Invasive cervical carcinoma
Carcinoma is one of the most common cancers of the cervix (70% of all cases). Squamous cell carcinomas cover the part of the cervix furthest from the vagina. Adenocarcinoma accounts for the remaining number of diseases (25% of cases). This type of cancer begins in the cells of the mucus-producing gland that lines the cervical canal. In less than 5% of cases, adenoscuminous carcinoma develops – when the tumor contains cells of carcinoma and adenocarcinoma at the same time.
Basically, cervical cancer begins in the area closest to the uterus, the transformation zone. HPV is the main risk factor for carcinoma. Cervical cancer usually develops slowly over many years. Before the cancer cells, dysplasia appears, and then the in situ condition (precancerous condition). At this early stage, abnormal cells are often removed using an outpatient procedure without the need for additional treatment. The prognosis of cervical carcinoma in situ is very good and accounts for almost 100% of surviving patients within five years.
Invasive cervical carcinoma is a later stage of cancer when malignant cells have already penetrated deep into the tissues of the organ. The last stages are characterized by the spread of metastases to other parts of the body.
Symptoms of invasive cervical carcinoma
There are no symptoms in the earliest stages. Invasive squamous cell carcinoma of the cervix may be accompanied by the following symptoms:
- pain or bleeding during or after sex, douching, or pelvic exam;
- pelvic pain;
- unusual vaginal discharge;
- bleeding outside the normal menstrual cycle.
Diagnosis of cervical carcinoma
Many women go for an examination after an abnormal Pap smear result, which indicates cancerous changes in the cervix. The main test in this case is a colposcopy (examination of the cervix using a magnifying device with a light source) and a biopsy using conization. In addition to confirming the diagnosis, conization can serve as an initial treatment, while simultaneously removing all precancerous or cancerous cells. In the case of cancer at a later stage, as in invasive squamous cell carcinoma of the cervix, imaging tests of the entire body are prescribed: chest X-ray, CT and MRI of the abdominal cavity and pelvis, PET-CT. This helps to identify metastases in other organs.
Treatment of cervical carcinoma
The prognosis for cervical carcinoma directly depends on the stage at which the disease was diagnosed. Early disease is often treated with surgery. Minimally invasive surgery is available in modern clinics: transvaginal, laparoscopy or robotic surgery. At the same time, the five-year survival rate of patients is about 90%.
Treatment of advanced cervical cancer includes a sentinel node procedure. This method of removing and testing the lymph node closest to the tumor allows you to understand whether the cancer has spread to other organs, and prescribe the right course of treatment. Systemic therapy in the last stages of oncology includes chemotherapy, radiotherapy, and targeted therapy.
