques on an outpatient basis.

If cervical cancer is detected, then the next step is to determine the exact size and location of the tumor; this process is called determining the stage of development of a malignant tumor. Determination of the stage begins with a general examination of the pelvic organs and several special types of studies (cystoscopy, X-ray examination of the chest organs, intravenous urography, sigmoidoscopy) to determine the extent of the spread of the cervical tumor to neighboring tissues or more distant organs. If necessary, additional tests such as computed tomography, intestinal x-rays using barium sulfate, and liver and bone scans may be done.

Treatment

Treatment depends on the stage of development of the cervical cancer. If the malignant tumor is limited to its superficial layers (carcinoma in situ), the doctor can remove such a tumor completely - a part of the cervix is ​​removed with a surgical method or with the help of a loop electrosurgical excision (excision). After such treatment, the ability to have children is preserved. Nevertheless, the doctor recommends that the woman come for examinations and perform a Pap smear every 3 months during the first year and every 6 months thereafter, since the malignant tumor may recur. If a woman has carcinoma in situ and she does not plan to have children, then she is recommended to remove (extirpate) the uterus.

If the cancer has reached a later stage of development, extirpation of the uterus is necessary in combination with the removal of the surrounding tissue (radical extirpation of the uterus) and lymph nodes. At the same time, normally functioning ovaries in young women are not removed.

Radiation therapy is also highly effective for treating advanced cervical cancer if the tumor has not invaded the pelvic organs. Although radiation therapy usually does not produce early side effects, it sometimes causes rectal and vaginal inflammation; later damage to the bladder and rectum may develop, and ovarian function usually ceases.

If the cancer has spread outside the pelvic area, chemotherapy is sometimes recommended. However, only 25-30% of patients receiving it can expect a positive effect, and this effect is usually temporary.

Pap test results: cervical cancer stages

• Absence of pathological changes
• Minimal cervical dysplasia (early changes that are not yet cancerous)
• Severe dysplasia (late changes that are not yet cancerous)
• Carcinoma in situ(malignant tumor limited to the most superficial layer of the cervical mucosa)
• Invasive cancer

Like other cancers of the skin, vulvar cancer begins on the surface and first spreads to nearby tissues without invading other organs. Although some tumors can be aggressive, most types of vulvar cancer grow relatively slowly. If treatment is not carried out, they are gradually introduced into the vagina, urethra or anus, penetration into the lymph nodes of this area.

Symptoms and Diagnosis

Cancer of the vulva can be easily detected with unusual lumps or sores near the opening of the vagina. Sometimes there are areas of flaking or discoloration of the skin. The surrounding tissue may appear wrinkled. The discomfort is usually mild, but itching in the vagina worries. In the future, bleeding often develops or a watery discharge appears. The appearance of these symptoms requires immediate medical attention.

The doctor will take a biopsy to make a diagnosis. After anesthetizing the suspicious area with an anesthetic, a small area of ​​the altered skin is removed. A biopsy is needed to determine if the skin changes are cancerous or associated with infectious inflammation or irritation. The biopsy also makes it possible to recognize the type of malignant tumor when it is detected and to determine the treatment strategy.

Treatment

A vulvectomy is an operation that removes a large area of ​​tissue from the vulva near the opening of the vagina. Vulvectomy is necessary for all types of vulvar cancer, except for preinvasive carcinoma, to remove squamous cell malignancies of the vulva. Such extensive removal is carried out because this type of vulvar cancer can quickly invade nearby tissues and lymph nodes. Since vulvectomy can remove the clitoris as well, the doctor discusses the treatment ahead with the woman who has vulvar cancer in order to develop a treatment plan that best suits her, taking into account her comorbidities, age, and aspects of her sex life. Sexual intercourse after vulvectomy is usually possible. Radiation therapy may be given postoperatively to treat cancer very late in its development, where complete cure is unlikely. If a malignant tumor is detected and removed early, then in 75% of cases there are no signs of its reappearance within the next 5 years; if cancer has invaded the lymph nodes, fewer than 50% of women survive.

Since basal cell carcinoma of the vulva does not tend to metastasize to distant organs, surgical removal is usually sufficient. If the malignant tumor is small, then removal of the entire vulva is not required.

Vaginal cancer

Only about 1% of all malignant tumors that arise in the female genital organs develop in the vagina. Cancer (carcinoma) of the vagina usually occurs in women between the ages of 45 and 65. In more than 95% of cases, vaginal cancer is squamous and morphologically similar to cancer of the cervix and vulva. Squamous cell carcinoma of the vagina can be caused by the human papillomavirus, the same virus that causes genital warts and cervical cancer. Diethylstilbesterol-dependent carcinoma is a rare type of vaginal cancer that occurs almost exclusively in women whose mothers have taken diethylstilbesterol during pregnancy.

Symptoms and Diagnosis

Vaginal cancer invades the lining of the vagina and ulcers, which can bleed and become infected. Watery discharge or bleeding and pain during intercourse appear. If the cancer becomes large enough, the function of the bladder and rectum may also be impaired, and there may be frequent urge to urinate and pain when urinating.

When vaginal cancer is suspected, the doctor performs a scraping of the vaginal mucosa to examine it under a microscope, and biopsies the growths, ulcers, and other suspicious areas seen during the pelvic exam. A biopsy is usually done during a colposcopy.

Treatment

Treatment for vaginal cancer depends on the location and size of the tumor. However, all types of vaginal cancer are treatable with radiation therapy.

If the tumor is located in the upper third of the vagina, removal (extirpation) of the uterus and pelvic lymph nodes and the upper part of the vagina is performed or radiation therapy is used. For cancer in the middle third of the vagina, radiation therapy is given, and for cancer in the lower third, surgery or radiation therapy.

After treatment for vaginal cancer, intercourse may be difficult or impossible, although sometimes a new vagina is formed with a skin graft or part of the intestine. Survival within 5 years is observed in approximately 30% of women.

Cancer of the fallopian tubes

A malignant tumor can also develop in the fallopian tubes. This is the most rare location of a malignant tumor of the female genital organs. Symptoms include vague abdominal discomfort, sometimes watery or bloody vaginal discharge. Usually, a nodular formation is found in the small pelvis, but the diagnosis is made only after removal and cytological examination of the tumor. Removal (extirpation) of the uterus, fallopian tubes, ovaries and omentum, followed by chemotherapy, is almost always necessary. The prognosis is about the same as for ovarian cancer.

Trophoblastic disease

Trophoblastic disease is a tumor-like growth of trophoblast tissue (an element of the tissue of the ovum); this definition denotes the pathology of trophoblast, which is clinically manifested in the form of cystic drift and choriocarcinoma.

Trophoblastic disease can develop from the epithelial cells of the chorionic villi remaining after a spontaneous abortion or full-term pregnancy, but, as a rule, arises from a fertilized egg as an independent pathological process of the transformation of chorionic villi into uviform formations (cystic drift). In rare cases, the placenta is affected in a normal fetus. In more than 80% of cases, trophoblastic disease is non-malignant, that is, it is a cystic drift; however, in 20% of cases, there is a malignant tumor - choriocarcinoma. A non-metastatic (invasive) form of trophoblastic disease and a metastatic form are distinguished, in which the tumor spreads outside the uterus throughout the body (liver, lungs, brain).

The likelihood of developing trophoblastic disease is highest when pregnancy occurs between 35 and 45 years. This tumor occurs in about 1 in every 2,000 pregnant women in the United States, and for unknown reasons, it is nearly 10 times more common among women in the Far East. In Russia, the frequency of gallbladder drift is 1 in 820-3000 births, and the frequency of choriocarcinoma is 1 in 5000 births.

Symptoms and Diagnosis

Vesiculate motility often appears shortly after pregnancy. The woman feels pregnant, but her belly grows much faster than it does in a normal pregnancy, because the growth of the tumor causes the size of the uterus to grow very quickly. This is accompanied by severe nausea and vomiting, uterine bleeding may occur; such symptoms indicate the need for immediate medical attention. With cystic drift, such dangerous complications as infectious inflammation, bleeding and pregnancy toxicosis (preeclampsia) develop, usually occurring in the second trimester of pregnancy.

A woman with a cystic drift does not feel fetal movements, its heartbeats are not heard. When bleeding occurs, there is a release of many bubbles with transparent contents, resembling bunches. Examination of this material under a microscope can confirm the diagnosis.

Your doctor may order an ultrasound (ultrasound) scan to make sure there is a mole, the absence of the fetus and the amniotic sac (the membranes that contain the fetus and the fluid around it). Blood tests are done to determine the content of human chorionic gonadotropin (a hormone normally produced as pregnancy progresses). With cystic drift, the concentration of gonadotropin is sharply increased, since the tumor produces a significant amount of this hormone. This analysis is less convincing in the early stages of pregnancy, when the level of gonadotropin is also high.

Treatment

The bubble drift must be completely removed. It is usually removed by dilatation (dilation) of the cervix and vacuum aspiration by scraping the uterus. Only in rare cases is the removal (extirpation) of the uterus required.

After the operation, regular monitoring of the content of human chorionic gonadotropin in the blood is performed to exclude the occurrence of choriocarcinoma. With the complete removal of the cystic drift, the hormone content returns to normal, usually within 8 weeks and remains so thereafter. If a woman becomes pregnant after removal of the cystic drift, then the explanation for the increase in the concentration of human chorionic gonadotropin becomes difficult, since it can be associated both with pregnancy and with the part of the tumor that has not been removed. Therefore, after removal of the cystic drift, women are advised to protect themselves from pregnancy for a year using oral (taken by mouth) contraceptives.

In the benign form of trophoblastic disease, chemotherapy is not required, but in its malignant form (that is, when choriocarcinoma occurs), chemotherapy is always prescribed. Medicines used for treatment include methotrexate, dactylonomycin, or a combination of these drugs.

The cure rate reaches almost 100% in women with cystic moles and non-metastatic trophoblastic disease and approximately 85% in women with late detection of the disease. As a rule, a woman can have children after removal of the cystic mole. After a course of chemotherapy, pregnancy occurs in 50% of women interested in it.

Benign tumors grow in width, but are unable to spread to other organs. But they are also oncological neoplasms, and if they are not treated in time, then complications are likely. There are these types of these neoplasms:

• fibroma;
• myoma;
• fibroids;
• cystoma;
• polyp.

Fibroids are characterized by manifestations on parts such as the ovaries, labia, or inside the cervix. Formed from fibrous connective tissue. Cancer manifests itself in women with signs of pain in the pelvis and difficulty with bowel movements.

Fibroids are characterized by heavy bleeding during menstruation and pain in the lower abdomen. With complications, the pain becomes worse, chills and fever appear. It represents the formation of nodules and seals.

Fibroids are formed in the uterus, and can reach significant sizes. During the development of the tumor, pressure arises in the pelvis, and the amount of discharge during menstruation increases.

Cystoma. Formed from a cyst. The first signs are irregularities in the menstrual cycle, discomfort and bloating. Sometimes pain, cramps and discomfort during intimacy are characteristic.

Polyps are soft, reddish-pink growths. They are arranged in bunches. With them, after intercourse, bleeding appears and the discharge increases during menstruation.

Common Symptoms

Often, cancer of the female genital organs does not have specific symptoms, and is similar to other diseases or disorders and abnormalities in work. There are a number of general signs that you should pay attention to, and if you find symptoms in yourself, you should immediately consult a doctor in order to prevent the development and exacerbation of oncology in advance:

• Bloating.

This symptom is significantly common in ovarian cancer and is most often neglected. This is one of the main symptoms, so if you cannot button your skirt or pants, pay attention to this.

• Stomach ache.

Pressure and constant aching pain in the area below the navel, not associated with menstruation, often indicate the development of cancer in the female genital organs.

• Back pain.

You can even get used to monotonous pains of a constant nature, and not pay attention to them, however, this is a symptom of oncology.

• Elevated temperature.

If you have a high fever all day for an extended period, you should see a doctor. This is a dangerous sign not only of ovarian cancer, but also disorders in the body or diseases.

• Profuse bleeding.

Unnatural bleeding from the genitals is a common sign of oncology. Excessive bleeding during menstruation, unnatural in the stages between them and during sexual intercourse, are symptoms of cancer in women.

• Upset stomach.

Diarrhea, constipation, flatulence and irregularity of feces, sometimes with the presence of blood, is a reason to see a doctor. These are signs not only of genital cancer, but similar manifestations indicate possible rectal cancer.

• Genital changes.

Changes that are unusual for the vulva or vagina (skin color, discharge, blisters, wounds) can signal the development of cancer, so a visit to the doctor is mandatory. Regular examination by a gynecologist is the basis for the prevention of cancer.

• Weight loss

Losing more than five kilograms a month without exertion and effort is unnatural. Fluctuations in weight are possible, but its rapid loss is not a positive fact.

• Fatigue

Chronic lethargy is one of the main signs of cancer in any part of the body. Exhaustion and fatigue, even from light exertion, are characteristic of the latter stages, but sometimes appear at the initial stage.

• Breast changes

Found seals, wounds, swelling or redness on the mammary glands during her examination is a bad sign, so you should immediately consult a doctor.

Before talking about cancer, you should know that it has four stages of development, and at the first stage, the symptoms are almost imperceptible.

Cancer of the uterus and its causes

The causes of cancer in women can lie in promiscuous sexual intercourse, early onset of sexual activity, viral diseases and cervical injuries. Cancer often develops due to herpes (papillomas), so it is recommended to take tests in order to detect pathology in time.

In the second and third stages of uterine cancer, specific signs are bloody discharge, the presence of blood in the urine, pain in the back and legs. It should be added that the first stage often has no symptoms, and it is possible to diagnose the pathology when examined by a gynecologist.

With cancer of the body of the uterus, polyposis growths are formed. A malignant tumor, germinating, affects the appendages and the abdominal cavity, therefore an unpleasant-smelling discharge is formed, consisting of a mixture of pus with blood.

Ovarian cancer

Ovarian cancer is slightly less common than uterine cancer, but it occurs often, and especially in older women who did not know the joys of motherhood. Sometimes this is influenced by genetic inheritance.

Nausea, vomiting, bloating, and constipation are characteristic features of this pathology. The early stages are asymptomatic, which is why they are dangerous, and the tumor itself changes the work of the intestines, causing the accumulation of fluid.

Vaginal cancer

As the first sign, purulent-bloody leucorrhoea can be distinguished. In this case, dense ulcers form on the walls of the vagina, which subsequently cause pain and lead to compression of the internal cavity. In this case, intoxication of the body occurs, and difficulties arise when urinating. It is observed more often in women during menopause and with menopause.

Cancer of the labia

This type develops during menopause, is ulcerative nodules with dense edges. Growing, the tumor penetrates deeper, affecting the lymph nodes. The initial signs are burning, itching, and pain. With an exacerbation, discharge of a purulent-bloody content occurs.

Prevention of cancer of the labia

Regular gynecological examinations help prevent the development of labia cancer, which not everyone can avoid. It is also advisable to follow the recommendations of oncologists to reduce the risk of getting sick. An increase in the immune status is well protected from cancer, for which it is recommended to lead a healthy lifestyle, which includes:

• moderate physical activity, hardening;
• absence of bad habits (alcohol consumption, tobacco smoking, drug addiction should be excluded);
• diet and proper diet with foods saturated with vitamins, microelements, plant fiber;
• full sleep and rest (it is better to avoid stressful situations and overwork, which, according to psychosomatics, provoke cancer);
• hygiene of the genitals;
• maintaining a healthy weight;
• lack of promiscuous sexual relations.

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Diagnosis of cancer of the external genital organs in women

Due to the similarity of early symptoms and clinical presentation of cancer and precancerous diseases, the onset of cancer often goes unnoticed. Cancer recognition can be helped by cytological examination of a smear-print from the surface of ulceration or a smear prepared from scrapings from a suspicious area of ​​the mucous membrane. The definitive diagnosis of cancer of the external genital organs in women is made with a biopsy. To diagnose metastases in the superficial lymph nodes, they are punctured in order to obtain a puncture for cytological examination.

Cancer of the external genital organs in women should be differentiated from the following diseases. Papilloma is a single lobular formation of a round shape, soft consistency, has a thin stem, does not infiltrate the underlying tissues.

Genital warts look like multiple soft thin papillae. They are found in young women and are located at the entrance to the vagina and on its mucous membrane around the anus.

A chronic ulcer is small in size, located in the region of the anterior and posterior adhesions, it is distinguished by sharp pain and inflammatory infiltration of the surrounding tissues.

A tuberculous ulcer is in the nature of a superficial ulceration with a granular sebaceous bottom and undermined edges.

Complications

With the development of cancer of the labia, there is a high probability of spread of metastases not only to nearby, but also to distant organs. Chemotherapy treatment is often accompanied by side effects such as swelling of the lower extremities, inflammation, rupture of stitches, which leads to the accumulation of fluid in the wound.

The role of tumor markers in the diagnosis of ovarian cancer

In addition, after chemotherapy, there may be the following consequences:

• decline immune systems;
• volume reduction vagina;
• apathetic condition;
• the discomfort during urination;
• general weakness;
• sensation anxiety;
• increased nervous condition.

After taking painkillers, patients experience nausea, dizziness, decreased blood pressure, dry mouth.

Diagnosis

Due to the localization of the pathology on the skin, there are no problems with diagnosis. This type of cancer is easier to diagnose than any other. First you need to contact your gynecologist.

The specialist will collect anamnesis, identify complaints, and then conduct an examination using mirrors.

During the examination, the patient will find a node or ulcer on the labia, fix the diameter of the growth or tissue damage. A magnifying glass or colposcope is used to accurately examine ulceration. With the help of palpation, the density and consistency of the neoplasm, the prevalence of the oncological process, the adhesion of the tumor with the rest of the tissues and mobility are determined.

The patient undergoes a biopsy: the skin area is sent for histological examination. This helps to perform differential diagnosis with other pathological conditions.

The following manipulations are shown for diagnosis:

• vulvoscopy;
• fluorescence microscopy of the vulva;
• radiological examinations using phosphorus radioisotopes;
• cytology of smears from the tumor surface;
• lymphography is an important study for assessing the condition of the lymph nodes;
• sigmoidoscopy - for visual assessment of the rectum;
• cystoscopy - if there is a suspicion of tumor-like formations in the bladder, urethra.

Women with suspected cancer of this type are also given a chest X-ray, since metastases affect the lung tissue. The condition of the small pelvis is also examined, because these organs are most closely located to the lesion focus.

Endometriosis:

Endometriosis- this is the proliferation of tissue, similar to the mucous membrane of the uterus, in its muscle layer in the cervix, vagina, fallopian tubes, ovaries, etc. The tissue retains hormonal dependence, undergoes transformations according to the menstrual cycle. The disease often occurs in women of working age, has a long duration, with a tendency to relapse. The disease is characterized by severe pain in the premenstrual period and during menstruation, profuse prolonged menstruation, intermenstrual bleeding, and frequent impairment of fertility.
In some cases, pain during intercourse is possible. Treatment of the disease is long-term, medical and surgical. Endometriosis can be promoted by uterine myoma, fibrocystic mastopathy, cholecystitis, gastritis.
Delay the growth of the tumor and can contribute to its disappearance normal pregnancy and childbirth, breastfeeding of the child.

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Stage IV vulvar cancer

Therapy

After the diagnosis is made, the woman is referred to an oncologist. He will develop competent therapy tactics. Most often, treatment begins with a surgical intervention.

The operation is performed without general anesthesia. Local anesthesia is well tolerated by the body, even in old age.

After surgery, a course of radiation therapy is indicated. The method is prescribed in order to prevent relapse.

If, according to the indications, they cannot carry out the operation, they are treated only with radiation therapy, but a large dosage of funds is prescribed. This technique is not as effective as the operational one.

Cancer at the initial stage can be removed using vulvectomy: the patient is excised large, labia minora, clitoris.

The amount of surgical intervention depends on the stage of the pathology:

1. The first is radical vulvectomy, the elimination of regional lymph nodes.
2. Second, the operation is combined with radiation therapy and fast electrons are used.
3. The third - in addition to the previous methods, the elimination of the inguinal lymph nodes, blood vessels.
4. Fourth, therapy is symptomatic, since other methods will not bring the desired result. The patient is prescribed pain medications, anti-inflammatory nonsteroids, narcotic analgesics. Blood transfusions, itching ointments, and antihistamines are sometimes recommended.

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Forecast

When diagnosing the disease at stages 1-2, the outcome is favorable. Life expectancy without recurrence within three years is observed in 50-70 percent of patients.

With metastasis, the prognosis will not be so reassuring, since the likelihood of death is significantly increased. Treatment success can be achieved only in 7-10 percent.

Clinical signs and symptoms

Symptoms of vulvar cancer at the onset of the disease are scarce (burning, itching, leucorrhoea, dysuric phenomena are possible).
Later, there are pains, bloody, purulent discharge, difficulty urinating. A vulvar tumor is most often localized on the labia majora, less often on the small ones, in the clitoris and on the posterior commissure of the lips, macroscopically it can be exophytic (nodular or papillary) or endophytic (ulcerative or infiltrative).

Complications and side effects of treatment

The use of platinum preparations causes nausea, vomiting, nephritis, leukopenia, thrombocytopenia, hearing loss, polyneuritis, dermatitis.
The use of fluorouracil can cause side effects in the form of stomatitis, diarrhea, leukopenia, thrombocytopenia, anemia.

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Classification

Specialists identify several of the most common sites of cancer localization.

Uterus

In most cases, the pathological process is called endometrial carcinoma. This is due to the fact that the initial formation of the tumor occurs in the mucous membrane of the uterine body. This condition is considered one of the most frequently diagnosed among all malignant processes of the female reproductive system.

The appearance of pathology occurs in the postmenopausal period and occurs in the female half of the population aged 50-60 years. Tumor cells are prone to metastasis not only to nearby, but also to distant organs and systems.

The fallopian tubes, lymph nodes and blood vessels can be affected. After entering the blood system, metastases spread throughout the body.

Uterine cervix

This is the lower part of the uterus that passes into the vagina. In medicine, the disease is also called carvical carcinoma.

The disease ranks second among the total number of malignant neoplasms affecting the female genital organs. A tumor can form in any woman, regardless of age group. Most often, however, it is diagnosed between the ages of 35-55.

In most cases, the onset of the disease is preceded by infection with the human papillomavirus, the transmission route of which is unprotected sex.

About 85 percent of cases are squamous cell carcinoma of the cervix, when the tumor forms from squamous epithelial cells, which are similar in structure to skin cells.

The first symptoms of cervical cancer

Other types of oncological processes are formed from the columnar glandular epithelium (adenocarcinoma). Also, both types of cells can participate in the development of a tumor.

Pathological cells can also metastasize both to nearby and distant systems and organs.

Ovaries

The development of ovarian carcinoma occurs at the age of 50-70 years. According to statistics, it occurs in one woman in seventy. This type of genital cancer is the third most common cancer.

It is also worth noting that ovarian cancer is considered the most dangerous disease. It accounts for more deaths than for any other malignant tumor of the reproductive system.

Since the structure of the ovaries is made up of different tissues, a neoplasm can form from one of them or several at the same time.

Cancer cells can spread to nearby tissues as well as to other organs through the lymphatic system. In addition, the entry of pathogenic cells into the circulatory system is noted.

As a result, metastasis will be diagnosed in distant organs. As a rule, the lungs and liver are affected.

Vagina

In this area, the formation of about one percent of all malignant processes is noted. Most often, the disease is diagnosed in women when they reach the age of 45-65. In about 95% of cases, cancer is squamous, morphologically similar to cancer of the vulva or cervix.

The cause of the development of the squamous type of neoplasm is the papillomavirus.

Also, experts isolate diethylstilbesterol-dependent vaginal carcinoma, which is a relatively rare disease. It is detected in women whose mothers used diethylstilbesterol during the period of gestation.

Vulva

It is a system of external female genital organs. Vulvar carcinoma accounts for about four percent of all female genital cancers. In most cases, it develops after the onset of menopause.

Usually the disease is characterized by tissue damage near the entrance to the vagina. Cancer is formed from the same cells as a malignant skin tumor.

90 percent is squamous cell carcinoma, about 4% is basal cell carcinoma. The remaining six percent are melanoma, Bartholin gland tumor, Paget's disease and others.

The development of the oncological process begins on the surface. Further, it spreads to nearby tissues without affecting other organs. Despite the aggressiveness of some types of ovarian malignant neoplasms, their peculiarity lies in a rather slow course.

If untreated for a long time, cells begin to spread to the vagina, anus, or urethra. They can also penetrate the lymph nodes of the reproductive system.

Pre-invasive vulvar carcinoma

Until recently, it was believed that the use of chemotherapy drugs in patients with vulvar cancer is impractical because of the low sensitivity of squamous cell carcinoma cells to their effects. However, clinical practice indicates the possibility of using chemotherapy drugs for the treatment of this pathology.
So, with pre-invasive carcinoma of the vulva, the use of fluorouracil ointment can lead to a cure: Fluorouracil, 5% ointment, apply 5 g to the affected area at night, 5 days, repeated courses every 6-12 weeks.

Differential diagnosis

It is necessary to carry out differential diagnosis of vulvar cancer with papillomas (exophytic form), ulcers with chancre, tuberculosis and syphilis (endophytic form).

Diagnosis of vulvar cancer is based on data from: ■ gynecological examination; ■ vulvoscopy using a colposcope; ■ cytological examination of fingerprints or scrapings from the surface of a suspicious area; ■ histological examination of a biopsy specimen.
To determine the state of the inguinal and femoral LU, palpation, ultrasound and puncture biopsy are used. In terms of structure, they are found: ■ predominantly squamous cell forms of cancer (keratinizing and non-keratinizing); ■ less often - glandular; ■ extremely rarely - basal cell.

Etiology and pathogenesis

The etiology and pathogenesis of vulvar cancer are not well understood.
The mechanism of development of various links of vulvar cancer is more often induced by hormonal changes occurring in menopause and postmenopause. This, to a certain extent, determines the fact that vulvar cancer occurs in women of relatively advanced age.
Background and precancerous diseases of the vulva are distinguished.
Background processes are characterized by a large number of clinical and pathomorphological manifestations, which are caused by degenerative changes in the vulva. Their occurrence is associated with metabolic and neuroendocrine disorders in the aging process and, to a large extent, with viral infection. According to clinical manifestations, kraurosis (lichen sclerosus), leukoplakia (squamous cell hyperplasia) and vulvar condylomas are distinguished.

Possible complications

This cancer can lead to metastases. Treatment that includes chemotherapy and radiation may cause side effects: leg swelling, inflammation, and suture dehiscence. Liquid may collect in the seam area.

There is a risk of consequences after surgery if the nerve is damaged. The woman has a tingling sensation, numbness. The seam does not heal well - it must be lubricated with the means prescribed by the doctor.

Complications of chemotherapy:

Taking pain medications can lead to the following effects:

• clouding of consciousness;
• feeling of nausea;
• dizziness;
• decrease in pressure;
• feeling of dry mouth;
• a constant desire to quench your thirst.

Cervical cancer

The tumor itself grows from the epithelial cells of the soft tissues of the inner walls of the cervix and the body of the uterus. The tumor has a moderately aggressive status and grows rather slowly compared to other tumors. Cervical cancer and uterine oncology is one of the most common diseases in women, and it ranks second after breast tumors.

Causes

The main reason is that a change occurs at the chromosomal level, and cells begin to randomly divide, multiply and lose the ability to self-destruct or die.

1. Papillomavirus.
2. Herpis.
3. Viral diseases that damage the soft tissues of the uterus.
4. It often appears in older women.
5. The risk group includes nulliparous women.
6. Rare sexual relations.
7. Diabetes.
8. Alcohol and cigarettes.
9. Excess weight.
10. Genetics.
11. Hormonal changes in the female body, drugs that affect them.

Stages

• 1st stage- the tumor is small in size and spreads only within one tissue.
• Stage 2- the cancer process affects the nearest tissues. Back pain and fever may already appear.
• Stage 3- is large, swelling begins. Cancer affects and damages nearby lymph nodes.
• Stage 4- Metastases go to the nearest organs: intestines, bladder, kidneys and liver. Headaches, pain in the bones of the muscles appear against the background of general intoxication of the body.

The most important thing to remember is that cancer in the early stages of development has a high survival rate, since metastases do not affect organs. At the 3rd stage, the lymph nodes are already being damaged, which is why usually surgeons at this stage remove the uterus along with the nearest lymphatic system.

NOTE! First of all, the patient needs to pay attention to pain, temperature and bleeding from the vagina and immediately consult a gynecologist for an examination.

Surgical, combined and radiation methods of treatment are generally accepted. Chemotherapy is not often used.
For systemic chemotherapy of vulvar cancer, all recommendations for mono- and polychemotherapy of cervical cancer can be used.
In the treatment of patients with cancer of the vulva, the leading method of treatment is surgery.
The combined method is used in 2 versions: ■ surgery followed by radiation therapy; ■ preoperative irradiation followed by surgery.
For patients in whom vulvectomy is not possible due to concomitant diseases or the spread of the tumor process, radiation therapy may be the only treatment that increases survival.

Recurrent vulvar cancer

In case of recurrence of vulvar cancer, a combined effect is also sometimes used, including chemotherapy (scheme 3), radiation, surgery, although the effectiveness of treatment is insignificant.

Precancerous diseases of the vulva

represented by epithelial dysplasias. Depending on the degree of damage to the epithelial layer, mild, moderate and severe epithelial dysplasia are distinguished. The diagnosis is made on the basis of a histological examination of biopsies.
Currently, the accepted classification of precancerous changes in the vulva in the form of intraepithelial neoplasia of the vulva (VIN). VIN I corresponds to mild dysplasia, VIN II - moderate dysplasia, VIN III - severe dysplasia and preinvasive carcinoma.
If we take into account the average age of patients with non-neoplastic dystrophic diseases (56 years), it is clear that in order to identify early forms of vulvar neoplasms, special attention should be paid to the age group of 60 years and older.
Anatomical and topographic features of the external genital organs, abundant blood supply and an extremely developed lymphatic network contribute to the rapid spread of vulvar cancer and metastasis.
The predominant path of metastasis in vulvar cancer is lymphogenous, hematogenous spread is very rare. Regional LN of the first order are superficial and deep inguinal-femoral LN, of the second order - deep pelvic LN. A retrograde pathway of metastasis is possible.

Stage III vulvar cancer

The following drug combinations are used as neoadjuvant chemotherapy for stage III vulvar cancer. Scheme 1: Bleomycin intramuscularly 10 mg / m2 2 r / week, 2-3 weeks + Methotrexate orally 10 mg / m2 2 r / week, 2-3 weeks. The courses are repeated after 3 weeks, 4 courses are carried out.
Scheme 2: Mitomycin IV drip 10 mg / m2 on the 1st day + Fluorouracil IV in the form of a 24-hour infusion, 30 minutes after the injection of mitomycin, 1 g / m2, 3 days.
Systemic chemotherapy with platinum derivatives or fluorouracil improves the results of treatment of patients with stage III vulvar cancer in combination with surgery and radiation.
Scheme 3: Cisplatin IV drip 100 mg / m2 on the 1st day + Fluorouracil IV in the form of a 24-hour infusion of 1 g / m2, 5 days.
The course is repeated after 3 weeks. The number of courses depends on the effectiveness of the therapy.
This combination chemotherapy induces complete tumor regression in 53–89% of primary inoperable patients.

Oncological pathologies of the female reproductive system are quite common. One of the most common diseases of this kind is uterine cancer.

This disease is called differently - endometrial cancer, cancer of the uterine body, cancer of the mucous membrane of the uterine membrane, etc. All these oncological processes are cancer of the uterus.

Disease concept and statistics

Cancer of the uterus is a malignant tumor process that develops from the inner epithelial layer - the endometrium.

On average, a similar disease is found in 2-3% of the female population. Endometrial cancer can occur in every woman, however, women after 45 are most susceptible to such oncology.

Classification

Oncologists classify uterine cancer into two types: autonomous and hormonal.

Autonomous cancer accounts for 1/3 of all cases of uterine oncology. This form of the disease occurs suddenly without any prerequisites and reasons.

Experts believe that such oncology has a hereditary etiology or arises under the influence of traumatic injuries.

The picture shows a uterine cancer cell under a microscope

The hormonal type of uterine cancer develops as a result of hormonal changes in the female body. Such oncology accounts for 2/3 of all cases of endometrial cancer. It is characterized by pronounced disorders of endocrine-metabolic origin.

According to histological data, cancer of the uterine body can be:

• Leiomyosarkinoma;
• Glandular squamous cell oncology, etc.

Depending on the degree of differentiation of cell structures, cancer can be highly differentiated, poorly differentiated, or moderately differentiated.

Causes of occurrence

As mentioned above, endometrial cancer can be hormone-dependent or autonomous. Based on this, several characteristic reasons can be distinguished from which cancer of the uterine body occurs:

• Increased stimulation of the epithelial uterine layer by estrogen hormones;
• Metabolic disorders such as obesity, diabetes, hypertension;
• Hormone-producing ovarian tumors;
• Adenoma of the adrenal cortex;
• Treatment with hormone-containing drugs;
• The presence of severe hepatic pathologies, accompanied by violations of metabolic sex hormonal processes (, hepatitis, etc.);
• Negative heredity, such as the presence of oncoformations in blood relatives in the intestines, mammary gland, ovaries or in the body of the uterus;
• Late onset of the menopausal period;
• Lack of pregnancies with natural childbirth;
• Long-term use of oral contraceptives like Dimethysterone
• Irradiation of low-basal organs, etc.

Symptoms of uterine cancer in women

Signs of oncoformations of the uterine body are very diverse, however, in the early stages of the development of the cancer process, as a rule, there are no symptoms.

First signs

Among the first alarming symptoms of uterine cancer, uterine bleeding, which is not associated with menstruation, is especially prominent.

A similar symptom, according to oncologists, is observed in almost 7-9 out of a dozen patients.

Such bleeding can be of a different nature:

• Abundant;
• Lean;
• Multiple;
• Breakthrough;
• One-time;
• Intermittent, etc.

Bleeding of a contact nature, arising from sexual intercourse, gynecological examination, lifting heavy objects, douching, etc., is very characteristic of uterine cancer.

In addition to discharge, when cancer of the uterine body reaches the later stages of development, it can be recognized by the following symptoms:

1. Hyperthermia with subfebrile indicators;
2. Drawing pain in the lumbar region, perineum, abdomen;
3. A noticeable reduction in working capacity, excessive and rapid fatigability, up to exhaustion;
4. Sexual intercourse is accompanied by pain, which can also appear after them;
5. Refusal to eat;
6. Problems with bowel movements such as constipation or diarrhea;
7. Strong weight loss.

How to identify uterine cancer by symptoms before menopause?

In women who are in premenopausal age, the presence of uterine spotting is considered quite normal, which gradually becomes scarce and bothers less and less.

If an oncological process begins to develop in the uterine body, then a typical decrease in symptoms does not occur, and it often happens that uterine discharge, on the contrary, becomes more abundant and frequent.

What manifestations can be observed in postmenopausal women?

In menopause, women, as a rule, do not have menstruation. Therefore, in the event of sudden vaginal discharge, you should always suspect the presence of a uterine cancer process.

Moreover, the frequency of such bleeding, their duration, intensity and abundance at a similar age no longer matter.

Stages and their lifespan

Oncologists distinguish several sequential degrees of uterine cancer:

• In the first stage oncoformation is located directly in the uterine body. The probability of recovery is about 80-90%;
• In the second stage the oncological process, the tumor formation penetrates beyond the boundaries of the body of the uterus, affects the cervical canal (cervix), however, nearby organs are not affected. Recovery occurs in about ¾ cases;
• On the third stage of cancer, the oncological process spreads to the appendages and the vagina. The survival rate is about 40% of patients;
• On the fourth At the stage of cancer of the uterine body, tumor processes spread beyond the pelvic region, the formation grows into the intestinal and urinary tissues. The survival rate is no more than 15%.

Consequences

Cancer of the uterine body is a very dangerous pathological condition. If there is no adequate therapy, then uterine cancer will certainly lead to the death of the patient.

Often, oncology of the uterus requires its removal along with the appendages, part of the vagina and the cervix. However, this factor usually does not play a significant role, because cancer is found mainly in women of 45-60 years of age with adult children.

Metastatic pathways

With cancer in the body of the uterus, the main routes of metastasis are the vessels and nodes, and at the terminal stage, the circulatory system also participates in the spread.

First, the lesion spreads to the lymph node structures in the iliac region and hypogastric region. Much less often, the lesion captures other groups of small-basal lymph nodes.

Metastasis extends to the cervical canal and beyond the uterine body. In a hematogenous way, metastases penetrate from the upper uterine region into the appendages, in addition, the vagina is also affected, and sometimes even the renal or hepatic or bone tissues.

Diagnostics

The diagnostic process for uterine cancer begins with a gynecological examination using mirrors. Then the patient is sent for an ultrasound examination, which allows to reveal the true size and structure of the uterus, as well as the structure and thickness of the endometrium.

The photo shows what uterine cancer looks like on ultrasound diagnostics

Scraping of the resulting biomaterial is often carried out. A similar procedure is carried out using general anesthesia in a hospital setting.

When analyzing for the detection of tumor markers of uterine cancer, markers are used:

• Cancer-embryonic antigen;
• HCG or human chorionic gonadotropin.

Thanks to the introduction into gynecological oncology practice, it was possible to save the lives of many patients.

How quickly does the disease develop?

The rate of development of the oncological process in the uterine body is determined by the histological type of formation, concomitant pathologies, the strength and intensity of the body's anticancer resistance, the adequacy of therapy, the patient's age and other similar factors.

Therefore, it is impossible to say for sure how long it will take for the final development of the cancerous process in the uterine body.

The difference between pathology and fibroids

They call the process of hyperplastic enlargement of uterine tissues arising from traumatic factors, frequent abortions, scrapings, a large number of sexual partners, urogenital inflammation, the absence of orgasms in a woman, etc.

Cancer of the uterine body and myoma do not relate to each other at all. These are completely different pathologies, so myoma never degenerates into cancer.

Benign uterine hyperplasia is formed in the muscular layer of the organ, and oncology - in the epithelial layer. When a fibroid is found, observation is usually done to determine if the fibroid is growing or not.

For this, the patient undergoes a gynecological examination every six months. As for direct scientific evidence of the relationship between cancer and fibroids, it is lacking.

Treatment and prevention

In general, it depends on the individual prognostic results:

1. The basis of treatment is an operation involving the removal of the uterine body together with the ovaries.
2. Sometimes, before and after surgery, radio irradiation is performed to reduce the risk of oncology relapses, but such treatment has absolutely no effect on survival rates;
3. In addition to surgical intervention, a chemotherapy technique is used. Such an approach to treatment is justified when the tumor process is widespread, as well as with the autonomous nature of the formation, the presence of active metastasis and relapses. Platinum preparations such as Cisplatin, Carboplatin, Adriamycin, as well as Doxorubicin, Taxol, Epirubicin, etc. are used. In hormone-dependent oncology of the uterine body, chemotherapeutic treatment is ineffective;
4. Hormone therapy gives good therapeutic results. For such treatment, progestogen drugs are usually used: Megeis, Depostat, Provera, 17-OPK, Farlugal, Depo-Provera, etc. These drugs can be combined with Tamoxifen or prescribed without it. If there is active metastasis, and treatment with progestogens is ineffective, then Zoladek is prescribed. Sometimes I combine hormonal treatment with chemotherapy.

When determining the appropriate therapeutic method, the oncologist takes into account several decisive factors such as the physiological state of the patient, the presence of endocrine disorders, histological parameters, the size and extent of the tumor, etc.

Preventive measures are the most effective anti-cancer measure. Primary preventive action involves avoiding oncology-like factors such as obesity, diabetes and infertility.

In other words, you need to strictly control your weight, treat reproductive functions and diabetes.

There are also secondary preventive measures that involve the timely detection and treatment of inflammatory pathologies, precancerous conditions.

Women over 40 are advised to undergo an annual screening examination by means of transvaginal echography. Such a procedure allows you to detect cancer of the uterine body in its infancy, which significantly increases the chances of recovery and long life.

If a precancerous disease was found in the patient, then it must be treated.

Patient survival prognosis

Every year the number of women with cancer of the uterine body is increasing, every year this pathology is found in half a million patients. But timely diagnosis and an adequate approach to the treatment process make it possible to achieve a high and favorable prognosis of survival.

In general, the prognosis for the survival of cancer patients is determined by the stage of initiation of therapy, the degree of cell differentiation, etc.

For example, with highly differentiated education with the first stage of development, the survival rate will be 96%, and with a low degree of cellular differentiation and 4 degrees of development, the percentage of survival does not exceed 18%.

How to recognize and treat uterine cancer, the following video will tell: