Cervical Cancer
This article deals only with forms of invasive cancer of the cervix uteri. To form the so-called in situ see Article cervical dysplasia
The cervical cancer is cancer that develops from the epithelium of the cervix. Cancer of the cervix is the second most common cancer among women worldwide after breast cancer. This cancer is directly related to sexual activity.
The detection of precancerous lesions is possible through the practice of Pap screening. The discovery of precancerous lesions including severe dysplasia or carcinoma in situ allows treatment to ensure healing of the patient with a very low recidivism rates.
Epidemiology
Cervical cancer is the 1st cause of cancer death in women in many third world countries and represents 20 to 30% of cancers of women in these countries against 4 to 6% of female cancers in North America and Europe . It is the second leading cause of female cancer in the world with nearly 500 000 new cases annually. He is responsible for nearly 270 000 deaths annually, more than three quarters in the third world countries. He has the distinction of touching the woman is relatively young, which makes the cancer responsible for the loss of more years of life in the Third World.
In France, the standardized incidence of cervical cancer is 9.5 / 100 000 in 1990 with a mortality of 3.5 / 100 000.
Mass screening by Pap smear allows diagnosis and treatment of tumor lesions backward. It contributes to a decrease in mortality of about 50%.
Prevention
The prevention of invasive cancer based on detection of precancerous lesions.
Clinical studies have demonstrated the effectiveness of the vaccine against HPV, in terms of prevention of cervical cancer. The commercialization of the first HPV vaccine in 2006 is a milestone in the fight against squamous cell carcinoma of the cervix.
The carrageenan extracted from red algae is a hundred times more effective in vitro against the human papillomavirus that the best inhibitor of this virus is currently on the market. Its effectiveness in women remains to be demonstrated.
Histological types
There are two main types of cervical cancer:
* In two thirds of cases it is a squamous cell carcinoma which develops from the epithelial lining of the cervix.
* In less than one quarter of cases, it is an adenocarcinoma that develops from the glandular lining of the cervix.
Signs functional
The main sign is bleeding from the genital tract, caused most often during intercourse, and that, outside the menstrual period. But any abnormal bleeding, whatever its characteristics may be cancer.
Vaginal discharge is also an event especially if superimposed infection.
The main sign is bleeding from the genital tract, caused most often during intercourse, and that, outside the menstrual period. But any abnormal bleeding, whatever its characteristics may be cancer.
Vaginal discharge is also an event especially if superimposed infection.
The pain is very late.
Clinical examination
In advanced stages, examination speculum, we see a lesion or the budding or ulcerative cervical or sometimes even ulcerative granulating. The vaginal examination will evaluate the extension of cancer beyond the cervix: vagina, lateral wall of the cervix, cul-de-sac, lateral vagina through which one feels the parameters that can be invaded, bladder and rectum (the DRE).
In case of non-visible lesions, colposcopy allows you to find the lesion and direct biopsy.
The biopsy of the lesion is the key examination confirmed the diagnosis and invasiveness of cancer, its histological type and grade of differentiation.
Extension
Before treatment, it is necessary to determine the volume of cancer. Indeed, the prognosis is directly related to the volume. In terms of volume, some treatments are useless because they do not allow a more prolonged survival.
The magnetic resonance imaging during the study of the urinary tract, can well see the lymph nodes, but if they are small, it does not adequately discriminate the normal lymph nodes. Positron emission tomography, coupled with computed tomography (CT) appears to be a promising technique in these cases.
Treatment
Treatment of cancer is, in most cases, specialized institutions and experts. There is no one single treatment, but multiple treatment options. Finally, the rapid evolution of medical knowledge requires the use of doctors with appropriate medical training.
Surgery
Two actions are possible:
* Surgical treatment is based radical hysterectomy, that is to say the removal of the entire uterus, fallopian tubes and ovaries. A radical trachelectomy can also be considered. In ways very localized and young women, may discuss ovarian conservation.
* Removal of lymph nodes or pelvic lymphadenectomy.
Radiotherapy
Several types of radiation therapy are available:
* Radiation from the vagina or endocavitary brachytherapy. This treatment is a standard with the use of brachytherapy low dose rate.
* External radiation therapy uses photons of energy equal to or greater than 10 MV after conducting a simulation.
Chemotherapy
Depending on the stage of cancer, chemotherapy may be used in combination with radiotherapy. It is also the only treatment on the occurrence of metastases.
Laser
In case of injury even high-grade but if they do not affect the endocervix and are fully visible to colposcopy, laser treatment can be proposed, which will destroy the lesion.
Read also Stomach Cancer
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