Cervical cancer treatment

Cervical cancer is a malignant disease that manifests itself as the development of a tumor from the cells of the mucous membrane of the cervical canal. It ranks 4th in prevalence among all oncological pathologies in women. In 2020, the disease was diagnosed in 371 thousand patients. Most of them are women aged 35 to 55, but the risk of the disease exists at any age.

The main cause of cervical cancer is considered to be infection with a highly oncogenic type of human papillomavirus (HPV). In this case, the development of the tumor is usually preceded by precancerous conditions, in particular dysplasia.

To diagnose these diseases, women are recommended to undergo an annual examination by a gynecologist and take a PAP test. Regularity of examination is important, since these pathologies develop asymptomatically in the early stages.

When treating cervical cancer at an early stage, more than 90% of women manage to achieve a complete recovery.

Oncologists use the international TNM system to determine the stage of cancer:

• T (tumor size) - tumor size;
• N (nodes) - lymph node involvement;
• M (metastasis) - presence of metastases.

Accordingly, the diagnosis can be defined as T1N1M0, T2N0M0, etc., which remains incomprehensible to most patients. Therefore, a more simplified classification has been used in parallel.

Thus, when talking about cervical cancer, they distinguish:

• Stage I - the tumor is limited to the cervix;
• Stage II - the tumor spreads to the upper part of the vagina and sometimes the body of the uterus;
• Stage III - the tumor grows into the lower part of the vagina, the body of the uterus and the pelvic bones;
• Stage IV - the tumor spreads to the bladder, rectum and/or gives distant metastases.

Diagnosis of the disease begins with a gynecological examination.

During the first visit, the doctor conducts:

• examination with mirrors - visually assesses the condition of the walls of the vagina and cervix;
• extended colposcopy - using a device that provides multiple magnification (with video colposcopy, the image is displayed on a computer screen), the specialist carefully examines the mucous membrane of the cervix, after which he applies an iodine solution to it, and dysplasia is diagnosed based on the reaction of the tissues; cervical cancer colposcopy allows you to suspect at the stage of the appearance of the first foci of atypical cells, but other studies are also necessary to clarify the diagnosis.
• scraping of cervical cells for cytological analysis (PAP test);
• smear of discharge for analysis of infection.

If cervical cancer is suspected, the gynecologist also performs a biopsy (takes a tissue sample) and sends the obtained material for histological analysis. It is he who allows to confirm or refute the diagnosis. If the patient has no complaints, this study is prescribed only upon receipt of the appropriate result of the PAP test.

With histological confirmation of cervical cancer to determine its type, stage and the presence of metastases, the woman may be prescribed:

• immunohistochemical analysis;
• blood test for squamous cell carcinoma antigen (SCC Ag);
• general blood and urine tests;
• pelvic ultrasound;
• CT scan of various areas and other studies according to indications.

Which studies need to be performed, the doctor decides individually.

The treatment tactics for cervical cancer depend primarily on the stage of the disease. The size and localization of the tumor, the involvement of nearby lymph nodes, and the presence of distant metastases are of great importance.

In the early stages, it is possible to perform an organ-preserving operation - removing only the changed tissues. This allows the woman to preserve her reproductive function and bear a child in the future.

If the tumor is large and has grown into the lymph nodes, a more complex operation may be required, in some cases with removal of the uterus.

In addition to surgical treatment, the patient may be prescribed:

• chemotherapy before or after surgery;
• radiation therapy;
• targeted therapy;
• immunotherapy.

The treatment program is drawn up individually based on state and international treatment protocols.

Oxford Medical employs experienced oncologists and surgeons who have modern surgical and conservative methods of treating cervical cancer.

The main cause of cervical cancer is HPV infection.

However, the likelihood of the disease is also increased by:

• early onset of sexual activity;
• frequent change of sexual partners;
• sexually transmitted infections;
• smoking;
• obesity;
• first pregnancy before the age of 17;
• more than 3 full-term pregnancies during a lifetime;
• taking hormonal contraceptives for more than 5 years;
• negative effects of radiation on the body, contact with carcinogens;
• weakened immunity;
• genetic predisposition.

To prevent cervical cancer, women are recommended to be vaccinated against the most common types of HPV, as well as use contact methods of contraception, not smoke and undergo an examination by a gynecologist 1-2 times a year.